Dissertations / Theses on the topic 'Community home-based elderly care service'

Large numbers of baby boomers and a shift towards home-based long-term care designate a need for a greater understanding of caregiver attitudes surrounding the financing of long-term home-based care. This study examined more fully the types of home-based long-term care services that family caregivers were utilizing for their parents. In addition, the willingness and ability of caregivers to privately fund these services for aging parents were explored. The study utilized a preexisting data set of qualitative interviews that were conducted with 30 family caregivers helping to provide long-term care for an elderly parent or older-generation relative. Participants in the sample used many home- and community-based services such as home health aides and nurses, physical therapists, cleaning services and adult day centers. Often these services were funded via Medicare, Medicaid, care recipient funds, state programs, and caregiver funds. In addition, caregivers were often willing, but unable to pay for long-term parent care on their own. Many caregivers in the study found paying for long-term parent care unnecessary. Family expectations, moral and religious responsibility, and a high aversion to nursing home care were cited as reasons for willingness to fund long-term care at home. Similarly, lack of family support and other personal obstacles were noted as reasons for inability to pay for care. Those who found payment for care unnecessary noted that care recipients had sufficient funds for their own long-term care.

Worldwide, the numbers of people living with chronic conditions are rapidly on the rise. Chronic illnesses are enduring and often cannot be cured, requiring a strategy for long term management and intervention to prevent further exacerbation. Globally, there has been an increase in interventions using telecommunications technologies to aid patients in their home setting to manage chronic illnesses. Such interventions have often been delivered by nurses. The purpose of this research was to assess whether a particular intervention that had been successfully implemented in the United Kingdom could also be implemented in Canterbury. In particular, this research assessed the perspectives of Canterbury based practice nurses and district nurses. The findings suggest that a majority of both district and practice nurses did not view the service as compatible with their current work situation. Existing workload and concerns over funding of the proposed service were identified as potential barriers. However, the service was perceived as potentially beneficial for some, with the elderly based in rural areas, or patients with chronic mental health needs identified as more likely to benefit than others. Practice nurses expressed strong views on who should deliver such services. Given that it was identified that practice nurses already have in-depth knowledge of their patients’ health, while valuing the strong relationships established with their communities, it was suggested that patients would most benefit from locally based nurses to deliver any community based health services in the future. It was also found that teletriaging is currently widely used by practice nurses across Canterbury to meet a range of health needs, including chronic mental health needs. This suggests that the scope of teletriaging in community health and its potential and full implications are currently not well understood in New Zealand. Significant events, such as the Christchurch earthquakes indicate the potential role of teletriaging in addressing mental health issues, thereby reducing the chronic health burden in the community.

In many developing countries including South Africa, there is an overwhelming number of people infected with HIV/AIDS in the hospitals, which the health care workers are unable to cope with. Therefore, an urgent need to develop alternative community based activities such as support groups, home based care programs and placement of 
orphans, for the provision of social health care services to the HIV client, arises. However, a deeper understanding of the challenges facing community organizations when 
providing home based care is crucial and necessary in order to formulate effective and relevant care services. The aim of the study was to explore the challenges faced by Umtha 
elanga Community Organization (UWCO) in the provision of HIV/AIDS home based care. The objectives of the study were to assess the current home based care of the UWCO and to explore the challenges that community based organizations have to face when providing care services to people being infected and affected by HIV/AIDS. The research design undertaken was the case study of UWCO. The qualitative approach with in-depth interviews with the 
management staff and home based caregivers was utilized. Data analysis began immediately after the interviews by transcribing and translating the audio-taped data. Thematic analysis was used in which data was coded and categorized. The findings of the research 
indicated that the home based care programme assists PLWHA clients in their natural home setting. All home based carers work voluntary and get supported by the organization as 
ell as by the department of social development and health such as the social workers. Finances appear to be, both for the organization and the home based carers, a huge 
hindrance. Research indicated that the organization experiences various challenges to provide the service to their community. It is recommended that Government must ensure that 
home based care workers get recognition, credit and support for their valuable contribution. Training for HBC employers needs to be extended to expose and add more skills. This 
will ensure that they are equipped for their tasks. Home based care workers must become registered and paid better salaries by the government.

Against a background of global ageing, the problem of ageing has become the basic national condition of China in the 21st century. China's ageing population presents the following characteristics: it is a large-scale, rapid process, an "ageing but not affluent society"; with an inclination to senility, and large regional differences. Wuhan City, in the Hubei Province, is a core city of central China. The basic characteristics of ageing in Wuhan are consistent with the national characteristics. China's rapid ageing coexists with a social background of not affluent population. As the ageing problem becomes gradually more serious, Community Home-based Elderly Care Services (CHECS) will also come under increasing pressure. With the availability of CHECS in China, as well as in Wuhan City, being restricted by scarce social resources and, therefore, unable to meet elderly's demand for services, the supply and demand for CHECS is seriously unbalanced. With the aim of solving this dilemma, the following research objectives have been defined in this thesis: the definition of CHECS and the reason for taking it as the basic supporting system for the elderly; the content of CHECS in Wuhan and the influencing factors of the elderly’s demand for CHECS; the review and analysis of elderly care policies in China and Wuhan City over the last 20 years, including the identification of current supply problems and influencing factors; a theoretical model of CHECS demand and supply is formed; and suggestions on improving the CHECS system in Wuhan are put forward. This thesis uses the Grounded Theory approach and qualitative research methods, including document analysis, participatory observation and in-depth interviews for data collection. Theoretical categorization of collected data was carried out with the coding method that allowed main categories to be extracted and the relationship between categories to be identified to form a substantive theoretical framework of the Demand and Supply of CHECS. In its analysis of the supply of CHECS, this thesis has thoroughly combed through the development context and content of China's elderly care policy in the past two decades, and identified two stages for China's elderly care policy: the normative development stage and the improving stage. Based on the influencing factors analyses, the CHECS demand and supply theoretical model was built. A further finding was that under the limited influence of government and limited resources, the supply of elderly home based care services by the community undergoes a dual problem of policy formulation and policy implementation, which arises from the defects present in the relationship between the different service provision actors.
Sob o pano de fundo do envelhecimento global, o envelhecimento tornou-se um problema nacional básica da China no século XXI. O envelhecimento da população Chinesa caracteriza-se por ter sido um processo rápido e em larga escala, por resultar numa sociedade envelhecida, mas não afluente, uma tendência para a senilidade e pela existência de grandes diferenças regionais. A cidade de Wuhan situa-se na China central na província de Hubei. As características básicas do envelhecimento em Wuhan são consistentes com as características a nível nacional. O rápido envelhecimento da China coexiste com um contexto social de carência. À medida que o problema do envelhecimento se torna mais sério, os serviços comunitários de assistência domiciliária (CHECS) sentem uma pressão acrescida. Com os escassos recursos disponíveis quer na China, quer na cidade de Wuhan, é impossível responder à procura deste tipo de serviços, o que provoca um desequilíbrio sério entre a procura e a capacidade de oferta. Esta tese tem como principal objetivo resolver este problema, tendo sido definidos os seguintes subobjetivos: a definição de CHECS e a justificação para ser considerado como serviço básico de apoio à população idosa; o conteúdo deste tipo de serviço em Wuhan e os fatores que influenciam a sua procura pelos idosos; revisão e análise das políticas públicas de apoio aos idosos nos últimos 20 anos, na China e em Wuhan, incluindo a identificação dos atuais problemas e dos fatores que influenciam a oferta de serviços; desenha-se um modelo teórico para a procura e oferta de CHECS; e propõem-se sugestões para a melhoria do CHECS em Wuhan. Esta tese usa a metodologia da Grounded Theory e métodos de investigação qualitativos, incluindo a análise documental, a observação participativa e entrevistas em profundidade, para a recolha de informação. Dos dados recolhidos foram extraídas categorias teóricas com a ajuda do método de codificação, tendo sido também identificadas as relações entre categorias, bem como o quadro conceptual para a Procura e Oferta de CHECS. No âmbito da oferta de CHECS, esta tese examina em detalhe o desenvolvimento contextual e o conteúdo das políticas publicas chinesas de apoio aos idosos nas últimas duas décadas, tendo identificado dois estádios: o estádio de desenvolvimento normativo e o estádio de melhoria. Constrói-se um modelo teórico para a procura e oferta de CHECS com base nos fatores explicativos das duas variáveis. Perante a influência limitada do governo e a existência de recursos limitados, é possível concluir que a oferta de serviços comunitários de apoio domiciliário à população idosa de um duplo problema de formulação e implementação das políticas, derivado das deficiências presentes na relação entre os diferentes fornecedores de serviços.

碩士
靜宜大學
社會工作與兒童少年福利學系
104
"Aging in place" is the goal of long-term care policy is currently driven in many advanced countries, and continuity of care is an important policy planning principles, the present study was to investigate in order to service users for the study of the main viewpoints, understand service users true feelings and community-based day care services involved in their personal and family support and what impact, which explore the use of day care services experience and process recommendations, summarized and analyzed in order to post as community-based day care services to promote the relevant professional, practice, reference policies. This study adopted qualitative research through interviews with service users understand the use of community-based day care services and process experience, the results show, community-based day care service contains a wealth of resources, and also provides substantial support to service users connotation , includes support for service users themselves, family and community; the service provider process, service providers need to understand the deeper clients and geographical differences, in order to make timely adjustments; but for policy-related cognitive still insufficient, the need to further strengthen the push. After the findings were based on analysis and discussion collate for professional and practical side, the policy side put forward specific proposals. 1.To enhance services and meals to provide individualized service planning. 2.Strengthening the family caregiver support services. 3.Provide enough space, we need to consider the space environment and regional connotations. 4.Strengthen service announcements to increase awareness and public awareness. 5.Enhance service quality assurance mechanisms. 6.Can enhance near and practical services. 7.The development of diversified day care service model.

博士
東海大學
社會工作學系
99
The hierarchical needs and service types of community-based long-term care for the elderly in Taiwan Hui-Chen Su Abstract 　　The purposes of this research are to explore the needs in Taiwan for community-based long-term care and its influencing factors, understand the community-based long-term care needs for the elderly and the opinions of practitioners, specialists, and families on the service types of the elderly, and thus serves as suggestions for the policy making and the development of community-based long-term care for the elderly in Taiwan. 　　The quantitative research method combined with qualitative research method was applied to this research. The quantitative research was based on the database of (the fifth) long-term investigation into the physical and mental conditions of the middle-aged to senior citizens in Taiwan. Among them are those aged 65 and above, deducting live-ins in the nursing homes or assisted living facilities. A total 2,659 items of data went through secondary data analysis, including the frequency distribution, percentile, linear regression analysis, hierarchical multi-linear regression analysis. The latter, based on purposive sampling, selected the elderly （6 persons）, families （4 persons）, snowball sampled practitioners（8 persons）, and then convenience sampled the specialists（4 persons）.After the in-depth interviews conducted by the semi-structural questionnaires examined by the specialists, the content of this study was analyzed based on the interpretations of phenomenology and content analysis. Finally, combined with the quantitative and qualitative research results, this research underwent integrated analyses and discussions and turned out to be the findings of integration. 　　The findings of this research are as follows：（1） The significant difference in the demography variable in physical health, mental health, social care（P＜.001）.（2）The impact of social psychologically related variable on the the degree of life satisfaction has a larger impact than physiological health needs，the social care needs are related to the physical and mental health needs.（3）In light of community-based long-term “needs” service users, the main caregivers, service providers and the specialists have points of similar and different views.（4）The aforementioned four items of data providers have similar and different points of view in light of community-based long-term care “service.” In lieu of these, the researcher propose the philosophy of immersing three-section five-level community-based long-term care hierarchical needs into the elderly care, highlighting “seven wholesome” care. In addition, this research provides twenty two suggestions as references separately for the governmental sectors, community-based long-term care service provider, community elderly-to-be, future researchers in developing the community-based long-term care needs and service types in Taiwan. Key words：the elderly , community-based long term care, hierarchical needs, types of service

The goal of this study is to examine the impact of formal home care on the spousal caregiver’sphysical and mental health. From a sample of 6.136 caregivers, who participated in the SHAREsurvey, 23% received formal home care. This project uses different methodologies: OrderedProbit regressions, Propensity Score Matching, and Fixed Effects estimation. The analysisrevealed that formal home care has no impact on caregiver’s physical and mental health, thatmale caregivers are more likely to benefit from it and seem to have a better overall experience.Also, the health status of the care receivers has a positive impact on caregiver’s health.

博士
國立成功大學
工程科學系
103
To address of the trend of population aging and declining birth rates, as well as the emergence of cloud services, this study proposed an event-driven architecture-based model to support collaborative distributed services. The proposed model can accommodate loosely coupled distributed services aimed at providing home care services for elderly adults who live alone through the development of an interactive home care service model; thus, the proposed model facilitates providing immediate safety and health management. The event messages of the proposed system architecture were based on the Health Level 7 (HL7) protocol. Thus, the system can provide rapid support for medical treatment and is compatible with all HL7-based medical information systems, thus enabling medical staff to provide immediate assistance to elderly adults in the event of an emergency. In recent years, population aging has been an ongoing concern. As societies gradually transition to an aging society, providing care for the elderly population becomes a crucial issue. Therefore, this paper also presents a mechanism for providing long-term care through a body sensor network (BSN) to ensure the mobile security and emergency monitoring of elderly adults. Moreover, the proposed mechanism can further facilitate providing welfare services for elderly adults as well as necessary information and assistance for medical personnel. This study focused on investigating health care by analyzing BSN data. The concept and learning mechanism are introduced to demonstrate how the proposed system can fulfill follow-up processing and applications. Moreover, because the BSN is powered by batteries, it effectively uses 45% less power than full-speed transmission networks operating under normal conditions. Thus, effective long-term monitoring is demonstrated in this paper.

碩士
健行科技大學
電子工程所
101
The home care for the elderly has become one of the major problems in our society. The elderly living by themselves encounter difficulties in finding someone instantly to assist with the regular tasks in daily lives from time to time, such as going to the hospital for treatments, preparing own meals, repairing house electronic devices. In addition, the elderly usually suffer from chronic diseases that require the family members or caregivers to monitor related data constantly (for example- the blood pressure) to reduce the risks of the diseases. With highly-developed Internet environment, the popularity of the elderly using social network website has gradually increased. However, the user interface (UI) of most of the existing social network websites and instant messaging software are not user-friendly to them. Therefore, the object of the research is to build a caring system through cloud services with user-friendly touch UI and to recruit volunteers with a variety of professional background in order to solve the problems for the elderly in their daily lives. The cloud caring system shall be as well as an ideal social network platform among their family, friends, or caregivers in terms of communication and discussion.

博士
東海大學
社會工作學系
106
Using Weichen residential community in Yilan County as an example, this study analyzed the development, constraints, and challenges of elderly care in the community, and examined the following topics: 1. The process and reasons behind elderly care service development in Weichen community; 2. The opinions and expectations of the community stakeholders; and 3. Feasible community-based elderly care services that can be developed based on the services in Weichen community. Accordingly, this study adopted a case study design. Purposive sampling was used to select Weichen community as the research sample, and the stakeholders of the community who were engaged in the community’s elderly care services were adopted as the units of observation. A total of 17 stakeholders were interviewed, which comprised 7 community managers, 3 volunteers, 4 older residents, and 3 residents with older family members. Participant observation, in-depth interviews, and document analysis were used for data collection and the collected data were analyzed using qualitative content analysis. From examining the development process of elderly care services in the community, this study found that the community residents had the following opinions and expectations: (1) aging in place; (2) residents being the caregivers of the older adults in the community; (3) flexibility for care service staff in providing community and home health care; (4) subsidies for employing foreign caregivers; (5) more attention and companionship to older adults in the community; and (6) small-scale multifunctional services in the community. On the basis of Weichen community as the research location, this study identified the following areas for developing elderly care services: (1) professional and diversified development in community-based elderly care services; (2) improvements in transportation services; (3) increased resources for medical healthcare; and (4) making community care centers available across all regions. The key factors to the successful development of community care in Weichen community were: (1) the initiators and team had a clear sense of mission and strong capabilities; and (2) courses and activities were held continually, which facilitated community cohesion and consensus. Thus, providing talent training and continuous community courses and activities are conducive to establishing community care mechanisms. The author proposed the following suggestions for the development of future community-based elderly care services in Weichen community: (1) increase the frequency of buses, subsidize shuttle buses for medical care, and provide community-based shuttle buses to alleviate transportation problems; (2) increase the number of operating hours available for medical visits at the community medical station, establish telehealth service systems, and provide shuttle bus services for medical care; (3) establish a community care network by linking institutions, schools, and community residents; (4) allow staff members of local community care services to serve older adults in their own communities and provide flexibility for them to provide day care and home health care services; (5) subsidize the expenses for employing foreign caregivers and increase the subsidies for long-term care as per the approved number of hours; (6) increase the number of locations for providing community care services according to the geographical location and the older adult population ratio; and (7) establish small-scale multifunctional services according to the care service locations in Weichen community. Through the conducted analyses, this study hoped to outline the development process of and challenges faced by community-based elderly care services. By integrating relevant experiences in community care, the findings of this study can serve as a reference for Weichen community in overcoming future challenges and developing innovations as well as for designing and implementing multifunctional community care services designs aimed at aging in place.

碩士
臺北醫學大學
醫務管理學系
92
The caring for the elderly is not only a challenge of community medicine but also an important issue in our society. The elderly hope to live longer as well as live with dignity. This study aims to offer a community-based day care services program for the elderly. In this program, the team consisting of health professionals, social welfare specialists and the volunteers living in the community provided services including blood pressure measurements, health consulting, appropriate exercises teaching, birthday celebrations, tuition lunch, phone call concerning, and home visits twice a week with about three hours per service for the community elderly. The purposes of the study are to explore (1) the reduction of the depression of the elderly and (2) the promotion of health related quality of life for the elderly, through the program. This research employed a quasi-experimental design. A total number of 174 elderly aged 65 or above who live in Central Community and Chen De Community in Taipei City were voluntarily selected to participate in the program. They were divided into two groups; The experimental group contained 82 participants who received the community-based day care services program, and the control group contained 92 participants who did not. The duration of the experiment lasted for 6 months from November 16, 2003 to May 15, 2004 and 167 participants have finished the experiment. A structured questionnaire consisting of demographic characteristics, health status, depression scales, social support scales, well-being scales and health related quality of life (the SF-36) were given to each participant at the beginning and at the end of the experiment. Standard statistical methods such as Paired t-test, analysis of covariance, Pearson correlation and regression analysis are used to analyze data by the software SPSS 10.0. The results of this study are summarized as follows. After the intervention of the community-based day care services program, (1) the participants in the experimental group showed significant reduction on the depression status, while those of the control group did not. And the predictors impacting the depression of the elderly are the engagement in this program or not, mental component summary, the satisfaction of social supports, economic status and the cognition function. Moreover, they can explain the variation of the depress status with 50.2%. And (2) the participants in the experimental group also showed more significant promotion on health-related quality of life than that of the control group did. Besides, the predictors impacting the health-related quality of life of the elderly are the engagement in this program or not, the satisfaction of social supports, the number of chronic diseases suffered, the economic status and the education level. Moreover, they can explain the variation of the health-related quality of life with 40.6%. The result of this study offers a concrete and effective community-based day care services program to help the elderly at high risk reduce their depression and promote their health-related quality of life. The health department and the social welfare department can extend it to each community to make the dream “aging in place” come true for the elderly.

There is compelling evidence for the effectiveness of home-based occupational therapy and physiotherapy rehabilitation for community dwelling elderly who may struggle with basic activities and the functions of daily living and mobility. Nonetheless, an estimated 2% of home care’s elderly clients receive these therapies. Ontario’s home care data indicates that 78% of clients that could benefit from these specific therapies are not receiving them. The study examined a subset of elderly clients receiving home care following a hospital discharge during 2009-2010. The aim of this study was to: understand the difference between those home care clients who received occupational therapy or physiotherapy and those who did not; and determine if receiving these therapies impacted the utilization of hospital emergency departments and inpatient admissions. A retrospective cohort design and multivariate and survival analysis of hospital and home care administrative data structured the study. Results suggest that home-based rehabilitation is offered to a minority of the home care population. Distinct client characteristics and process variables significantly associated with the increased likelihood of receiving home-based occupational and physical therapies included: clients who were older, females, admitted to home care from hospital inpatient units, assessed as non-acute for clinical and service needs and required more home making support and assistance with activities of daily living. Almost one quarter of the total sample returned to hospital. Visits to emergency departments accounted for the greater part of hospital utilization and primarily for sub-acute general symptoms and signs, post-procedural complications, infections or acute episodes from chronic obstructive pulmonary disease and renal failure. Slightly over half of the clients returning to hospital did not receive home-based rehabilitation. Clients who received occupational therapy returned to the hospital sooner following their home care admission whereas clients receiving physiotherapy spent the longest time before rehospitalizing. The majority of the clients receiving occupational therapy were admitted to home care having just resolved sub-acute conditions or symptoms, many of which are known to influence functional and physical decline. Moreover, analysis of process variables indicated that the wait time for a referral to occupational therapy was two times longer compared to physiotherapy. These same clients also waited, on average, over one month before an occupational therapist’s first visit. The need to discriminate who receives home-based rehabilitation is essential to understanding how specific therapies contribute to improving systems outcomes. This study is the first examination that focuses specifically on home-based occupational therapy and physiotherapy rehabilitation and the client characteristics and process variables associated with receiving/not receiving these therapies and the impact these factors have on the time-to-rehospitalization.
Thesis (Ph.D, Rehabilitation Science) -- Queen's University, 2013-06-27 12:24:53.085

Background: The past two decades have witnessed transition from in-patient hospital settings to Community and Home Based Care in Zimbabwe. This is because of an increase in the number of people developing chronic health conditions such as diabetes, hypertension and cancers, and thus needing longer treatment durations. The increase in chronic conditions has mainly been attributed to the increase in incidence and prevalence of Human Immunodeficiency Virus and Acquired Immune-deficiency Syndrome in Sub-Saharan Africa. Many Governments, including that of Zimbabwe, endorsed and promoted community and home based care to provide a continuum of care to the chronically ill. Despite the implementation of Community and Home Based Care programmes, no studies known to the researcher have been done to investigate the congruency of service users’ needs and the programme goals. Purpose: The purpose of the study is twofold; firstly to explore whether Community and Home Based Care interventions provide services that effectively meet users’ goals in a dynamic social environment and secondly, to develop guidelines for enhancing care provision as well as congruency of service users’ needs and programme goals. Methods: A mixed-method approach combining qualitative and quantitative data collection and analysis was used. Concurrent collection of data with equal status was placed on both qualitative and quantitative data. For qualitative data interviews and focus groups were used with home based care service users, family care givers, and health providers. Structured questionnaires were used for the quantitative data. Framework: Imogene King’s Interacting Systems Framework and Theory of Goal Attainment were adopted to guide the study. These were utilised because of the assumption that mutual agreement on goals for effective care can be achieved through nurse-client interactions and communication Research findings: Community and Home Based Care programme in Zimbabwe does not comprehensively meet the needs of its service users. Service users have diverse needs and goals depending on the specific condition and symptoms they experience. They perceive access to medication for symptom management and pain control, food and financial stability, as priority needs. The study found that nursing services provided in Community and Home Based Care generally align with the physical needs of service users and was deficient in addressing the socio-economic and psycho-social needs of service users. Conclusion: No single sector can achieve the users’ and the programme`s goals of quality health on its own. The goals may only be realised when other stakeholders and relevant sectors contribute to the Community and Home Based Care programme, which requires diverse resources. Guidelines to enhance integration of Community and Home Based Care with social services were developed.
Health Studies
D.Litt. et Phil. (Health Studies)

Home First is an Ontario transition management approach that attempts to reduce the pressure on hospital and Long Term Care (LTC) beds through early discharge planning, the provision of timely and appropriate home care, and the delay of LTC placement. The purpose of this qualitative descriptive study was to obtain descriptions from South Eastern Ontario Home First clients and their family caregivers of their experiences with and thoughts about care transitions, the provision of care, and the Home First approach. The goal was to enable insight into the Home First approach, care transitions, and the provision of care through access to the perspectives of study participants. Nine semi structured interviews (and one or more follow-up calls for each interview) with Home First clients discharged from hospitals in South East Ontario and their family caregivers were conducted and their content analyzed. All participating Home First clients were pleased to be home from hospital and did not consider LTC placement a positive option. All had family involved with their care and used a mix of formal and informal services to meet their care needs. Four general themes were identified: (a) maintaining independence while responding (or not) to risks, (b) constraints on care provision, (c) communication is key, and (d) relationship matters. Although all Home First clients participating in the study were discharged home successfully, a sense of partnership between health care providers, families, and clients was often lacking. The Home First approach may be successfully addressing hospital alternative level of care issues and getting people home where they want to be, but it is also putting increasing demands on formal and informal community caregivers. There is room for improvement in how well their needs and those of care recipients are being met. Health professionals and policy makers must ask caregivers and recipients about their concerns and provide them with appropriate resources and information if they want them to become true partners on the care team.
Thesis (Master, Rehabilitation Science) -- Queen's University, 2013-05-23 16:10:53.323

碩士
實踐大學
家庭研究與兒童發展學系高齡家庭服務事業碩士在職專班
107
In 2018, Taiwan became aged-society which more than 14% people are over 65 years old in Taiwan. Based on dramatically changed of Social structure, economic activities, ethical and moral values, family caregivers, who taking care disabled elderly, are facing how to make the decision in terms of balance decreasing family resources and increasing governmental community-based care services for the elderly. This study explored the decision-making process and examined the reasons for family caregivers by using community-based long-term care services based on the perspective of social exchange theory. Face to face half-structural interviews were created. Eight family members were interviewed, including those disabled elders who are currently using day-care services, living in group homes, respite care in assisting living facilities or family caring services for at least 6 months. After analyzed and categorized the written interview data, the study found that the understanding, assessment and post-serviced assessment are important references to make decisions for family caregivers. To choose the patterns of care services are based on different health conditions of the disabled elders. Family caregivers also look for help from external sources for the lack of internal information. When having different opinions, family members tend to protect themselves’ best interests and would reach common views by offering benefits. Elders lost their exchanging advantages during their aging process. Suggestions: Caring for elders were no longer a family problem. The aged Taiwan is badly in needs of a sound and continuous elder-caring services. Public knowledge should not be ignored when government carrying out elder-caring related policies. Families should communicate caring expectation when elders are healthy.

碩士
國立成功大學
老年學研究所
101
To face the population aging in Taiwan, there is not only more active treatments for elder people by medical technology improvement, aggressive continuation of rehabilitation therapy service after treatment are demanded. Through the provision of rehabilitation therapy service, more and more elderly people may not only achieve disease recovery and functional improvement, decrease the possibility of functional disability, but also increase the quality of life. Home and community-based physical therapy play an important role in the rehabilitation service. However, what is the whole home and community-based physical therapy service delivery model and what is the predicament of this model in long term care system in Taiwan? This is the subject of concern in this study. The method of this study was literature review and expert interviews to analysis and explore. Through export interviews and the operation method of system review, collecting and organizing the literature by the key words: rehabilitation, community, home, long term care, Physical therapy, and elderly, in order to realize that the status of home and community-based physical therapy service delivery model and ideal model may development in the future. The result indicated that home and community based physical therapy service could improve most of the physical and functional ability and quality of life. The ideal service model is indirect service with appropriate needed evaluation. Physical therapist and related physical therapy professional association should not only advertise the content of community-based physical therapy service to people and professions, but also supervise and urge the government and legislative office to pass related acts.

In South Africa prior to 1994, community-based care and support services were established for whites only. The majority of older African (black) persons received informal support from their adult children and relatives. This has waned over the years due to the social and economic changes that have put into doubt the continued viability of such support. The Older Persons Act of 2006 requires social workers to establish community-based care and support services for older persons. Hence, the study was conducted to understand the factors that influence social workers in establishing CBCSS for older persons in Bloemfontein in the Free State Province. A qualitative research method was undertaken to accomplish the goal of the study. Purposive and snowball sampling techniques were used to identify suitable participants. Face-to-face semi-structured interviews were conducted with fifteen social workers who provide services to older persons. The data was analysed through Tesch’s (cited by Creswell, 2009:186) eight steps of qualitative analysis and data verification was conducted following Guba’s (Kreftling, 1991) model. The major finding is that there is a need for social workers to specialise in older persons programmes (gerontology). For the programmes to be a success, it is recommended that the Department of Social Development (DSD) strive to retain social workers who are knowledgeable and experienced in older persons programmes.
Social Work
M.A. (Social Science)

Text in English
With the Acquired Immune Deficiency Syndrome (AIDS), first recognised in 1981 as a new disease that subsequently took on pandemic proportions, home-based caregivers became instrumental to ensure that, notwithstanding the encumbered health care systems, people living with HIV and AIDS (PLWHA) receive care, support and treatment within their households to live prolonged dignified lives. Despite their pivotal role in the field of HIV and AIDS care, there seems to be a dearth of literature, and research locally and internationally, from the ambit of Social Work on the topic of how HBCGs manage and cope with the work-related challenges they experience when caring for PLWHA and their need for Social Work support. Through this exploratory, descriptive, contextual and phenomenological qualitative study, I scrutinised the HBCGs’ experiences and associated challenges and the coping strategies they employ to address these challenges as well as their views on how social workers could support them in overcoming these challenges in the specific case on home-based care to PLWHA. Twenty-five HBCGs were identified and recruited through purposive and snowball sampling techniques from twelve home-based care organisations in South African provinces, namely, North West, Limpopo and Gauteng. Data was collected through individual face-to-face semi-structured interviews using an interview-guide. Data analysis was conducted through Tesch’s eight steps (in Creswell 2014:189) while Guba’s model (in Shenton, 2004) was adopted for data verification. Cast against Loretta Williams’ (2014) middle range theory of caregiving dynamics (Williams 2014), the coping theory of Lazarus and Folkman (1984) and the strength-based perspective (Saleebey, 2013) adopted as theoretical frameworks for this study, the following findings were revealed. The HBCGs were motivated by, among other factors, their mere desire to care for PLWHA; their personal experiences of caring for an ill relative; and future career aspirations to become involved in this care work. HBCGs were found to face various work-related challenges in connection with reactions from community members, the patients and their relatives; their unsafe working conditions; as well as from their colleagues, other role players and their own organisations. It was found that for most of the HBCGs their care work saddened, pained and discouraged them. In the midst of feeling sorry for their patients, they feared getting infected themselves, in addition to their work-related challenges that caused them to experience feelings of failure. The strategies adopted to cope with their work-related challenges included getting support from employers, receiving counselling and becoming involved in support groups. Finally, several suggestions were directed to the management structures of HBC organisations, the HBCGs themselves and social workers on how they could address the work-related challenges. Based on the research findings, some recommendations are forwarded concerning guidelines for Social Work support directed at work practice, policies and programmes; associated education and training endeavours; and continuous professional development initiatives, as well as avenues for further research.
Social Work
D. Phil. (Social Work)