Family caregivers of the elderly: quality of life and coping in Estonia

The purpose of the study was to analyse the assessments of elderly people aged 65 and more about family caregiving as a factor influencing their quality of life and coping. The study is based on the project SUFACARE—‘Supporting family carers and care receivers in Estonia and in Finland’—in the framework of which the Institute of Social Work of Tallinn University carried out postal surveys in 2010. The Estonian survey was conducted in Tallinn and Lääne-Viru County. The total number of respondents was 581 (70% female and 30% male), of whom 98 (n=74 female and n=24 male) were family caregivers. Caregiving has not influenced the physical and mental health of caregivers, the reason being that many people who receive care are not of very ill health or suffer from dementia. People mostly take care of their spouses. Based on the Estonian Family Law Act (RT I 2009, 60, 395), adult descendants are required to provide maintenance if their relatives are not able to care for themselves. Caregivers whose health is below average consider caring to be physically demanding. We cannot speak of the social isolation of respondents who have care duties—they communicate actively and do not feel lonely. Women report caregiving to be physically strenuous more often than men. The mental health of male caregivers is better—fewer male respondents claimed to feel unhappy or depressed compared to female respondents.     

Child-centered approach in the context of the assessment of children in need: Reflections of child protection workers in Estonia

Objective

This article describes empirical results on how practitioners understand the concept of child-centered approach and how it is applied in practice, extending knowledge of the unresearched phenomena in Estonian child protection practice.

Method

A small-scale study included twenty child protection workers from different regions in Estonia, exploring the child-centered approach in assessment practices through in-depth semi-structured interviews.

Results

Results indicate that child-centered approach in the child protection workers' practice is characterized, firstly, by doing work for the child, and less by working with the child, including the fact that some practitioners are somewhat unclear about the meaning of child-centered principle. Majority of the participants underscored the importance of child involvement and partnership in the decision-making process, nevertheless, their case reflections showed that most of them did not include the child in the assessment.

Conclusions and implication for practice

Findings highlight several challenges in Estonian child protection system and suggest a need to find ways to support child protection workers' competence and confidence to conduct comprehensive assessments based on the child-centered approach, including the child in the assessment process.     

Community orientation of services for persons with a psychiatric disability. Comparison between Estonia,Hungary and the Netherlands

This article explores the way mental health services and social services are orientated on assisting people with a psychiatric disability to participate in different areas of community life. A large research project about community participation in three different countries (Estonia, Hungary and the Netherlands) confirms the findings of other studies that – regardless of geographical location – people with a psychiatric disability have difficulty fulfilling social roles in the community. They are often faced with fewer opportunities than other citizens, due to their health problems, stigma, discrimination and poverty [World Health Organisation. (2011). World report on disability. Geneva: WHO]. An important objective of social work is to help people find their way in society. Surprisingly enough, in all three countries, most social workers are mainly focused on solving individual problems, and not on community participation. Shifting the focus starts by having a clear awareness of the notion of community participation. Social workers have to work both on supporting individuals to find their way in the community (individual support), and on supporting social networks in the community to accommodate persons with a disability on the basis of equal and valued citizenship (community support).     

Juvenile offender rehabilitation in Estonia: interprofessional collaboration in written assessments and specialists’ perceptions

Qualitative and quantitative research methods were used to study an interprofessional assessment model in rehabilitation services and its implementation in Estonia based on (1) a sample of rehabilitation plans for 160 juvenile offenders aged 7–18 and (2) expert interviews with 10 members of an interprofessional assessment team. Each specialist’s role was compared with the assessments. While each team member is assigned a discrete role based on discipline, in practice, the disciplines’ work overlapped considerably during the assessment process. The overlap seems to occur because team members conduct their assessments individually, rather than following the collaborative best practice model for interprofessional teams described in the literature. The expert interviews indicate that rehabilitation specialists perceive the individual-level elements of interprofessional teamwork to be consistent with the ideals articulated in the Perception of Interprofessional Collaboration Model, while the substantial overlap in assessments that occurred in practice could be related to lack of interprofessional collaboration at group and organizational levels. Recommendations to improve the functioning of teams serving juvenile offenders include establishing an interprofessional education system, increasing the flexibility of the legal framework for service provision, and improving the interprofessional assessment instrument.