“That Model is Sooooo Last Millennium!” Residential Long-Term Care as a System,Not a Place

The current quandary with the design of existing long-term care settings results from focus on structures (“institutions”) instead of on a system of supports and services that transcends physical and traditional boundaries across settings, including nursing homes, assisted living residences, and the home. Supported by analyses of the commonalities, socio-historical and political contexts, core values, and fallacies of social and medical models in existing and emerging long-term care options, a holistic model is proposed based on new core values that facilitate community and family integration and that asserts dignity and personhood as universal attributes in an array of settings.     

Happily Ever After? The Journey From Foster Care to Adoption

Providing the foster child with a forever family through adoption is often seen as a happy ending to the long and painful journey through foster care. This qualitative study explores this complex journey from foster care to adoption from the perspective of 30 young adults aged 18 to 25 who were adopted from the foster care system after the age of 8. The results indicate that the foster and adoption experience for these youth cannot be compartmentalized when trying to understand the impact adoption has had on their overall sense of self. Implications for future research to explore the emerging concept of foster/adoptive identity for older youth adopted through the foster care system are provided.     

Home Is Where the Help Is

Abstract

Policy regarding long-term care has been an issue of rising national concern. In this paper we examine the transition of Danish long-term care policy with special attention to Skævinge, the first community in Denmark to integrate institutional and community-based services for the elderly. Recent studies on the variation between costs and services in Danish communities and the results of U.S. studies on community-based care suggest that successful implementation of integrated institutional and community-based long-term care is feasible in the United States. Lessons from Denmark highlight conditions that will facilitate success in this endeavor.     

Long-Term Care Policy and Financing as a Public or Private Matter in the United States

Summary

Effective approaches to assure adequate resources, infrastructure, and broad societal support to address chronic care needs are volatile and potentially unpopular issues that can result in many losers (those getting far less than they want) and few winners (those who gain access to scarce societal resources for care). In the United States, debates on long-term care involve a complex set of issues and services that link health, social services (welfare), and economic policies that often pit public and private sector interests and values against one another. Yet long-term care policies fill a necessary function in society to clarify roles, expectations, and functions of public, non-profit, for profit, individual, and family sectors of a society. By assessing and developing policy proposals that include all long-term care system dimensions, a society can arrive at systematic, fair, and rational decisions. Limiting decisions to system financing aspects alone is likely to result in unforeseen or unintended effects in a long-term care system that stopgap “fixes” cannot resolve. Three underlying policy challenges are presented: the need for policymakers to consider whether the public sector is the first or last source of payment for long-term care; whether government is seen primarily as a risk or cost manager; and the extent to which choice is afforded to elders and family caregivers with regard to the types, settings, and amount of long-term care desired to complement family care.     

Eight years after – a follow‐up study of mothers and children at psychosocial risk who received early treatment: does early intervention leave its mark?

One‐hundred forty‐five mothers at psychosocial risk who, with their babies, had been given treatment at a parent–baby clinic during a 2‐year period starting in 1999, treatment designed to strengthen the mother–child relationship, were followed up 8 years later. Both the mothers who had agreed to take part in the treatment programme (n= 73) and those who had declined (n= 72) were searched for in the records of the Social Welfare office to determine if the treated mothers had been focused on to a lesser degree in the following 8 years than those who had declined treatment, a hypothesis that was initially put forward. The behaviour of the children whose mothers had undergone treatment (n= 46) was studied. The initial hypothesis had to be rejected; support and intervention from the social authorities had been equally common in both groups. However, the children of treated mothers had fewer externalizing behaviour than children of untreated mothers at psychosocial risk.     

Chapter 10. Care Needs of Older Adults Following a Traumatic or Disastrous Event

SUMMARY

This chapter addresses biopsychosocial and spiritual needs of older adults following a traumatic or disastrous event. It assumes that most older adults have established a pattern of positive adaptation over the life course as they encountered acute stress or chronic adversities. The importance of social supports and mutual aid is also described.     

试论生态美学视野中的当代审美文化建设

文化是人类在改造自然的过程中创造的自我生存方式,然而正是对自然的过度征服和改造酿成了生态危机,使人类所追求的崇高美走向了悲剧和荒诞、喜剧,也使审美文化面临着价值悖论的危机;生态美学的建设,不但为自然的复活指明了一条出路,其所内蕴的人文关怀和生态关怀的价值取向,也为当代中国审美文化的建设提供了价值依据。     

新写实小说如何体现对人性的关怀——谈中国作家的创作策略

本文阐述了新写实小说产生的社会历史根据,探讨了作家如何成功地领引当代文学的发展和认知策略。在当代中国多元思想的整合中,面对中国文学“无主题”的困惑,作者试图分析并提炼新世纪进步文化的人性内涵,为领悟欣赏当代意识的中国文学,洞开了新的审美向度和思想空间。     

附地而生的困惑——农民遭遇现代化进程

城乡二元制在客观构成城乡之间的差异,走出农村的农民在城市谋生时并不是把城市当作自己生存的根基,他们在心理和生活的归宿认识上仍然是"附地而生"的."附地而生"的形成原因应该从两个角度分析:一方面农民自身的局限性使他们对于所介入的城市没有什么感情,他们所关注的往往是利益,不在乎自己的道德失范行为会给城市带来什么样的后果;另一方面,进城后的民工在由于社群关系的缺失而丧失了来自于社群内部的人文关怀的同时,由于市民的公民心态没有成熟,进城的农民无法从市民那里获得必要的人文关怀.综合造成农民"附地而生"的原因,笔者提出解决的根本途径在于构建现代社会的人文关怀体系.     

我国城乡二元社会医疗保险体系衔接探析

我国城乡社会医疗保险体系有着明显的二元化特征。二元社会医疗体系曾有其积极作用,但随着改革的深入与社会转型,这种体系的固化使城乡统一的社会医疗保障体系的建立变得相当困难。今后我国的医疗保险制度改革应从城乡有机衔接的立场出发,根据我国社会转型的实际并借鉴国际成熟经验,循序渐进扩大现代社会医疗保险的覆盖面,在我国建立全方位、多层次、城乡有机衔接的社会医疗保险体系,最终实现“国民皆医保”的城乡整合,使城乡居民能够实质平等地分享国家经济与社会发展的成果。