Engaging Experts: Expanding Participation and Enhancing Research in Chinese Eldercare Institutions

Due to the myriad factors straining China’s traditional family-based eldercare system, today unprecedented numbers of older adults are turning to institutions for caregiving needs. As researchers and policy makers organize conferences, analyze trends, and allocate resources, the subjective experiences of elders themselves are often forgotten or ignored. While providers recognize that institutionalized elders are at an increased risk for mental health issues, most cite personnel and resource shortages as insurmountable barriers to provision. Using examples from ethnographic research in Chinese eldercare institutions, this article examines the link between participation and mental health for contemporary Chinese elders and makes a case for expanding the role of elders in research in order to improve both the experience and understanding of institutional eldercare.     

The Association Between the New Rural Cooperative Medical System and Health Care Seeking Behavior Among Middle-Aged and Older Chinese

The new rural cooperative medical system (NCMS) is the primary form of social insurance in rural China. This study aims to explore how the NCMS influences the health care seeking behaviors of middle-aged and older Chinese, considering the family and community contexts. A series of multi-level (three-level) models using data from the first wave of the China Health and Retirement Longitudinal Study (CHARLS) are used. We find that the presence of NCMS coverage has a statistically significant association with seeking inpatient and outpatient care but not physical checkups among middle-aged and older rural Chinese: Rural residents insured by NCMS were more likely to seek inpatient and outpatient care than people who were not insured. Other factors at the individual level (such as self-perceived health and number of doctor-diagnosed chronic diseases), the family level (such as living arrangements and household expenditures), and the community level (such as the presence of township hospitals within the community) are also significant predictors of health care seeking behaviors.     

The Impact of In-Home Services Utilization on the Institutionalization of Older People in Korea

As a result of aging populations, institutionalization of older people is creating an increasing financial burden in many countries. The purpose of the present study was to explore the impact of in-home service utilization on institutionalization. The subjects were newly certified as eligible for long-term care insurance between January and February 2009 in Korea. The follow-up period was 40 months, to April 2012. We used logistic regression models to identify factors influencing the transition to institutional service, adjusting for gender, age, living status, income level, activities of daily living, and chronic disease. The institutionalization rate was estimated to be 17.3% over 40 months. The interval from transitional living to institutionalization was 36 ± 8 months. Risk factors of transition to institutional services are being female, having advanced age, living with friends or cousins, getting dementia, and not using in-home services. We determined that institutionalization is mitigated by use of in-home services. Therefore, supplying appropriate in-home services to current nonusers would help to greatly reduce the rate of institutionalization of older people.     

What survivors want: Understanding the needs of sexual assault survivors

Objective: Sexual assault is a pervasive crime on our college campuses and many survivors do not seek post-assault resources. This study will explore components of alternative interventions to consider in the development of campus-based interventions for sexual assault survivors. Participants: Three stakeholder groups including survivors (n = 8), healthcare providers (n = 6), and advocates (n = 19) were recruited from May 2014 to December 2014 from two university campus communities using flyers and purposive sampling. Methods: A qualitative study design utilized semi-structured interviews and semi-structured focus groups with survivors, healthcare providers, and advocates. Results: Five themes emerged to consider for future campus-based sexual assault interventions: (a) culture of caring, (b) one-stop shop, (c) validation, (d) survivor control and agency, and (e) confidentiality. Conclusions: Although accessible and effective options for post-assault care do currently exist, participants described alternative future interventions that were either (a) print materials or (b) technology-based.     

Schools must include faculty and staff in sexual violence prevention efforts

Creating a normative campus environment intolerant to sexual violence is important for prevention. While prevention initiatives focusing on students are vital, faculty and staff have a central role in supporting and sustaining a comprehensive strategy for preventing campus sexual violence. Nationwide, colleges and universities recently implemented campus climate surveys. At Emory, we decided to survey faculty and staff as well as students, motivated by our use of an ecological framing of campus sexual violence. Faculty and staff are long-term members of the community, and can provide stability and continuity that reinforces prevention efforts prioritized for students. We recommend that schools use a trauma-informed approach to guide the involvement of faculty and staff in prevention. We encourage colleges and universities to consider the experiences and needs of their faculty and staff, as professionals who serve as leaders on campus and as those who guide students through their academic experiences.     

‘There’s a lot of places I’d like to go and things I’d like to do’: the daily living experiences of adults with mild to moderate intellectual disabilities during a time of personalised social care reform in the United Kingdom

Adult social care services in the United Kingdom have undergone a period of transformation over recent years, characterised by a drive towards personalised care. Concurrently, social care budgets have been significantly reduced. This study aimed to explore the daily living experiences of adults with mild/moderate intellectual disabilities, who are at risk of no longer meeting eligibility criteria for statutory support. Focus group discussions, which included both people with intellectual disabilities and support workers, were analysed thematically. Two broad themes are presented: independence and agency; and social capital and well-being. While some participants echoed ideas central to the personalisation narrative, a number of contextual barriers to achieving greater independence and agency were discussed. Moreover, greater independence was not a desired goal for all participants. The findings highlight the potential mismatch between personalised social care, as delivered within significant budget constraints, and the needs of adults with intellectual disabilities.     

Named social workers – better social work for learning disabled people?

In 2016, the Department of Health in England announced that it would pilot the role of Named Social Worker. We chose to be part of the pilot because we regularly witness too many people’s lives being defined by restrictions imposed by professionals. Erroneous associations between the concepts of risk and danger have become the norm in how learning disabled people’s decision-making is perceived and managed. However, we believe social workers educated in the social model of disability and grounded more generally in disability studies offer an alternative perspective. The pilot is an opportunity to test our hypothesis that social work practice rooted in social model thinking can successfully challenge oppressive practice and disabling barriers, thus providing the opportunity for social workers to genuinely be ‘servants not masters’ in the lives of disabled people.     

Care in a Time of Austerity: the Electronic Monitoring of Homecare Workers’ Time

Austerity places intense pressures on labour costs in paid care. In the UK, electronic monitoring technology has been introduced to record (and materially reduce) the working time and wages of homecare workers. Based on empirical findings, we show that, in a ‘time of austerity’, care is reductively constructed as a consumption of time. Service users are constructed as needy, greedy, time‐consumers and homecare workers as resource‐wasting time‐takers. We point to austerity as a temporal ideology aimed at persuading populations that individual deprivation in the present moment, self‐sacrifice and the suppression of personal need in the here and now is a necessary requirement to underpin a more secure national future. Accordingly, women in low‐waged care work are required to eschew a rights‐bearing, present‐tense identity and are assumed willing to suppress their entitlements to lawful wages as a sacrifice to the future. By transforming our understandings of ‘care’ into those of ‘time consumption’, and by emphasizing the virtue of present‐tense deprivation, a politics of austerity appears to justify time‐monitoring in care provision and the rationing of homecare workers’ pay.