Palliative care patients' experiences of healthcare treatment

Kennett C, Payne M. Palliative care patients' experiences of healthcare treatment Int J Soc Welfare 2010: 19: 262–271 © 2009 The Author(s), Journal compilation © 2009 Blackwell Publishing Ltd and the International Journal of Social Welfare. This article reports on a thematic analysis of the opinions of 34 palliative care patients about medical and healthcare treatment expressed in comments, narratives and discussions during a series of facilitated group discussions undertaken as part of training events for medical students. Palliative care patients often have long healthcare careers, which enables them to compare different professionals and services, thus offering a more powerful and complex analysis of patient experience than that obtainable from analysis of complaints or satisfaction surveys, and permits some understanding to be obtained of the attitudes that condition evaluations of services. The patients balanced negative views with positive experiences. They appreciated open, listening, equal and friendly relationships with professionals in which careful explanation fostered their confidence in the overall service. They criticised inflexible services that did not consider their broad needs, and in which relationships with professionals were characterised by busy‐ness and professional distance.     

Exploring Policy and Financing Options for Long-Term Care in Taiwan

Summary

Policy and financing arrangements for long-term care are important themes in each country and/or region, and Taiwan, with its unique historic and politico-economic background, can be regarded as a bridge between well-developed and under-developed countries. Policy formulation about long-term care in Taiwan involves several agencies in the government, including Ministry of Health, Interior Affairs, Education, Insurance Bureau, and Economic Council, and formulation of policy objectives has progressed considerably in the last five years. Financing arrangements are less well-developed because the National Health Insurance Program began only in 1995, and most long-term care is not yet covered. As demand for long-term care exceeds supply, and this gap will grow in future, current resource allocation measures are concerned to facilitate the expansion of community care rather than allowing institutional care to absorb more resources. Developing future financing options is now a central task for policymaking, and government must continue to take a leading role in consolidating financing and integrating the service systems.     

危重病性多发性周围神经病与肌病的临床及肌电图探讨

目的探讨危重病性多发性神经病与肌病的临床、电生理特点。方法对6例危重病性多发性神经病与肌病患者的临床资料、肌电图结果进行分析。结果患者均因严重感染等基础疾病转入ICU,均进行气管插管呼吸机辅助呼吸,6例患者均出现四肢基本对称的肌力下降、感觉异常及腱反射减弱。肌电图结果示四肢周围神经的运动及感觉复合电位波幅明显下降或引不出,4例患者同时合并肌病样改变。结论危重病性多发性神经病与肌病是重症患者气管插管呼吸机辅助呼吸后常见的并发症,电生理检查有助于本病的诊断,早期认识及治疗本病与预后关系很大。     

Locating “youth voice:” Considering the contexts of speaking in foster care

Within social services, an increasingly significant movement supports giving “voice” to children and youth, enabling them to express their views and to have those views taken into account in matters that affect them. In this article, the author draws from narratives of young people who grew up in foster care, examining stories of their efforts to impact the course of their own lives. The article explores the ways that very specific contexts and relationships of power shaped the utterances of young people in the foster care system and distorted, muted, or amplified their abilities to express their need and interests. This is a beginning attempt to identify ways that contexts of speaking in foster care can be understood and altered in order to strengthen the capacity of young people to voice their concerns and aspirations.     

Resettlement challenges faced by refugee claimant families in Montreal: lack of access to child care

Adult refugee claimants experience several well‐documented post‐migratory challenges. Little is known about the resettlement process for refugee claimant families with children. This study reports on 75 open‐ended, in‐depth interviews with refugee claimant families in Montreal about their resettlement challenges and their proposed solutions to them. These interviews were conducted with 33 dyads and triads of children and parents attending a paediatric hospital. Experiences accessing formal and informal child care in Montreal were addressed. Subsequently, a comparative policy analysis was conducted on residency eligibility criteria for child care subsidization. Twenty‐eight out of 39 parents (73%) report a lack of informal or formal child care and 15 out of 33 families (39%) propose improving access to formal child care services. They describe a lack of informal child care as a result of reduced social networks, and affordability as a barrier to formal child care services. Refugee claimants are not eligible for subsidized child care in Quebec. A comparative policy analysis within Canada and comparable countries reveals that this situation is not unique to Quebec. However, most provinces and European countries offer child care subsidies to refugee claimants. Refugee claimants should qualify for child care subsidies. Social workers and community organizations should consider their clients' child care needs in designing programmes and services.     

Professional Social Work Education in End-of-Life Care

Abstract

Social work education in both BSW and MSW level courses is missing vital content about end-of-life care, palliative care, and bereavement. End-of-life care training opportunities through continuing education programs have also been limited. This deficit is significant because a vast number of social workers are already confronted with end-of-life issues on a daily basis in a variety of practice settings. Through the Project on Death in America, Social Work Leadership Development Awards initiative, many programs and models for professional social work education and training in end-of-life care have been developed and are presented in this article. These include: end-of-life care courses, symposia, training manuals, certificate programs and fellowships. Although the curricula continue to be refined, many of these programs are available to practitioners to advance their knowledge and skills and their curricular models are available to social work educators for possible replication.     

The Digital Practitioner:

No abstract available for this article.     

Equal Division of Estates and the Exchange Motive

Abstract

Although the bequest motive is one of the most important theoretical extensions of the life-cycle hypothesis, few empirical studies have measured determinants of unequal estate division. We estimated whether several proxies that are consistent with exchange and altruism lead to unequal estate division using data from a longitudinal survey of deceased elderly persons linked to probate court records. Equal division was the rule-between 70 and 83% of estates were divided equally, depending on the strictness of the definition of equal division. Several measures of exchange were not significant predictors of unequal division. Two factors that are consistent with both exchange and altruism-writing the last will and testament within five years of death and having more children-predict unequal estate division. The models control for selection, because many decedents do not file a record in probate court.     

Supporting Care Leavers to Fulfil their Educational Aspirations: Resilience,Relationships and Resistance to Help

Most children in state care do not do as well in school as their peers, but the period of leaving care and transition to adulthood may offer a ‘turning point’ for positive change. Based on a small study of care leavers in England, this article employs the concept of resilience to explore the significance of supportive relationships in enabling this group of young people to make decisions about their future and encouraging them to overcome setbacks in educational attainment.     

Shared Family Care: Fostering the Whole Family to Promote Safety and Stability

ABSTRACT

Shared Family Care is an innovative child welfare service that temporarily places whole families in the homes of community mentors who, along with a team of professionals, help the families to obtain the skills and resources they need to move toward self-sufficiency and adequately care for their children. This article provides an overview of this model, identifies existing programs in the United States, discusses key elements of the model, summarizes outcomes and comparative cost information, identifies implementation challenges, and provides tips for starting a Shared Family Care program in any community.