Form Of Hours Research Articles

Mental health effects of caregivers respite: Subsidies or Supports?

We study the causal effect of the introduction of caregiving respite in the form of hours of home help (caregiving supports) and financial subsidy (caregiving allowance) on the mental health of caregivers. We exploit evidence of a policy intervention that universalized previously means-tested caregiving subsidies and supports in Spain. Our estimates suggest evidence of an heterogeneous effect depending on the intensity of care provided. We find that caregiving supports reduce the probability of depressive symptoms among caregivers providing more than 50 hours of care. In contrast, caregiving subsidies give rise to a reduction in the probability of depressive symptoms among caregivers providing less than 50 hours of care. Consistently, we find evidence of an improvement in life satisfaction upon the receipt of subsidies and home supports . The latter effect is higher among part-time caregivers who spend between 20 and 50 caregiving hours/week which is explained by behavioural and preventive lifestyle changes. Finally, we estimate the ‘hypothetical caregiving subsidy’ amount that would have fully compensated caregivers’ for their wellbeing losses. We find estimates ranging between 800 and 850 euros/month, a magnitude well above the actual subsidy in Spain.

A new service model in East Lothian community learning disability team: evaluation of service with and without specialist positive behaviour support team

AimsTo evaluate the provision of services to patients with challenging behaviour in East Lothian Community Learning Disability population with and without specialist behaviour support team.BackgroundBehaviour that proves to be a challenge to manage (Challenging behaviour) is not uncommon in adults with intellectual disability and has a reported prevalence of 10–15%.1,2Positive behaviour support (PBS) is recommended as evidence-based intervention for adults with intellectual disability who have challenging behaviour. East Lothian community learning disability team (CLDT) underwent a change in service model for people with challenging behaviour. This change followed a Health and Social care partnership agreement that behaviour support and management could be provided by multidisciplinary CLDT rather than region-wide specialist team.MethodData collection was split into two cycles. First cycle looked retrospectively at six months prior to exit of Specialist Positive Behaviour Support Team (SPBST). Second cycle looked prospectively at 6 months after exit of SPBST.In first cycle, data were collected doing retrospective review of cases known and referred to SPBST. This included calculating time spent on each individual case by SPBST and by CLDT. SPBST provided information in the form of hours spent on each individual case for patients identified by them. For CLDT, electronic medical records system (TRAK) was used by looking at appointment entries on TRAK. For second cycle, newly developed Complex Behaviour pathway was used to identify the patients. Data were collected by using TRAK system as in the first cycle for CLDT.Data collected in both cycles was compared at the end of second cycle.ResultIn first cycle, 5 patients were managed jointly by SPBST and CLDT in 96.4 hours over six months and average clinical time spent on each patient was 19 hours. SPBST spent a total of 59 hours and CLDT spent 40 clinical hours. In second cycle, 12 patients were managed by CLDT alone in 130 hours over six months and average clinical time spent on each patient was nearly 11 hours.ConclusionResults of this evaluation suggest that SPBST had been providing significant contribution to East Lothian CLDT not only with their expertise but also with clinical time. More than 50 % of total clinical time spent on the patients with challenging behaviour in first cycle, was provided by SPBST. This is also evidenced in second cycle where there is an increase in clinical time of some professions when SPBST was withdrawn.

Adult Child Migration and the Health of Elderly Parents Left Behind in Mexico.

Research on international migration often focuses on the outcomes for emigrants at their destination, thereby overlooking the consequences for the family members of migrants remaining in the home country. In source countries with rapidly aging populations such as Mexico, a critical public policy concern is how the elderly dependents of U.S. migrants fare while their children are away. This paper begins an examination of that topic by investigating the relationship between children’s migration status and parental health outcomes. Conventional wisdom suggests that family members of migrants should benefit from international migration due to the large flows of remittances from the U.S. to Mexico. Nonetheless, little is known about the fraction of these remittances going to elderly parents, particularly when migrants are old enough to have established separate households. In addition, elderly parents may require physical support in the form of hours of care from their children which may be disrupted when one child migrates and for which there may be no close substitutes. Finally, elderly parents may suffer emotionally when their children are absent, particularly when children lack the documents to legally cross the U.S.-Mexico border. The relationship between children’s migration and the health of elderly dependents left behind is thus theoretically uncertain and has been a growing area of research. John Giles and Ren Mu (2004) examine the question of how elderly health affects children’s migration choices in China. Randall S. Kuhn, Bethany Everett, and Rachel Silvey (forthcoming) explore the effect of children’s migration on elderly parents in Indonesia. Estimating a causal effect between children’s migration and elderly health, however, is naturally plagued by problems of endogeneity. Children may respond to parental health shocks by migrating themselves or both migration and parental health may be driven by some unobserved variable. Francisca Antman (2009) uses instrumental variables estimation to address this endogeneity problem for the case of Mexico-U.S. migration and finds evidence of a causal link between poor elderly health outcomes and children’s migration to the U.S. This paper aims to take a first step at exploring this issue by asking whether elderly parents of children in the U.S. suffer from worse health outcomes than their counterparts with no children in the U.S. Overall, I find evidence that a child’s U.S. migration is associated with a greater chance that his elderly parent in Mexico will be in poor physical and mental health.