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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences & Services".

Deadline for manuscript submissions: closed (31 October 2020) | Viewed by 14151

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Special Issue Editor

Prof. Dr. Liat Ayalon

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Guest Editor

School of Social Work, Bar-Ilan University, Ramat Gan 5290002, Israel
Interests: ageism; the intersection of formal and informal care; home care; migrant workers

Special Issue Information

Dear Colleagues,

Most older adults and their family members prefer to age at home. As a result, institutional care is often used as a last resort. Because of a variety of demographic changes, including the increase in lifespan, the reduction in childbirth, the move towards nuclear families, and the entrance of women into the workforce, family care is often supplemented by paid care at home. Home care workers usually do not have formal training in the delivery of care, yet they are responsible for a large chunk of the caregiving tasks worldwide. Past research has shown that when paid home care workers are involved in the care, family members do not relinquish responsibilities. Instead, care is divided so that family members provide instrumental care and supervision in an attempt to ensure adequate care, whereas personal care is provided primarily by paid home care workers. As the provision of home care services to older adults is often seen as a low-status job, there is a shortage of paid home care workers worldwide. As a result, migrants tend to capture paid care positions in many countries. This Special Issue aims to address the home care arrangement from multiple perspectives, with an emphasis on the impact of this care arrangement on older adults, their family members, the home care workers, and society at large.

Prof. Dr. Liat Ayalon
Guest Editor

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Keywords

long-term care
home care
older adults
migrants
globalization
welfare
caregiving
aging in place

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Published Papers (5 papers)

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Research

15 pages, 1442 KiB

Open AccessArticle

Evaluation of Reablement Home Care: Effects on Care Attendants, Care Recipients, and Family Caregivers

by Yu-Hsien Chiang, Hui-Chuan Hsu, Chiung-Ling Chen, Chen-Fen Chen, Shu-Nu Chang-Lee, Ya-Mei Chen and Shang-Wei Hsu

Int. J. Environ. Res. Public Health 2020, 17(23), 8784; https://doi.org/10.3390/ijerph17238784 - 26 Nov 2020

Cited by 7 | Viewed by 3170

Abstract

Background: The traditional home care model entails caring “for” people with disabilities, not “with” them. Reablement care has been applied to long-term care, but the evidence for care attendants, home care recipients, and family caregivers simultaneously is limited. Methods: First, a survey was conducted to explore the needs of home care recipients and family caregivers to achieve independence at home to develop the reablement home care model for home care. Then, an intervention with two groups was implemented. The experimental group included a total of 86 people who participated in the reablement home care model. The control group included 100 people and received usual home care. The self-reliance concept, job satisfaction, and sense of achievement for care attendants; quality of life for home care users; and caregiving burden for family caregivers were assessed. Results: The reablement home care model improved the job satisfaction and achievement of home care attendants, improved mutual support and independence in the self-reliance concept and quality of life among the users, and reduced the stress of the users and family caregivers. Conclusion: The reablement home care model improved the outcomes for providers, care recipients, and family caregivers. Reablement home care is suggested in long-term care policies. Full article

(This article belongs to the Special Issue Home Care Services for Older Adults)

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11 pages, 291 KiB

Open AccessArticle

Turning Community Elder Care into a Profession: Insights from Trainees, Developers, Employers and Supervisors

by Aya Ben-Harush, Liat Ayalon and Shiri Shinan-Altman

Int. J. Environ. Res. Public Health 2020, 17(16), 5867; https://doi.org/10.3390/ijerph17165867 - 13 Aug 2020

Cited by 3 | Viewed by 2054

Abstract

This study explores the process of turning elder care into a profession, by giving a voice to different professionals who took part in developing and implementing a new Israeli training program for community care workers. The program attempts to offer a response to the shortage of paid long-term carers for older adults by turning community elder care into a profession. Interviews with graduates, trainees who dropped out of the program, developers, employers and supervisors from three regions of the training program were conducted. Analysis explored attempts to transition community care from an occupation to a profession. The community care worker’s role and its uniqueness in comparison to the traditional paid long-term care worker are discussed. The difficulties that stem from the ambiguity of the definition of this new occupation are described. Full article

(This article belongs to the Special Issue Home Care Services for Older Adults)

18 pages, 528 KiB

Open AccessArticle

Between Migrant Care Work and New Occupational Welfare Tools: Changing Home Care Arrangements in Italy

by Georgia Casanova, Mirko Di Rosa, Oliver Fisher and Giovanni Lamura

Int. J. Environ. Res. Public Health 2020, 17(15), 5511; https://doi.org/10.3390/ijerph17155511 - 30 Jul 2020

Cited by 10 | Viewed by 2762

Abstract

Austerity measures on services provision, introduced due to recent economic crises, have stimulated the search for innovative welfare solutions, including options that are not directly or entirely funded by public sources. In Italy, recent legislation has promoted the development of occupational welfare (OW) measures, aimed at strengthening the supply of services to support employees with informal (elder) care responsibilities. This paper aims to describe how the newly introduced OW schemes might innovate existing care arrangements, by identifying their impact on the different actors involved in home care provision (care recipients, family carers, home care service providers and migrant care workers), as well as at a macro level in terms of promoting social innovation. The international relevance of the Italian case comes from the fact that it is one of the more representative familistic care regimes, largely characterized by home care provided by informal carers and migrant care workers (MCW). The importance of Italian OW schemes is increasing, and in 2018 their presence in company-level bargaining agreements grew by more than 15%. A rapid review of the literature and expert interviews allowed us to describe the complex Italian OW schemes system, and to identify the positive implications of their application for the country’s long-term care (LTC) context, underlining what makes these measures a clear example of “social innovation” likely to have a future positive impact on home-based care in Italy. Full article

(This article belongs to the Special Issue Home Care Services for Older Adults)

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12 pages, 317 KiB

Open AccessArticle

Health Literacy among Non-Familial Caregivers of Older Adults: A Study Conducted in Tuscany (Italy)

by Guglielmo Bonaccorsi, Francesca Pieralli, Maddalena Innocenti, Chiara Milani, Marco Del Riccio, Martina Donzellini, Lorenzo Baggiani and Chiara Lorini

Int. J. Environ. Res. Public Health 2019, 16(19), 3771; https://doi.org/10.3390/ijerph16193771 - 8 Oct 2019

Cited by 6 | Viewed by 3018

Abstract

Many older adults who live at home depend on a caregiver. When familial support cannot provide the necessary care, paid caregivers are frequently hired. Health literacy (HL) is the knowledge and competence required of people to meet the complex demands of health in modern society. The aim of this study is to assess the HL level of paid non-familial caregivers who were enrolled through two different sources: from the homes of assisted people in two Tuscan health districts (first sample) and during job interviews in a home care agency operating in Florence (second sample). The two different recruitment contexts allow us to provide a broader view of the phenomenon, presenting a picture of the HL level of those who are already working and those who are looking for a new job in this field. One-on-one face-to-face interviews, which include the administration of the Newest Vital Sign (NVS) to measure HL, were conducted. Recruitment resulted in 84 caregivers in the first sample and 68 in the second sample. In the first sample, the mean age was 51.2 ± 9 years; 94% of the participants were women. A high likelihood or likelihood of inadequate HL (i.e., a low level of HL) was found in 73.8% of cases. In the second sample, the mean age was 43.7 ± 11.5 years; 83.8% of the participants were women, and 80.9% had a low level of HL. In both samples, HL was statistically associated with the level of understanding of the Italian language. In conclusion, inadequate HL is an under-recognized problem among non-familial caregivers. Educational programs that aim to increase HL skills could be an effective approach to improving the qualification of informal healthcare professionals. Full article

(This article belongs to the Special Issue Home Care Services for Older Adults)

17 pages, 794 KiB

Open AccessArticle

Perceived Discrimination and Stigma in the Context of the Long-Term Care Insurance Law from the Perspectives of Arabs and the Jews in the North of Israel

by Liat Ayalon

Int. J. Environ. Res. Public Health 2019, 16(19), 3511; https://doi.org/10.3390/ijerph16193511 - 20 Sep 2019

Cited by 5 | Viewed by 2475

Abstract

The Long-Term Care Insurance Law provides support to older Israelis who wish to remain in their home. The present study evaluated the experience of perceived discrimination and stigma in the context of the law among Arab older adults, their family members, and their paid home care workers. For triangulation purposes, we interviewed 15 National Insurance Institute workers (NII; responsible for implementing the law; 47% Arab), 31 older adults (81% Arab), 31 family members (87% Arab), and six paid home care workers (83% Arab) in the north of Israel. Respondents were queried about their home care experience and their encounter with the NII. Thematic analysis was conducted. Four main themes emerged: (a) a strong sense of perceived discrimination among Arab interviewees, (b) reports suggesting the internalization of stigma and the adoption of negative views regarding the Arab population by some Arab respondents, (c) implicit stigma manifested in claims concerning the Arab population (primarily) as “cheating” the system, and (d) the negation of discrimination of Arabs as reported by Jewish interviewees and NII workers. The findings show that a sense of perceived discrimination is common and colors the experience of service seeking among Arabs. On the other hand, the Jewish interviewees in this study completely negated any discrimination or stigma directed toward Arabs. The findings point to the importance of group affiliation (e.g., minority vs. majority) in interpreting the existence of discrimination. The findings likely have major implications for both service providers and policy-makers and legislators. Full article

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