Implementing a Point‐Based Rewards System as an Educational Tool in Children's Home: From Standardisation to Coconstruction and Negotiation

From a wider educational ethnography, we analysed the implementation of a point‐based reward system as an educational tool in a Spanish children's home. This is examined within a policy and ideological framework strongly influenced by Evidence‐Based Practice, Standardization and New Public Management. The findings show, first, how this system relied on a balance between greater use of standard tools and the experience of the managers; second, how, in practice, basic procedures regarding the system's rigour and objectivity were altered; and third, how the ratings given to evaluate children were very often coconstructed and influenced by broader individual, social and institutional processes.     

VA Staff Perceptions of Barriers and Facilitators to Home-and Community-Based Placement Post–Hospital Discharge

This study identifies factors U.S. Department of Veterans Affairs (VA) staff perceived to promote or impede home- and community-based services (HCBS) placement post–hospital discharge among Veterans cared for within the VA. Data derive from 35 semi-structured interviews with staff from 12 VA medical centers from around the country. VA staff reported that Veteran’s care needs and social and financial resources influence HCBS placement. They also reported prerequisites for successful placement, including housing, unpaid informal care, and non-VA services funded privately and by public programs such as Medicaid and the Older Americans Act. Lack of staffing and failure to offer the specific types of services needed limit referral to and use of HCBS. Budgetary imperatives influence the relative availability of HCBS across VA medical centers. Findings highlight patient-, provider-, and system-level constraints that impede successful placement at home and in the community of Veterans in need of long-term services and supports after hospitalization.     

Quality indicator survey versus traditional survey in New York State: a comparison of results from annual nursing home surveys

Despite the passage of OBRA’87 for nursing home reform, concerns about care in facilities continue. The Centers for Medicare and Medicaid developed new regulations and the Traditional Survey (TS) process for annual nursing home survey. The survey is conducted by state regional offices to determine facility compliance with federal regulations. Despite the regulations and new survey process, the TS inconsistently identified problems. A computerized process called the Quality Indicator Survey (QIS) was subsequently developed. This study was designed to compare results from TS and QIS on overall deficiencies, select quality indicators, high-severity deficiencies, and severity differences of seven quality indicators in New York State over a 6-year period from 2010 through 2015. Results of t-tests determined a significant difference in the overall mean number of deficiencies (p < .001), and on four indicators: choices (p < .001), nursing staff (p < .001), dental (p < .001), and dignity (p < .05). Facilities using the TS showed a higher mean number of harm level or higher deficiencies (p < .001). Chi-square tests for severity levels showed significantly more higher severity deficiencies on two quality indicators: nutrition (p < 0.001) and hydration (p < 0.05). Thus, the QIS produced a greater mean number of deficiencies, while TS produced more higher severity deficiencies in New York State.     

Experiences of Young Indian Girls Transiting out of Residential Care Homes

Leaving the residential care home is one of the most significant occurrence in the life of every care‐leaver. It encompasses vast changes which has a long term impact on the care‐leavers future. This study captures the lived experiences of twenty‐four young Indian girls who have left care in the past four years. It addresses their journey of moving out of care at two levels — their preparation to leave care and their present experience. The primary focus of the study is to explore the interpretation and meanings attributed by these girls to the phenomena of transition out of care; identifying the uniqueness and commonalities that emerges from their experiences. The results exposes a plethora of emotions and episodes the girls have encountered at each step of their path. It also emphasises on the role played by multiple environmental factors — support network (friends, peer group, family, social workers, etc.), residential care home, state and other social processes — operating at different systemic levels, highlighting the interface between the ‘self’ and the ‘environment’, based on the Ecological Framework.     

The circumstances surrounding the death of 105 elders as a result of resident-to-resident incidents in dementia in long-term care homes

Resident-to-resident incidents in dementia in long-term care homes resulting in deaths represent a growing concern among residents, family members, care providers, care advocacy organizations, and policy makers. Despite these concerns and experts’ predictions by which injurious and fatal incidents will increase in the coming years due to the projected growth in the number of people with dementia, no studies have been conducted in North America on these fatal incidents. This exploratory pilot study makes first steps towards bridging this major gap in research and practice. Using publicly available information (primarily newspaper articles and death review reports), practically useful patterns were identified pertaining to the circumstances surrounding the death of 105 elders as a result of these incidents. The findings could inform various efforts to prevent future deaths in similar circumstances, keep vulnerable and frail residents safe, and encourage researchers to examine risk and protective factors for these incidents.     

Of Bricks and Glass: Learning to Accommodate the Everyday Rhythms of Home

Abstract

Much of the growing focus of research on home cultures and materiality emphasizes eventful or disruptive temporalities: extensions, renovations, retrofits. Here, we trace how homes and lives are reshaped materially and conceptually, in response to other less disruptive temporalities of accommodation. Interviews with suburban Australian households reveal how people gradually come to know the built fabric of their home over time. Lay expertise is acquired through small material adjustments across multiple timescales: triggered by overlapping rhythms of body and building amidst broader lifecourse rhythms. To explore the role material engagements play in mediating these rhythms we focus on two ubiquitous suburban materials—glass and brick. We seek to demonstrate how bodies learn to work with the qualities of these materials and adjust their rhythms to engender comfort through dwelling in place over time. These comparatively mundane processes of spatial, behavioral and material adjustment take on further significance when connected with questions of entrenched routines and practices, material stewardship, vulnerability, and the ability of households to adapt to a changing climate.     

Continuing/Life Care Facilities and the Continuum of Care

The proliferation of continuing/life care facilities in the United States in recent years holds the promise of providing retirees with a full continuum of care. This survey of continuing/life care facilities in the state of Florida was undertaken to ascertain if they indeed were providing the services necessary to fulfill this promise. The results indicate that only a small percentage of continuing/life care facilities offer all the services the authors believe necessary for a full continuum of care, with shelter care being the least frequently offered service.     

Treatment and treatment outcomes in children's homes

A follow-up study of 141 young people in 48 children's homes examined changes in their moods, relationships with their family and adjustment. The average scores of the group on these variables changed little between first interview and follow-up 6–9 months later. However, some individuals improved and others deteriorated. Improvements in family relationships were more likely in homes where the head of home could describe strategies for fostering family ties. Improvements in adjustment were also more likely in homes where the head of home could articulate ways of enabling change in key areas of the residents' lives. Residents who spoke of attempts to bully them were more distressed at the time of the first interview and less adjusted at follow-up. The study underlines the damaging effects of bullying and the key role of the head of home.