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 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.     

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.     

Caregiver perceptions of empowerment and self-efficacy following youths’ discharge from residential care

ABSTRACT

Residential care is one of the most restrictive out-of-home care settings; however, this is a temporary placement and youth eventually reintegrate into the home and community setting. Reintegration presents many challenges, and aftercare becomes critical for maintaining youth gains and promoting family stability. Aftercare programs and supports should align to individual family needs that entail understanding individual and familial characteristics. Previous studies have explored characteristics related to family functioning, mental health, behavior, and perceptions of need during reintegration; yet little is known regarding how affective characteristics (i.e., self-efficacy, empowerment) factor into reintegration, or the implications this may have for providers. The purpose of this study was to address this gap by exploring empowerment and self-efficacy in caregivers (N = 120) who had a child return home within 1 month of departing residential care. Overall, caregivers reported high levels of empowerment and self-efficacy during the initial transition period. Significant differences for empowerment and self-efficacy were present in characteristics such as race, income, number of children in the home, and free/reduced lunch status.     

‘More like a daughter than an employee’: the kinning process between migrant care workers,elderly care receivers and their extended families

ABSTRACT

This paper explores the intersections of formal and informal care in the relationships that develop between elderly care receivers and their families and migrant domestic care workers and their families. The domestic migrant care literature has tended to focus on two main ‘hidden costs’ of this ‘care-chain’: the ‘care exploitation’ of paid carers by their employers and the ‘care drain’ impact on the family members left behind by the migrant. In this paper, we employ a care circulation framework to examine the process of becoming kin-like – or ‘kinning’, which remains relatively under-explored and warrants further research. An analysis of this process of kinning helps to highlight how the domestic space of care receiver homes are transformed – through the negotiation of relationships with migrant care workers – into transnational social fields that bring the diaspora worlds of the migrants into the everyday worlds of the locals.     

The Importance of “Empty Gestures” in Recovery: Being Human Together

What do clients/patients want or value from their encounters with healthcare providers? Based on ethnographic research conducted with individuals suffering from drug addiction and mental health issues, this article argues that clients/patients treasure “everyday” or “human” interaction with medical staff. Everydayness is accomplished through three generic social processes: **co‐silence, inclusion in back‐stage activity, and physical dramatizations of authenticity. These processes and other ordinary interactional strategies for “being human together” should be seen as vital tools for recovery.     

Exploring Home Sharing for Elders

Research suggests that third party-arranged home sharing (“TPAHS”) enables elders to remain at home in advanced age by connecting elder home owners with suitable live-in “matches.” TPAHS potentially saves elders, their families, and Medicaid budgets millions of a dollars per year in avoided and postponed nursing home costs. In interviews with elder TPAHS participants of one TPAHS program, we found that similarity in values, ability to utilize the TPAHS organization's guidance, and, when relevant, familiarity with their matches' mental health challenges, correlated with said participants' satisfaction with their matches while a lack of these qualities correlated with match dissatisfaction. With these findings in mind, we suggest strategies TPAHS organizations can use to best serve the elderly TPAHS participants who may benefit from intensified match support but may not seek it.