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Family-centered practices in home-based support for families with children with an intellectual disability: judgments of parents and professionals
- Authors:
- VANDERKERKEN Lien, et al
- Journal article citation:
- Journal of Intellectual Disabilities, 25(3), 2021, pp.331-347.
- Publisher:
- Sage
- Place of publication:
- London
Background: The realization of the family-centered approach (FCA) in home-based support (HBS) for families with children with an intellectual disability (ID) in Flanders was investigated, and parents’ and family workers’ perspectives were compared. The relation between parents’ educational level, the family worker’s education, and his/her experience in HBS; and parents’ and family workers’ judgments on the realization of the FCA was considered. Method: Parents (N = 58 families) and family workers (N = 46) completed the helpgiving practices scale and the enabling practices scale. Results:The FCA was largely present, parents rated its realization higher than family workers. Considering family workers’ answers, parents’ educational level appeared an important factor for parental autonomy. Conclusions: The study confirms recent research on the realization of the FCA. Including different perspectives, a nuanced view on the realization of the FCA was obtained. Further research on the concrete meaning, interpretation, and elaboration of the FCA is needed. (Edited publisher abstract)
Care regimes on the move: comparing home care for dependent older people in Belgium, England, Germany and Italy
- Authors:
- DEGAVRE Florence, et al
- Publisher:
- Universite Catholique de Louvan. Centre Interdisciplinaire de Recherche Travail, Etat et Societe
- Publication year:
- 2012
- Pagination:
- 290p.
- Place of publication:
- Charleroi
Taking the reforms of the 1990s as its starting point, this report examines the dynamics of change experienced by Belgium, England, Germany and Italy in their home care sectors. Central to our analysis is the process of “marketisation”. This constitutes one of the major trends in all these four countries, yet its nature and impact show important national variations. The data referred to in this report relate to developments in and around various home care sectors, and cover both societal and organisational dynamics. Country-based research teams gathered the information, each team following identical methodological guidelines. This report uses official documents and grey literature from the care sector to analyse the discourses underpinning reforms in the field. The conclusions of this research will be of relevance for any country or region struggling to design a home care system for an ageing population. The coordinators of this research project have submitted a proposal for a special issue of Ageing and Society based on the main chapters of this report.
"Squeezed like a lemon": a participatory approach on the effects of innovation on the well-being of homecare workers in Belgium
- Authors:
- BENSLIMAN Rachida, CASINI Annalisa, MAHIEU Celine
- Journal article citation:
- Health and Social Care in the Community, 30(4), 2022, pp.e1013-e1024.
- Publisher:
- Wiley
Innovative programs that emerge in response to the rapidly changing care needs of older adults provide an opportunity to study the transformations in working and employment conditions within the homecare sector. This study seeks to understand how innovations introduced in the homecare sector have affected the well-being of homecare workers providing non-medical domestic support to older adults who wish to age in place. Our study is based on a participatory approach involving homecare workers exposed to two innovations in Wallonia (Belgium) that relate to flexible working hours, worker training, and technological equipment. We conducted a literature review, six semi-structured individual interviews with managers, and eight workshops based on the 'Group Analysis Method' involving 9 to 12 homecare workers. The results revealed that the innovations deteriorated working conditions, intensified occupational psychosocial risk factors, and impacted work-life balance. This gave rise to tensions that ultimately had a negative impact on the well-being of workers and on the quality of their care relationship with older adults/caregivers, while also weakening the viability of the services. The workers proposed some avenues to improve and regulate these tensions. (Edited publisher abstract)
Exploring the cost of ‘ageing in place’: expenditures of community-dwelling older adults in Belgium
- Authors:
- FRET Bram, et al
- Journal article citation:
- Ageing International, 45(3), 2020, pp.209-229.
- Publisher:
- Springer
- Place of publication:
- New York
This paper aims to give an overview of the different sources of income and the expenditures of community-dwelling older adults and to what extent they can make ends meet to explore the affordability of care and support at home. Despite research on the affordability of residential care, evidence on the cost of ‘ageing in place’ is still missing. 173 questionnaires were gathered within a non-random sample of community-dwelling older adults (60+). Both frequencies and bivariate tests (to explore whether there are certain risk groups with low incomes and high expenditures) were performed on the data. Results indicate the variety of income sources, the necessity of financial compensations to make ends meet and that especially older women and older tenants are at risk for facing financial difficulties. Also, this research indicates that ‘ageing in place’, especially for older adults with care needs, is not always affordable and can be a challenge within our ageing society. (Publisher abstract)
Cost‐effectiveness of an in‐home respite care program to support informal caregivers of persons with dementia: a model‐based analysis
- Authors:
- VANDEPITTE Sophie, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 35(6), 2020, pp.601-609.
- Publisher:
- Wiley
Objectives: To evaluate cost‐effectiveness of an in‐home respite care program in addition to standard community‐based dementia care to support informal caregivers of persons with dementia compared with standard community‐based dementia care. Methods: An age‐dependent decision‐analytic Markov model was applied from a third‐party payer and a societal perspective projecting results of a quasi‐experimental study over a time horizon of 5 years assuming a repetition of the program every 6 months. Additionally, to deal with uncertainty and to test robustness of the model scenario, one‐way and probabilistic sensitivity analyses were conducted. Results: Implementing the program resulted in a quality‐adjusted life year (QALY) gain of 0.14 in favor of the invention group compared with controls and an incremental cost of 1270€ from the third‐party payer perspective and of 1220€ from the societal perspective. Next, an incremental cost‐effectiveness ratio of 9042€/QALY and of 8690€/QALY was found in the base case, from the third‐party payer perspective and the societal perspective, respectively. The scenario, one‐way sensitivity, and probabilistic analyses demonstrated robustness of the base‐case results. Conclusion: This cost‐effectiveness analysis suggests that an in‐home respite care program in addition to standard community‐based dementia care is a cost‐effective approach compared with standard community‐based dementia care only. These findings provide more insight into the value of such services for the patient, the caregiver, and for society. (Publisher abstract)
The electronic, personalizable Rosetta system for dementia care: exploring the user-friendliness, usefulness and impact
- Author:
- HATTINKA B.J.J.
- Journal article citation:
- Disability and Rehabilitation: Assistive Technology, 11(1), 2016, pp.61-71.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Purpose: This research aimed to integrate three previously developed assistive technology (AT) systems into one modular, multifunctional system, which can support people with dementia and carers throughout the course of dementia. . In an explorative evaluation study, the integrated system, called Rosetta, was tested on usefulness, user-friendliness and impact, in people with dementia, their informal carers and professional carers involved. The Rosetta system was installed in participants‘ homes in three countries: The Netherlands, Germany and Belgium. Methods: Controlled trial with pre- and post-test measures across three countries (randomized controlled trial in Germany; matched groups in the Netherlands and Belgium). Participants completed questionnaires for impact measurement and participated in semi-structured interviews regarding usefulness and user-friendliness of Rosetta. Results: All participants agreed that Rosetta is a very useful development. They did not rate the user-friendliness of the system highly. No significant effects were found on impact measurements. Conclusion: All participants found Rosetta a very useful development for future care, and would consider using it. Since Rosetta was still in development during evaluation, a discrepancy between expectations and actual functioning of Rosetta existed, which may explain the lack of findings on the impact of the system and the low appreciation of user-friendliness.
Analysing equity in the use of long-term care in Europe
- Authors:
- RODRIGUES Ricardo, ILINCA Stefania, SCHMIDT Andrea
- Publisher:
- European Commission
- Publication year:
- 2014
- Pagination:
- 39
- Place of publication:
- Brussels
There are significant differences across social protection systems in Europe in the scope, breadth and depth of coverage of the risk to need long-term care in old-age. Together with other factors, such as education, household structure or societal values regarding care for frail older people, these differences can have a significant impact on the use of long-term care. Using SHARE data, this Research Note compares differences between European countries in the use of long-term care across income groups, for older people living at home. It analyses not only inequalities in the use of long-term care, but also differences in use that persist after differences in need have been taken into consideration, i.e. horizontal inequity. For this purpose, concentration indices, concentration curves and horizontal inequity indices are estimated for home care services and informal care. The countries analysed here are Austria, Germany, Sweden, the Netherlands, Spain, Italy, France, Denmark, Greece, Belgium and Czech Republic. The findings suggest that differences in use of home care services across income groups mostly reflect differences in need between those same groups. For informal care, the differences in use persist even after accounting for needs, and less affluent individuals are much more likely to use informal care. Some possible causes for these differences and policy implications are considered.
Service use in family caregivers of persons with dementia in Belgium: psychological and social factors
- Authors:
- ROELANDS Marc, VAN OOST Paulette, DEPOORTER AnneMarie
- Journal article citation:
- Health and Social Care in the Community, 16(1), January 2008, pp.42-53.
- Publisher:
- Wiley
This study aims to investigate whether selected social and psychological characteristics of family caregivers of persons with dementia are related to community-based service use in Belgium. Two aspects were distinguished in service utilisation: volume (number of contacts) and diversity (number of services). Within a selected region, dementia caregivers were traced via the detection of persons with dementia known to community health or social services. A probability diagnosis was made with the Geriatric Mental State and the computer algorithm AGECAT. Family caregivers of persons with dementia (N = 168) were interviewed at home by means of a structured questionnaire. Data were analysed with multiple regression analysis. Co-residence, a positive attitude towards home service use, and increased problem-solving coping were found to be direct predictors of increased diversity of services used, whereas a lower burden of behaviour problems, living apart, and increased avoidance coping were found to be direct predictors of increased volume of service use. Care recipients’ behaviour problems and functional status were not found to be related to service use. The results suggest that social and psychological factors have a larger impact on service use in family caregivers of persons with dementia, compared to objective or subjective burden. Interventions to increase awareness of relevant services, to improve attitudes towards their use and support problem-solving coping in family caregivers may be considered to increase the use of appropriate services.
Socio-economic status differences in older people's use of informal and formal help: a comparison of four European countries
- Authors:
- van GROENOU Marjolein Broese, et al
- Journal article citation:
- Ageing and Society, 26(5), September 2006, pp.745-766.
- Publisher:
- Cambridge University Press
This study investigates the variations by older people's socio-economic status (SES) (i.e. educational level and social class) in the use of informal and formal help from outside the household in Great Britain, Italy, Belgium and The Netherlands. In all these countries, it was older people in low SES groups who mostly used such help. Multinomial logistic regression analyses showed that, in each country and for both types of help, there were SES gradients in the utilisation of both formal and informal care, and that differences in age, health and marital status largely accounted for the former but not the latter. Cross-national differences in the use of both informal and formal help remained when variations in sex, age, SES, health, marital status, home ownership and the use of privately-paid help were taken into account. Significant interaction effects were found, which indicated that older people in low SES groups in Great Britain and The Netherlands had higher odds of using informal help from outside the household than their counterparts in Italy, and similarly that those in The Netherlands were more likely to use formal help than their Italian peers. The results are discussed in relation to the cultural differences and variations in the availability of formal services among the countries.
Older people
- Author:
- MANTHORPE Jill
- Journal article citation:
- Research Matters, 2005, pp.37-42.
- Publisher:
- Community Care
This article reports on studies from four continents into age discrimination in the workplace, home care support and mental health issues give valuable pointers for UK practice.