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Aim of the present monograph is the economic analysis of the role of MNEs regarding globalisation and digital economy and in parallel there is a reference and examination of some legal aspects concerning MNEs, cyberspace and e‐commerce as the means of expression of the digital economy. The whole effort of the author is focused on the examination of various aspects of MNEs and their impact upon globalisation and vice versa and how and if we are moving towards a global digital economy.

The purpose of this study was to re-examine racial and gender differences in home and community-based services utilization. Using the 1999 National Long Term Care Survey, the Anderson-Newman (1995) health behavioral model, social supports and structural factors were used to examine predictors of service use among four in-home and two community-based services. The results showed that race did not have a significant main effect on service use, but gender had a significant main effect for housework, home delivered meals, and congregate meals. Using an interaction term, older white women reported higher usage of housework. Among the predictors, enabling factors had the strongest effect on the use of personal care/nursing, home delivered meals, transportation and senior centers’ services. The results also indicated the importance of social supports and structural factors, particularly service awareness, in predicting service use. Implications for policies and practice to improve community outreach, access and utilization of services by different racial groups of elders are discussed.

Purpose: The aim is to explore how family relations are affected by societal changes in relation to informal and formal caregiving and self-determination of older adults.

Design/methodology/approach: Care managers (CMs)/social workers (SWs) (N = 124) participated in a comparative vignette study including Japan, South Korea, and Sweden. Systems theory was used.

Findings: Japanese CMs/SWs clearly describe their efforts to create networks in a relational way between formal and informal actors in the community. South Korean CMs/SWs balance between suggesting interventions to support daily life at home or a move to a nursing home, often acknowledging the family as the main caregiver. In Sweden, CMs/SWs highlight the juridical element in meeting the older adult and the interventions offered, and families primarily give social support. Regarding self-determination, the Japanese priority is for CMs/SWs to harmonize within the family and the community. South Korean CMs/SWs express ambivalent attitudes to older adults’ capability for self-determination in the intersection between formal and family care. Swedish CMs/SWs adhere to the older adult’s self-determination, while acknowledging the role of the family in persuading the older adult to accept interventions. The results suggest emerging defamilialization in South Korea, while tendencies to refamilialization are noticed in Japan and Sweden, albeit in different ways.

Research limitations/implications: In translation, nuances may be lost. A focus on changing families shows that country-specific details in care services have been reduced. For future research, perspectives of “care” need to be studied on different levels.

Originality/value: Using one vignette in three countries with different welfare regimes, discussing changing views on families’, communities’ and societal caregiving is unique. This captures changes in policy, influencing re- and defamilialization.

Two major reform movements have shaped child and adolescent mental health services over the past quarter-century: the Systems of Care movement, and more recently, the movement toward evidence-based practice. Results from several studies indicate that youth served in traditional residential or inpatient care may experience difficulty re-entering their natural environments, or were released into physically and emotionally unsafe homes (Bruns & Burchard, 2000; President's Commission on Mental Health, 1978; Stortz, 2000; Stroul & Friedman, 1986; U.S. Department of Health and Human Services, 1999). The cost of hospitalizing youth also became a policy concern (Henggeler et al., 1999b; Kielser, 1993; U.S. Department of Health and Human Services, 1999). For example, it is estimated that from the late 1980s through 1990 inpatient treatment consumed nearly half of all expenditures for child and adolescent mental health care although the services were found not to be very effective (Burns, 1991; Burns & Friedman, 1990). More recent analyses indicate that at least 1/3 of all mental health expenditures for youth are associated with inpatient hospitalization (Ringel & Sturm, 2001).

The purpose of this study is to examine the satisfaction of older adults in the services they receive from the Neighbors Helping Neighbors (NHN) program – a program designed to assist older adults to remain independent in their homes and communities.

A questionnaire examining various domains of service was developed and administered to 49 older adults who had been receiving assistance from NHN for at least six months.

Findings revealed that 87 percent (41) of the participants were satisfied with services and believed that NHN helped them remain independent in the community.

The study was a cross‐sectional design and did not look at change over time based on a pre/post test research design. Therefore, no causation can be implied. Another limitation is that the study was conducted internally by NHN; program participants may have responded in a socially desirable way in order not to reflect negatively on the program.

Findings from this study may have implications for developing sustainable home‐ and community‐based support programs for older adults.

With the aging of societies and cutbacks in government social services, it is important to examine how the needs of aging citizens can be met.

The paper shows that the NHN model is innovative in its use of students, community‐building approaches, and volunteers in meeting the needs of older adults. The NHN program provides an innovative model that can be replicated by other universities or other community‐based organizations around the country.

To describe, analyze, and compare two long-term care (LTC) systems for elders in Germany and Israel.

Secondary analyses of data on LTC beneficiaries, structure of service provision and content analyses of policy documents in a comparative perspective based on the Esping-Andersen welfare state typologies.

Descriptive background of demographic attributes in the two countries; discussion of LTC development laws which in Israel focuses on “aging in place” concept, where in-kind services are geared only to community-dwelling frail elders while in Germany it’s for community and institutionalized elders. Analyses of various service types provided their use, resources invested, and benefits incurred for frail elders and their family caregivers.

The advantages and shortcomings of the two systems were analyzed with recommendations for future developments. Such comparisons across nations can inform social policy debates in Germany and Israel as to how to prepare for population aging. The originality of such comparison can shed light on issues for LTC service development in other countries.

This paper aims to identify the characteristics of 260 adults, 65 and over, who applied for services through an Area Agency on Aging in a western state in the United States, and to determine the conditions that resulted in referral to the state‐funded Home and Community Based Alternatives Program (Alternatives) or the Medicaid Aging Waiver (Waiver) program.

The study was an exploratory one utilizing quantitative data from an existing database of older adults who sought home and community based services from Mountainlands Area Agency on Aging (AAA) between January 1, 2006 and December 31, 2007.

Although most of the sample lived at or near poverty levels, results suggest that higher monthly income and living alone predict referral to the Alternatives program, whereas greater need for assistance with bathing and performing heavy housework are the primary determinants of referral to the Medicaid Waiver program.

This study adds to the body of knowledge concerning the characteristics of people who access home and community based services. Most people in this study, who were seeking assistance from public programs, were living at or below the US Federal Poverty Line. One home and community based program was more likely to serve people who lived with others and had cognitive impairments, and referral to a Medicaid home and community based program was more likely for people who needed assistance with bathing and heavy housework.

The following is an introductory profile of the fastest growing firms over the three-year period of the study listed by corporate reputation ranking order. The business activities in which the firms are engaged are outlined to provide background information for the reader.

Purpose – Medicaid funding for long-term services and supports (LTSS) is a key avenue for community access for people with disabilities and others. Between 1997 and 2009, the boundaries of community access were redrawn and redefined with the introduction of a series of 13 bills to change how Medicaid requires states to fund LTSS. Although they did not successfully pass into law, their presence is felt in the language of the Community First Choice (CFC) Option, part of the Patient Protection and Affordable Care Act (PPACA) of 2010. This chapter documents and analyzes the changes in the concept of community access as reflected across these bills and the CFC.

Methodology – The text of these 13 bills and the CFC were compared with attention to structure, order, and meaning. Documents were hand coded and electronically searched. Codes were entered into atlas.ti for comparison and analysis.

Findings – Four significant changes in the conceptualization of community access emerged: (1) who deserves access to community, (2) what community access entails, (3) why people deserve access to community, and (4) how community access should be organized. With the exception of the reasons why people deserve access to community, the expanded concept of community access illustrated across these bills is reflected in the text of CFC.

Originality/value of the chapter – This chapter contributes to the limited literature that documents and analyzes the historical development of community access across policy documents. In addition, it highlights the relevance of incremental analysis to understanding social change through the legislative process.