Comfort with discussions about death,religiosity, and attitudes about end‐of‐life care

In end‐of‐life (EOL) care research, death anxiety and religiosity are often overlooked. Terror management theory (TMT) may provide a useful conceptual model with which to examine how comfort discussing death and religiosity influence attitudes related to EOL care. A telephone‐based survey was conducted among community‐dwelling adults in the Unites States. Via random sampling, with over‐sampling of Hispanics/African Americans, 123 completed survey interviews (response rate = 46%) were analyzed. Respondents were more likely to have better attitudes toward EOL care if they were older or white, religiously active, and comfortable with the subject of death. Religiosity and comfort discussing death were correlated with each other and remained significant predictors of attitudes about EOL care even without demographic covariates. Findings suggest that promoting an open dialogue about mortality may improve attitudes about EOL care and utilization of palliative care services. The study also provides evidence about the utility and applicability of TMT for EOL care.     

Population aging and long-term care policies in the Gulf region: a case study of Oman

Population aging is a phenomenon occurring across the globe including in countries traditionally exhibiting population dividends and “youth bulges.” The Gulf Corporation Council countries are no exception as they currently experience a process of population aging, albeit at a different stage from many developed countries. However, due to historically high fertility rates and fast-paced epidemiological transition, some of these countries will experience population aging at a higher pace than what has been observed in Europe and the United States. This article reviews recent developments in long-term care policies in the Gulf region with a focus on Oman as an example of a high-income Arab country that is experiencing population aging while still being governed by traditional family aged-care norms. Utilizing existing data and published research complemented by policy analysis and field visits, we analyze the process of population aging in Oman and neighboring countries and its policy implications.     

Design of ISD-1: an instrument for social diagnosis in care homes for older persons*

This article describes the design process and main features of an instrument developed for use in the specialist area of intervention in care homes for older persons. The essential aim of ISD-1 (instrument for social diagnosis) is to permit the correct formulation of social diagnoses and to standardise and define the professional language used by social workers. Its content has been organised into 4 dimensions of social diagnosis, divided into 15 sub-dimensions containing 83 diagnostic categories. This work was performed in Spain, in the 24 care homes of the Madrid Social Care Agency of the Community of Madrid, involving the participation of the 40 social workers practising in these centres. ISD-1 is an easily understood and used tool, of potential use for social workers practising in care homes for older persons and capable of being adapted for use in other institutional environments, as well as being capable of adaptation and translation for its application in other countries.     

Parents’ perspectives of social support and social cohesion in urban contexts of diversity

Although provisions for young children are increasingly considered as ideal places to foster an inclusive and socially just society by embracing issues of social support and social cohesion, there is no in-depth understanding of the role these provisions can play in enabling supportive and cohesive encounters in contexts of diversity. Even more striking is the absence of parents’ voices in this discussion. Based on an analysis of qualitative interviews with 18 parents who use childcare services in urban contexts of diversity, our findings show the relevance of ephemeral contacts with diverse people that could offer bridging opportunities in terms of social connectedness to familiarise within diversity while decoding the other in urban contexts of diversity. However, neither bonding nor bridging contacts appear as self-evident. Our research shows that the role of childcare services might be vital in creating light and temporal communities as the prerequisite for social cohesion to flourish, in both individual as well as collective dimensions.     

Everything for the Children: Orphans Growing Up in Informal Adoptive Families in China

Most orphaned children in China are cared for by their extended families or become state wards under the guardianship of child welfare institutions. Some exceptions are children who are found and cared for by families in the community, without a formalized adoption or foster relationship. In some locations, institutions now accept guardianship for these children and support the informal adoptive family to continue to care for them. This article examines the outcomes for these children as they became young adults by comparing these 12 children raised within the system as they approach or have approached young adulthood (now aged 16–40 years-old). Some of the participants were either informally adopted or lived in institutional care. The results of this study found that the family environment was more conducive to the young people’s wellbeing as they approached or entered adulthood. The participants raised in informal care appeared to be treated similar to the biological children in these families. When the institution formalized the state guardianship responsibility, it also meant the families had state resources for support to protect the children’s rights to economic security, education, health care, and social participation. This practice by the institution supported the addition of informal adoption, as one step closer to permanency than foster care. Future implications include considering this option to help promote the family system assisting these children, families, and the state.     

Key Determinants to using Telehealth Technology to Serve Medically Ill and Depressed Homebound Older Adults

Despite the increasing evidence for the effectiveness of telehealth technology in screening and treating chronic diseases, and comorbid depression among older adults, they have been slowly adopted by home health care (HHC) agencies. Therefore, this study aimed to identify factors that determine telehealth technology adoption. Twenty directors from the National Association for Homecare & Hospice member agencies completed a 45-min telephone interview. Questions were asked regarding their perceptions of telehealth, the key determinants of telehealth adoption and use, and recommendations they would give on telehealth adoption. The majority of the participants perceived telehealth as effective for managing symptoms and reducing cost. Meanwhile, some participants had a mixed feeling toward telehealth for depression care as they did not recognize their agency as equipped with the necessary resources and trained staff. Moreover, significant determinants of telehealth adoption included the agency-related characteristics, the patient-home environment, reimbursement and cost-related factors, and staff telehealth perception. Findings imply that there is a need for financial support both at the state and the federal levels to encourage telehealth adoption among HHC agencies. Future studies should consider exploring strategies used by successful programs to overcome barriers.     

孤残儿童的机构照顾与社会融合

机构照顾是我国目前孤残儿童福利服务的主要模式,对孤残儿童的衣、食、住、行、医有了较全面的保障,并为这些特殊儿童提供了安全、健康的集体环境。但随着我国改革开放的不断深入,儿童福利照顾的理念和照顾模式也在发生新的变革,跟很多发达国家的发展经历相似,在照顾模式中,改革、变化的趋势是:从大机构到小机构的转变,从机构照顾到家庭寄养和家庭收养模式的转变。本文重点探讨国外孤残儿童机构照顾的实践及其反思,以及我国孤残儿童机构照顾模式存在的问题,特别在社会融合方面存在的缺陷。试图分析孤残儿童走向社会融合的可能途径,并以上海市儿童福利院为例,从现实操作层面来看这些途径的有效性。     

福建省养老服务问题及对策初探

在分析福建省养老服务事业发展所面临的问题基础上,对发展福建省养老服务事业提出对策和建议,指出要以科学发展观为指导,发展养老服务理念;加快政府职能转变,推进养老服务体系建设;建立社会多元筹资模式,鼓励社会力量投入养老产业;提升社区服务水平,优化社区养老服务体系运行机制;建立专业化养老工作者队伍,充分发挥志愿者作用,力图为发展养老服务需求提供政策理论依据,积极有效地应对福建省人口老龄化以及社会变迁。     

Differences and similarities in monetary benefits for informal care in old and new EU member states

This article presents an overview of the monetary benefits available in the context of long‐term care provided by family or other informal carers in 11 old and 10 new EU member states. All but one country in our sample offer at least some monetary benefits that can be used to help finance informal care. Old EU member states tend to direct benefits to individuals in need of care, whereas new EU member states place more emphasis on benefits for carers. Among new EU member states, monetary benefits are less often means‐tested and tend to be lower compared with benefits in old EU member states. Because social policies in many countries increasingly rely on monetary benefits rather than on benefits in kind and because the share of informal care in the overall provision of elderly care will scarcely decline, monetary benefit incentives for labour market participation need to be carefully monitored.     

Placement characteristics and stability: a longitudinal analysis of Norwegian children in foster homes

This paper investigates how enhanced support for foster parents, such as covering fees and providing consultants and relief, may reduce the number of replacements experienced by children in foster care. It also investigates the extent to which replacements are associated with family (kin) vs. non‐family foster parents, or with legal characteristics of the placement (i.e. forced administrative decisions vs. relief measures agreed upon by the parents). Statistical analyses of administrative data from Norway investigated the longitudinal relationships between these characteristics and the number of replacements at two levels – children (N = 16 109) and municipalities (N = 418) – over 5 years (2007–2011). The results reveal modest associations between enhanced support and fewer replacements; for example, replacement rates are lower for children placed in homes of kin than in non‐family homes. Replacements also tend to be fewer when the placement is forced rather than consensual.