Search results

The purpose of this article is to, within the specific Sri Lankan figures on ageing within South Asia (comparatively high longevity and high figures on intergenerational family‐living), look into the interpretations of social care and everyday social life in urban elder homes in Colombo. What does everyday social life look like and how are underlying meanings of care given shape? To highlight the taken for granted quality of much of everyday care, comparisons are made on the basis of earlier ethnographic research by Indian scholars on Dutch senior homes.

The methodology relied on analysis of existing quantitative data on ageing in Sri Lanka and on research generated by the four‐year team‐study of which the author was part. Specific data in this article were collected through qualitative research by the author: regular visiting and participating in activities within certain selected homes in Colombo, over a period of four months. In addition survey data were collected on 55 senior homes in Colombo.

Against a background of available statistical data on ageing; family and institutional care, qualitative research findings are provided on everyday life within the Colombo homes, Sri Lanka. What kind of care (“Araksha kerime”) is given and/or aimed for? The concept of “social care” (Daly and Lewis) is the starting point to understand how normative and social frameworks within which “care” is understood and undertaken. Cross cultural comparison with every‐day life in Dutch senior homes articulates the impact of taken for granted socio‐cultural similarities and differences embedded in the concept of “senior home” and its everyday life.

The four year research project by three main researchers (of which the author was one) resulted in a substantial data base and several publications. This specific qualitative section of research is based in an additional period of four months of regular visiting of five selected Colombo elder homes. Survey data were collected on another 55 senior homes.

The points made in the paper could be constructively discussed cross culturally and contribute to a debate on the taken for granted underlying socio‐cultural meanings within which universal definitions of – in this case – care within senior homes is pursued cross culturally. Money does not always make all the difference.

The article attempts to combine data from different disciplines and compare different socio‐cultural settings for old‐age care. This can shed a different light on the taken‐for‐granted elements in the shaping the social life in senior homes. For example, it becomes clear why the causes of loneliness and isolation among elders in a certain setting seem so “natural” within and so strange from beyond.

The purpose of this paper is to propose five organisational factors associated with abuse, neglect and/or loss of dignity of older people resident in care homes. It derives from one set of findings from the ResPECT Study of Organisational Dynamics of Elder Care commissioned by Comic Relief and Department of Health through the Prevention of Abuse and Neglect In the Care of Older Adults programme.

A knowledge synthesis method was selected to identify organisational aspects of elder mistreatment in residential care settings. The method was selected for its suitability in examining ill-defined and contested concepts such as; elder mistreatment – where the available evidence is dispersed and produced in varied forms. A rapid review comprising a search of three academic databases and a detailed examination of selected investigation reports into institutional mistreatment was followed by panel meetings with subject matter experts to complete the knowledge synthesis.

This paper identifies and elaborates five organisational factors associated with elder mistreatment; infrastructure, management and procedures, staffing, resident population characteristics and culture. It also indicates macro-structural factors affecting care quality.

Further research is needed to elaborate the influence of these organisational factors on mistreatment and to understand any interactions.

As an adjunct to personal factors, the knowledge synthesis indicates common organisational factors contributing to institutional abuse. This suggests that care quality is produced systemically and that it can collapse as a result of seemingly minor and unrelated organisational changes.

Care home safety and quality is an ongoing concern, with popular analysis frequently stopping at the point of describing individual errant behaviour. However, as “problem” organisations are closed down, “problem” organisational factors continue to recur elsewhere.

The paper identifies and elaborates organisational aspects of elder mistreatment in residential care settings. The findings are original, valuable and grounded in relevant experience by the method of analysis and synthesis of the findings from inquiry reports as well as research and the contribution to the development of findings by those central to the issue, residents, relatives and care providers.

Asia's traditional experiences with care provision differ considerably from those of the West given the prevalent family‐based social norms about care and policies in this region. In recent decades, Asia has experienced profound social and demographic transformations and is thus faced with significant challenges around care. However, care in Asian countries is a relatively less studied topic. There is an urgent need for a comparative study on recent policy and practice changes in care for the elderly and young children in different regions of Asia. The purpose of this special issue is to examine complicated boundary shift in care provision and financing between the state, market, community and family in East, Southeast and South Asia and to explore the implications of these changes in care policies and practices for social stratification by class and gender in Asia.

The introduction to this special issue gives an overview of the social and demographic transformations and new strains on care in Asia as a background and introduces the framework of welfare mix employed in this special issue, especially the concepts of social care and the welfare/care diamond.

The introduction summarizes the variations in regard to the governance and provision of care between different Asian countries and compares the differences in the state involvement between Asia and Europe.

The authors also discuss some of their contributions to methodological approaches and analytical frameworks in studying care and the implications of the current research for future studies.

The economic reforms which turned the centrally planned economy to a market economy have profoundly changed the tripartite relationship between the state, work unit, and citizen in urban China and brought significant changes to the institutional care provision for young children. The aim of this paper is to investigate the changes to the institutional care since 1980, with particular emphasis on the most recent years from mid‐1990s, and explore how the institutional care has changed over the recent decades without a clear institutional basis.

The analysis draws on second‐hand materials from published literature, a range of longitudinal national and local statistics and policy documents, and also on first‐hand information which was collected in Beijing from in‐depth interviews with key informants and case studies of different kinds of kindergartens.

The paper finds that the previous work‐unit based public care system has changed to a much more complicated care mix in which the roles of the state, employer, community, market and the informal sector of the family in terms of provision and funding have all changed significantly.

The findings of this paper may help to inform appropriate policy responses in Chinese child care provision. The study suggests that formal care provision should be expanded towards universal access regardless of people's income and employment status in China.

The paper questions and complicates the “state withdrawal” representation of social welfare change and argues that it is not “the state” but “the work unit and community organization” retreat from public care provision. It also argues that the change in the role of the state has been multifaceted, and not a simple one‐directional movement of marketization in which the state retreated from welfare provision in entirety.

As populations are ageing and the global average life expectancy is rising, the provision of care for older people is an increasingly salient issue. This paper aims to focus on family-provided care for older immigrants, examining how older immigrants and care providers experience and construct family caregiving.

Based on interviews with care recipients, family care providers, municipal staff and representatives for migrant organisations in Sweden, this study presents a typology of family caregiving for older immigrants.

The authors found three caregiving types, namely, solely family-provided care and a combination of family care and public care (predominantly one or the other). The decision to select family-provided or publicly-funded care depends on personal and institutional factors.

The paper makes three empirical contributions to the literature on care provision for older immigrants. Firstly, this study provides insights into the structural and personal factors that shape care-giving arrangements for older immigrants. Secondly, this study examines the perspectives of care recipients and care providers on family-provided care. Care expectations differ between both groups and sometimes result in intergenerational disagreement. Thirdly, in terms of institutional support, this study finds that the Swedish state’s notion of individual needs does not match the needs of immigrant elderly and their caregivers. The paper places the care types in a broader discussion about eldercare provision in the Swedish welfare state, which has experienced a decline in publicly funded care services and an increase in family caregiving in the past 30 years. In addition, it addresses questions of dignified ageing from a minority perspective.

The paper compares the introduction of universal long‐term care schemes and the regulations of migrant care work within the framework of multi‐level governance in Austria and Germany. The aim of the paper is twofold. First, it reveals the characteristics of country‐specific universal policy schemes and second, it explains their designs – the new type of universalism and its completion by regulations of migrant care work within the family framework – by the policy‐making process.

Conceptually, the paper combines approaches within long‐term care research to define dimensions of universalism, as well as on multi‐level governance and new‐institutionalism to examine the policy‐making process. Empirically, Austria and Germany are selected as two cases.

The findings reveal the significant dimensions of the new type of universalist policy design and of policies towards migrant care work. The country differences are explained by the policy‐making process within countries and with cross‐border effects. In particular, the impact of the disability movement in Austria and the coalition between the political parties in Germany resulted in a country‐specific definition of universalism. The integrated approach towards migrant care work in Austria is contrasted with the fragmented approach in Germany. In both countries, the regulations of migrant care work question the idea of universalism.

The impact of societal actors and their ideas on the creation of a new type of universalism and the interrelated regulation of migrant care work has only rarely been examined. The analysis contributes to an understanding of the policy‐making process and its interrelationship with selected policy designs.

Quality of care in the residential aged sector has changed over the past decade. The purpose of this paper is to examine these changes from the perspectives of staff to identify factors influencing quality of residential aged care, and the role and influence of an aged care accreditation programme.

Focus groups were held with 66 aged care staff from 11 Australian aged care facilities. Data from semi-structured interviews were analysed to capture categories representing participant views.

Participants reported two factors stimulating change: developments in the aged care regulatory and policy framework, and rising consumer expectations. Four corresponding effects on service quality were identified: increasing complexity of resident care, renewed built environments of aged care facilities, growing focus on resident-centred care and the influence of accreditation on resident quality of life. The accreditation programme was viewed as maintaining minimum standards of quality throughout regulatory and social change, yet was considered to lack capacity of itself to explicitly promote or improve resident quality of life.

For an increasingly complex aged care population, regulatory and societal change has led to a shift in service provision from institutional care models to one that is becoming more responsive to consumer expectations. The capacity of long-established and relatively static accreditation standards to better accommodate changing consumer needs comes into question.

This is the first study to examine the relationship between accreditation and residential aged care service quality from the perspectives of staff, and offers a nuanced view of “quality” in this setting.

The purpose of this paper is to describe an inventory of the strategic responses of institutional providers of mental handicapped care to the strengthening of consumer choice through a personal care budget (PCB)

Semi structured interviews were conducted among 26 providers covering 52 per cent of the total market volume of about 100,000 clients annually.

A representative number of providers was included; on average a percentage below the national average of PCB users was found to be served. Of the 26 providers, 16 indicated adaption to their strategy in response to expected consumer empowerment. The actual deployment of this response in the organisations seemed not to be very thorough or explicit. Surprisingly, as a growing part of PCB‐clients choose alternative providers, no concerns were raised concerning the possible emergence of new service providers.

Although the market share of PCB users is growing fast and existing providers do not seem to absorb this accordingly, a lack of market analysis and strategic behaviour of the traditional providers in response to this development was found. Based on this research growth of market shares of disruptive service providers can very well be anticipated.

This paper aims to examine the role of information and communication technology (ICT) in the knowledge creation practices adopted by a health care organization. The organization is delivering care to patients of a genetic disorder, called the sickle cell, in tribal communities. The paper identifies how ICT intermediates knowledge creation practices across the organizational boundaries wherein tribal patients, front-line counselors and expert physicians interact, which then produces context-specific, evidence-based medicine (EBM).

The knowledge-in-practice approach is adopted to conduct an ethnographic study of sickle cell care practices in a non-profit health care organization in Western India. The analysis focuses on ICT-mediated interactional practices among the physicians, front-line counselors, tribal patients and their families, for more than a year-long observation. These are supplemented with informal and formal interviews, archival records and vignettes based on several episodes to explicate the key knowledge creation practices.

Technology-mediated informative interactions at organizational boundaries can bridge socio-linguistic and interpretive barriers between actors, while also providing a generative structure that leads to the creation of longitudinal clinical evidence about a rare genetic disorder. Three specific ICT-entwined knowledge creation practices emerge, namely, knowing the community, increasing interactional engagement and constructing gradients of socio-clinical history. These practices generate organization-wide knowledge about the social and clinical dimensions of the genetic disorder. The findings are presented through vignettes and a novel conceptual framework.

This study identifies various useful knowledge creation practices in health care delivery for resource-constrained emerging economy contexts. Further, the study suggests that the involvement of local front-line actors and ICT can become important resources in the delivery of health care in these settings.

A novel framework is developed which demonstrates knowledge creation at organizational boundaries wherein the actors use ICT-based practices for effective delivery of health care. The proposed framework may be used by health care organizations in similar contexts providing care to marginalized communities.

The term assistive technology (AT) is relatively new but its origins go back a long way. Some of the elements of assistive technology, such as aids and adaptations, have been a feature of policies for many years. Before the late 1990s it was more usual to focus on the most common types ‐ telephones, alarms, aids and adaptations. More recently telemedicine and smart houses have come to the fore in policies and research. What is confusing now is that a variety of other terms are being used. In this paper the development of these terms in recent policies and the changing terminology are traced. It is suggested that a narrow interpretation can play down the important role of AT in enabling older people to maintain their independence but that it must be seen in conjunction with other services, especially housing.