构建老人福利机构危险管理机制——日本经验之启示

"养儿防老"是中国传统的养老模式,长期以来老人的养老主要依靠子女来解决,但是随着生活方式的改变、家庭规模的日趋小型化,老人的长期照顾问题受到了社会的广泛关注。近年来国家制定了相关的政策、制度以及服务来满足老人及其家人的需求,然而老人福利机构及所提供的照顾服务,其服务质量离人性化照顾服务仍有一段距离。就现阶段而言,老人福利机构所提供照顾服务的质与量,均有提升与改善的空间。日本是亚洲第一个施行公共性长期照顾保险的国家,其施行之初也面临着一些与我国同样的问题,为提升长期照顾机构的服务质量,日本厚生劳动省在介护保险制度施行后的2002年,就开始倡导老人福利机构应建立危险管理机制的理念,并于2006年修订老人长期照顾福利机构管理规则,规定老人福利机构应建立危险管理机制,以提升照顾服务质量。有鉴于此,本文将对日本老人长期照顾福利机构建立危险管理机制的过程、基本架构,以及相关课题做系统说明,为我国老人福利机构经营管理提供参考,也可为我国未来在探讨老人长期照顾问题之际,提供必要的配套依据。     

Improving the Mental Health Outcomes of LGBTQ Youth and Young Adults: A Longitudinal Study

ABSTRACT

The purpose of this groundbreaking study was to evaluate outcomes of 482 LGBTQ (lesbian, gay, bisexual, transgender, or questioning) youth and young adults who received services and supports through the Comprehensive Community Mental Health Services for Children with Serious Emotional Disturbances Program (CMHI). This study was a secondary data analysis using data from a larger study of 3208 LGBTQ and non-LGBTQ youth ages 11 through 21 who had a serious emotional disturbance (SED). This study is significant in that it evaluates functional outcomes for young people identified as LGBTQ based on a specialized service framework (i.e., system of care approach). In essence, do LGBTQ youth with SED benefit from a specific approach to intervention? In addition, a comparison at intake on suicidality, bullying and victimization was conducted between the LGBTQ and non-LGBTQ identifying youth from the larger sample. The youth and a caregiver were interviewed face-to-face separately at intake, 6-months, and 12-months. Significant improvements were found across all of the dependent variables, supporting the viability of SOC for improving outcomes for LGBTQ youth. Future research should continue to build on this study by adding to the design a control group to improve internal validity of the findings.     

How Do We Understand Partnership Working? Experiences from a Telecare Project

Implementing telecare requires experience and knowledge from different disciplines and sectors; business, technology and care. The uptake of telecare has been slow, which is assumed to be caused by difficulties in co‐operation within telecare partnerships. This article presents a new approach to improve understanding of telecare partnerships. The approach builds on theories of trust and partnership working and is informed by rational choice theory. Within this article the approach is applied to recent experiences from a telecare project in Norway, to demonstrate how different ways of interpreting the complex social interactions in telecare partnerships yield new insight and understanding. Examples from the Norwegian project illustrate how different understandings of actions and choices affected trust and caused either improved or deteriorated co‐operation in the partnership. The partners that were able to develop trust through a common evaluation of the problems co‐operated better. However, when partners lacked or had insufficient knowledge, either of each other or of the situation, this led to disparate understandings that threatened trust and affected further co‐operation. The new approach presented here is helpful in analyzing and understanding the actions of different partners within a telecare partnership and identifying why things worked well or went wrong. The approach may have wider relevance for other partnerships.     

人口老龄化背景下的社区养老服务

人口老龄化的趋势不断加快是当前人口发展的态势,在传统家庭养老功能趋于弱化的同时,如何有效地建立满足老年人需求的服务体系是老年工作面临的挑战之一。本文结合老年人的身心特点阐述了社区养老服务的内涵及优越性,在分析了社区养老服务的现状及问题的基础上,提出了社区养老的发展思路和建议。     

Absent Role of the State: Analysis of Social Support to Older People with Disabilities in Rural China

China is experiencing rapid population ageing and already has 44 million older people with disabilities aged over 59 years. Yet social support of these older people with disabilities is undeveloped and not well researched. This article contributes by using a disability rights framework (right to life and protection, economic security and social support) to analyze local cases in rural China. It finds that, although the family is still the main provider of economic and care support to rural older people with disabilities, the absence of a state role in welfare provision has negative impacts on the well‐being of older and younger generations in rural families.     

Social Work Student Views on Palliative Care Learning Resources

Abstract

Many social workers are expected to work with individuals and families who are dealing with life-limiting illnesses, yet during their university education they may not have been exposed to materials that address issues related to death and dying. The Social Work Department of University of New England in Armidale, Australia designed and delivered a palliative care teaching and learning session using publicly funded online materials. Themes emerging from questionnaire and focus group data analysis included appreciation for the importance and emotional demands of the materials, sensitivity and flexibility among educators who ideally have work experience in the field, expanding presence of social work philosophy in curriculum materials and exploring spirituality, and examining culture-informed practice in greater depth. Among the implications is the need for concerted efforts to teach about death and dying using high quality accessible materials, while ensuring social work values and approaches are reflected in the content.     

浅析彝族传统农耕文化中的苦荞文化

彝族传承着别具特色的农耕文化,苦荞文化是彝族传统农耕文化中的重要组成部分。苦荞麦是彝族人的日常生活中重要的粮食之一;在长期的生产实践中,彝族人总结了苦荞麦生产的习俗和经验;在彝族节日、婚丧嫁娶、祭祀鬼神等民俗活动中,苦荞麦往往也是不可或缺的物品;苦荞麦可食可药,具有很好的医疗保健功效和巨大的市场开发价值。     

Using photography to understand change and continuity in the history of residential care for older people

The Last Refuge by Peter Townsend is a seminal study of residential care for older people. The fieldwork was carried out in the late 1950s and the data are now deposited in the National Social Policy and Social Change Archive at the University of Essex. We have undertaken research, funded by the ESRC, which has revisited Townsend's work and some of the homes he studied in order to conduct an overtime comparison. In this paper we focus on Townsend's use of photography and our subsequent use of photography in our revisiting study. We argue that although Townsend did not analyse his photographs, they were significant data for use in his arguments critiquing residential care. They were, however, the product of a different socio‐historical context to our own and as such posed considerable practical and ethical challenges for us when attempting to use this aspect of his methodology for an overtime comparison. We argue that despite the resulting constraints, photography was an important part of our methodology, enabling comparisons and illuminating historical patterns in residential care for older people.     

On the frontline or on the side-line? Homelessness care and care avoiders

Homelessness is a social problem that is subject to many definitional issues and problems. These problems can be discerned on both the conceptual and the practical level. Based on research carried out in Ghent, Belgium, this article deals with ways in which social workers involved in homelessness care construe the problem of ‘care avoiders’, who seem to be perceived as a separate category within the homeless population. We show that: (1) different categories of homelessness are created on an organisational and on an individual level (2) specific services have been developed for those who do not enter regular facilities and (3) a residual group has been created, which social work does not really know how to deal with.     

Editorial

This article describes the development of a new degree course (incorporating the DipSW) which has been designed to address the issue of 'relevance' in professional level education for the residential child care sector in Scotland. Funded by the Scottish Executive, a new body--the Scottish Institute for Residential Child Care--has been charged with devising and delivering a continuum of training, education and other resources to the sector in order to improve the quality of the residential experience of young people. One central element in this provision is the development of a BA/DipSW course that meets CCETSW requirements via a 'particular pathway' in residential child care. The article outlines some of the innovatory features of the course, the first of its kind in the UK, and identifies some of the perspectives that will inform the course curriculum. Brief comparisons are made with developments in the field of child and youth care elsewhere and attention is paid to issues around the provision of practice learning opportunities.