Search results for ‘Subject term:"vulnerable adults"’ Sort:
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Dreaming the impossible dream? An exploratory study on the expectations of Dutch clients with multiple problems concerning the co-production of public services
- Authors:
- BOER Lieke Reinhoudt-den, HUIJSMAN Robbert, VAN WIJNGAARDEN Jeroen
- Journal article citation:
- Health and Social Care in the Community, 29(6), 2021, pp.e240-e248.
- Publisher:
- Wiley
Currently, many policymakers try to encourage client involvement during the public service delivery process and make it a co-production. Clients are encouraged to act as active agents and embrace an integrated approach to address their problems to empower them. However, different studies have raised questions regarding to what extent these ambitions are appropriate for clients with vulnerabilities, such as clients with multiple problems. Aiming to further explore this issue, we studied the expectations of clients with multiple problems concerning the co-production of public services. We interviewed 46 clients with multiple problems at the start of their support trajectory. All 46 participants lived in five districts in Rotterdam, the Netherlands, and were recruited via community-based primary care teams. Our study indicates that co-production ambitions might not resonate with clients with multiple problems. The study shows that these clients’ expectations are driven by their feelings of being overwhelmed and stressed out by their situation, feelings of being a victim of circumstances, bad experiences with public services in the past, their evaluation of what counts as a problem and the envisioned solutions. These clients expect public service providers to take over, fix their main problem(s) and not interfere with other aspects of their lives (not an integrated approach). Although participants seek a ‘normal’ life with, e.g., a house, work, partner, children, holidays, a pet, and no stress (a white picket fence life) as ideal, they do not feel that this is attainable for them. More insight into the rationale behind these expectations could help to bridge the gap between policymakers’ ambitions and clients’ expectations. (Edited publisher abstract)
High incidence of clinically relevant depressive symptoms in vulnerable persons of 75 years or older living in the community
- Authors:
- DOZEMAN Els, et al
- Journal article citation:
- Aging and Mental Health, 14(7), September 2010, pp.828-833.
- Publisher:
- Taylor and Francis
Incidence rates of depressive symptoms and their predictors were examined in a vulnerable elderly population. In a community-based cohort, 651 vulnerable elderly people aged 75 and over were identified by means of the COOP-WONCA charts (Dartmouth Coop Functional Health Assessment Charts/World Organisation of Family Doctors). To study the incidence of clinically relevant symptoms of depression and their predictors, 266 people with no symptoms were selected and measured again for clinical relevant symptoms of depression at 6 and 18 months. Logistic regression analyses were applied to determine risk indicators. The results showed that after 18 months 48% of the elderly people had developed clinically relevant symptoms of depression. No specific risk factors were identified within this population. The article concludes that the incidence of depressive symptoms identified in the study were considerably higher than those previously found in elderly populations living in the community. A vulnerable health status is associated with a high risk of depressive symptoms.
The impact of physical distancing on socially vulnerable people needing care during the COVID-19 pandemic in the Netherlands
- Authors:
- DE VRIES Daniel, et al
- Journal article citation:
- International Journal of Care and Caring, 6(1-2), 2022, pp.123-140.
- Publisher:
- Policy Press
What was the impact of physical distancing on socially vulnerable groups needing care during the first COVID-19 pandemic lockdown in the Netherlands? The researchers conducted repeated qualitative interviews with 141 people in care relationships and 106 professionals, and two repeated surveys among older populations outside (n = 1697) and inside long-term care facilities (n = 2619). Findings show a diversity of experiences, ranging from relative calmness and feeling socially normal, to loneliness and loss of perspective. Care must be seen as essential social traffic needed to guarantee basic quality of life for these groups during disease outbreaks. Findings emphasise an empirical ethics approach to policy interventions. (Edited publisher abstract)
Theory, social work methods and participation
- Author:
- LUB Vasco
- Journal article citation:
- Journal of Social Work, 19(1), 2019, pp.3-19.
- Publisher:
- Sage
Summary: This paper examines the use of theory in social work methods geared towards promoting participation of vulnerable groups, a subject that has been barely – if at all – researched empirically. The study comprised an analysis of 46 methods documented in the database of the Netherlands Institute for Social Development and interviews with social workers and educators. Findings: Social work methods for participation are interspersed with theoretical notions. While the study shows that there is no shortage of theories in this field, what is more problematic are their use and integration. Incorporating theories in such a way that they provide an underpinning of the work method poses a challenge. Many theories appear to be presented out of window dressing, deviate from their original source in the literature, or are narrow in their paradigmatic focus, overlooking alternative theories that could promote or offer better nuanced participation perspectives. Applications: The paper proposes criteria for a ‘theoretical underpinning’ and provides suggestions for a proper use of theory in social work methods. (Publisher abstract)
Victims with mild intellectual disabilities in the criminal justice system
- Authors:
- SPAAN Nienke A., KAAL Hendrien L.
- Journal article citation:
- Journal of Social Work, 19(1), 2019, pp.60-82.
- Publisher:
- Sage
Summary: People with mild intellectual disabilities are more vulnerable to become victims of crime. Victims with intellectual disabilities can face attitudinal, procedural and practical barriers within the justice system. This exploratory study looked at obstacles encountered by victims of crime with mild intellectual disabilities in effectuating their rights, their vulnerability to secondary victimization and ways to support them. In 2014, 35 respondents from across the Dutch justice system and 10 respondents with mild intellectual disabilities-expertise were interviewed. Inductive and deductive content analysis was carried out. Resonance of findings was checked in an expert meeting. Findings: Three major problems were identified: (1) victims’ incomprehension about the process and the proceedings; (2) victims’ difficulty meeting system requirements and expectations; and (3) impact of prejudices concerning mild intellectual disabilities. A system adequately set up to deal with victims with mild intellectual disabilities could ease these difficulties. However, additional problems were identified, namely: (1) limited recognition of mild intellectual disabilities; (2) insufficient knowledge and understanding of consequences of mild intellectual disabilities; (3) issues related to accessing and accepting support; (4) communication unsuited for victims’ reading and comprehension-level. These problems influence the ability of victims with mild intellectual disabilities to effectuate their rights and increases risk of secondary victimization. Applications: Besides the importance of these findings for policymakers, results are of importance for all those working with victims or with people with mild intellectual disabilities. Individually tailored forms of support are required to overcome the identified problems. Awareness of the barriers that victims with mild intellectual disabilities may encounter will aid providing adequate support for victims with mild intellectual disabilities to exercise their rights and protect against secondary victimization. (Publisher abstract)
The ambiguity of social return policies in the Netherlands
- Authors:
- YERKES Mara A., BRAKEN Leydi Johana van den
- Journal article citation:
- Social Policy and Administration, 53(1), 2019, pp.113-127.
- Publisher:
- Wiley
Social procurement policies, which aim to create employment opportunities for vulnerable groups, such as the long‐term unemployed and the disabled, have become increasingly popular in recent years. Despite their growing popularity, empirical research on this topic is limited. Combining insights from the social policy and public administration literatures, the authors explore the development and implementation of “social return” policies by the Dutch government. These policies are a form of social procurement that require private employers to spend a percentage of public tenders to hire individuals far removed from the labour market. Social procurement appears, by definition, to be a form of social investment. However, analysis of the ideas underlying its use in the Netherlands suggests that significant contradictions exist, with evidence of neoliberal New Public Management tendencies, social investment, and the more recent form of public administration, New Public Service. Using extensive document analysis of parliamentary documents, discussions and evaluative reports from 2008 to 2014, the authors reveal the tensions inherent in the Dutch approach and discuss possible implications for understanding of social policy and administration as well as social protection. (Edited publisher abstract)
Who said dialogue conversations are easy? The communication between communication vulnerable people and health‐care professionals: a qualitative study
- Authors:
- STANS Steffy E.A., et al
- Journal article citation:
- Health Expectations, 21(5), 2018, pp.848-857. Online only
- Publisher:
- Wiley
Objective: To gain insight into how communication vulnerable people and health‐care professionals experience the communication in dialogue conversations, and how they adjust their conversation using augmentative and alternative communication (AAC) or other communication strategies. Methods: Communication vulnerable clients and health‐care professionals in a long‐term care institution were observed during a dialogue conversation (n = 11) and subsequently interviewed (n = 22) about their experiences with the conversation. The clients had various communication difficulties due to different underlying aetiologies, such as acquired brain injury or learning disorder. Results from the observations and interviews were analysed using conventional content analysis.Results: Seven key themes emerged regarding the experiences of clients and professionals: clients blame themselves for miscommunications; the relevance of both parties preparing the conversation; a quiet and familiar environment benefitting communication; giving clients enough time; the importance and complexity of nonverbal communication; the need to tailor communication to the client; prejudices and inexperience regarding AAC. The observations showed that some professionals had difficulties using appropriate communication strategies and all professionals relied mostly on verbal or nonverbal communication strategies. Conclusion: Professionals were aware of the importance of preparation, sufficient time, a suitable environment and considering nonverbal communication in dialogue conversations. However, they struggled with adequate use of communication strategies, such as verbal communication and AAC. There is a lack of knowledge about AAC, and professionals and clients need to be informed about the potential of AAC and how this can help them achieve equal participation in dialogue conversations in addition to other communication strategies. (Publisher abstract)
How older persons explain why they became victims of abuse
- Authors:
- MYSYUK Yuliya, et al
- Journal article citation:
- Age and Ageing, 45(5), 2016, pp.96-702.
- Publisher:
- Oxford University Press
Background: Elder abuse greatly impacts the quality of life of older individuals. Prevalence rates range from 3 to 30% depending on the definition used. Only about a dozen studies have explored how older victims themselves experience and explain abuse. It is essential that healthcare professionals understand the perceptions of older victims as they are among the most important groups to handle and report abuse. Design: A qualitative study on the perceptions and experiences of victims of elder abuse was conducted using in-depth semi-structured interviews. Setting: Abused individuals living independently, in residential care facilities and nursing homes. Subjects: six males and 11 females aged 63–90 years. Results: The main causes of abuse identified by older victims themselves were mutual dependency between victim and perpetrator, power and control imbalances, loneliness and a marginalised social position of older persons. Effects of abuse included negative feelings, physical and psychological distress, a change of personal norms and values, changed perspectives on money and low self-efficacy. These differential effects depended upon the types of abuse experienced and the relationship with the perpetrator. Coping strategies mentioned by victims were seeking informal or professional help and using self-help strategies. Conclusion: Older victims perceive abuse differently depending on the expected acceptability of the type(s) of abuse experienced and the anticipated stigma associated with the perpetrator involved. The effects and chosen coping strategies are influenced by these considerations and therewith also influence their help-seeking behaviour. Healthcare professionals are encouraged to use these findings in practice to prevent, detect and intervene in elder abuse. (Publisher abstract)
Depression and risk of cognitive decline and Alzheimer's disease. Results of two prospective community-based studies in the Netherlands
- Authors:
- GEERLINGS M.I., et al
- Journal article citation:
- British Journal of Psychiatry, 176, June 2000, pp.568-575.
- Publisher:
- Cambridge University Press
Investigates whether depressed elderly people with normal cognition are at increased risk of cognitive decline and Alzheimer's disease. Results found that in the two independent samples of older people used, depression was associated with an increased risk of Alzheimer's disease and cognitive decline, but only in subjects with higher levels of education
Precious memories: a randomized controlled trial on the effects of an autobiographical memory intervention delivered by trained volunteers in residential care homes
- Authors:
- WESTERHO Gerben J., et al
- Journal article citation:
- Aging and Mental Health, 22(11), 2018, pp.1494-1501.
- Publisher:
- Taylor and Francis
Objectives: This study assesses the effects of an autobiographical memory intervention on the prevention and reduction of depressive symptoms in older persons in residential care. Trained volunteers delivered the intervention. Methods: A randomized controlled trial was carried out with depressive symptoms as the primary outcome. The experimental condition received the intervention Precious Memories one-on-one, whereas the control condition had individual unstructured contacts with a volunteer. Participants were 86 older persons living in residential care. There were three measurements: pre-intervention, post-intervention (2 months after the first measurement), and follow-up (8 months after the first measurement). Besides depressive symptoms, the retrieval of specific positive memories was measured as a process variable. Anxiety, loneliness, well-being, and mastery were assessed as secondary outcomes. Results: Depressive symptoms improved equally in the intervention and the control condition at post-measurement. Participants with clinically relevant depressive symptoms also maintained the effects at follow-up in both conditions. The retrieval of specific positive memories improved more in the autobiographical memory intervention, although this was not maintained at follow-up. Anxiety and loneliness improved equally well in both conditions, but no effects were found for well-being or mastery. Conclusion: It is concluded that volunteers can deliver the intervention and contribute to the mental health of this highly vulnerable group of older adults. (Edited publisher abstract)