Residential Care Institutions Research Articles

Sexuality of ‘Dehumanized People’ across Post-Soviet Countries: Patterns from Closed Residential Care Institutions in Lithuania

Following the collapse of the Soviet Union, former Soviet countries inherited a widely developed network of residential social care institutions intended for persons who have intellectual disabilities. Monitoring inspections carried out by disability and human rights organizations in these regions reveal fundamental human rights violations at the institutions concerned. The aim of this article is to analyze one of the most severe and under-reported human rights violations experienced by women who have intellectual disabilities, while residing in social care institutions: the violation of their sexual and reproductive rights. Authors of this article employ Foucault’s viewpoint with regard to disciplinary society and understanding of control of sexuality as an expression of power. The institutional culture that prevails in residential care institutions and allows room for hiding serious human rights violations is also discussed in this article. Restrictions imposed on sexuality in care institutions are not merely limited to a number of individual cases, but they are connected with broader systematic issues. Above all others, the system of residential care institutions itself allows for violations of most of its residents’ rights to occur, including violations of sexual and reproductive rights. None of these rights can be safeguarded and promoted sporadically or partially; therefore, systematic changes are needed, as well as shifts in public mentality and amendments in mental health policy.

Norovirus in healthcare settings.

Purpose of reviewTo provide an overview of the burden of norovirus disease in healthcare settings and the factors responsible for outbreaks in these institutions; to assess progress on interventions aimed at reducing the burden of norovirus disease.Recent findingsNorovirus outbreaks in healthcare settings are driven by confluence of viral diversity, the built environment, and host factors. Some of these characteristics may be modifiable and the target of successful interventions.SummaryMost norovirus outbreaks in hospital and residential care institutions are associated with a particular genotype, known as GII.4. The persistence of norovirus is associated with strain diversity, which is driven by immune evasion and viral adaptation to interaction with a variety of human histo-blood group antigens. The healthcare environment presents serious challenges for control, both because of the physical structure of the built space and the high levels of contact among patient populations who may have compromised hygiene. Increased vulnerability among the populations in healthcare institutions is likely to be multifactorial and may include the following: nutritional status, immunodeficiency or senescence, chronic inflammation, and microbiome alterations. Current control measures are based on general infection control principles, and treatment is mainly supportive and nonspecific. Vaccines and antiviral agents are being developed with promising results, but none are currently available.

Savarankiškumas – socialinės globos įstaigoje gyvenančių vyresnio amžiaus asmenų gyvenimo kokybės veiksnys

Lithuanian society is aging, and need for social services for elderly people is constantly increasing as it allows enjoying better quality of life. Elderly people (+65) who become socially dependent have possibility to move to the residential care institution. The scenario of moving into long-term care institution has big and often negative impact on life quality of elderly person. Empirical research data was collected 2011““2013. The age of participants was 60““92 years at the moment of interview. The data was collected during multiple visits to residential long-term care institutions in different regions of Lithuania (both in rural and urban areas). The conducted interviews were semi-structured; participants“™ life story narrative was major focus. Constructivist grounded theory methodology (Charmaz, 2006) was the tool to analyse subjective quality of life, values and attitudes of elderly socially dependent residents. In the process of constructing grounded theory seven factors of life quality were identified. The most important factor is independence (self-reliance) understood as capability and wish of the elderly person to make decisions that have direct impact on her/ his everyday life (day regime, activities, and aspects of private finances management). “Independence“ as one of the main analytical categories is analysed through the example of life story of  Ruta using particular elements of biographical research on micro level. Capability to stay independent while participating in care process, maintain vital social relations, and consciously reflect on changes in last stage of human life have ultimate meaning for elderly people. Care professionals should be aware of the need of methods and skills how to effectively manage situations when meaning of life, apathy, boredom, preparing for death become ultimately important.

Изучение психологических особенностей адаптации студентов-сирот начального этапа обучения и студентов – воспитанников семей

We present a study of psychological characteristics of preadult orphans, their psychological adaptation to the conditions of learning in high school compared to the norm population (students living in family). We assumed that the level of adaptation of the orphan students is significantly smaller than in other students, because of their special life circumstances (maternal deprivation, living in residential care institutions, sometimes bad heredity, lack of life skills in everyday issues, personal problems). The results of the survey of 49 orphan students (26 girls and 23 boys) and 49 first-year students brought up by parents (28 girls and 21 boys), confirmed this hypothesis and allow us to tell that orphan students need special psychological help in the learning process in high school to grow at a personal and professional level.

The Quality of Life Factors of Assisted Elderly People

SummarySocial scientists emphasize the importance of elucidating the factors that influence the quality of life of elderly people, especially those in need of social assistance. Aim: to present findings of an empirical theory-grounded research on the factors of the quality of life of socially dependent elderly people living in long-term care institutions. Methods: The data were collected in half-structured interviews and analysed by the constructivist version of the grounded theory methodology by K. Charmaz. Elderly people (aged 60–92), living in residential care institutions, were interviewed.Results and conclusions. While analysing 21 semi-structured interviews with assisted elderly people, the following main factors of the quality of life were identified: (1) independence and self-sufficiency;(2) re-creating the important life moments; (3) sustaining lively social connections with important social actors; (4) acceptance of assistance services; (5) vitality (both physiological and psychological). Also, two latent factors were identified: (6) eventuality which manifests as a catalyst of all processes; (7) financial decisions which are fundamental for sustaining the desired level of the quality of life.

Religion als Gehorsam: Konfessionelle Heimerziehung in der Bundesrepublik Deutschland 1945–1975

The debate in Germany about boarding schools and residential care in the 1950s and 1960s dealt with brute force and child abuse. More than seventy percent of the residential care institutions were run by the churches. The relation between religion, obedience and discipline was characteristic for this field of socialdisciplinary intervention. The draft will show statistical evidence and outline the tradition and reality of correctional education in Germany. It shows the development from the poor conditions in the early years after the Second World War to the change of generations and educational institutions at the end of the 1960s in Germany. In many respects everyday life in these educational homes had the character of „total institutions“, according to the concept of Erving Goffman. Religious education reinforced authoritarian behaviour and was paired with a quantitative and qualitative lack of personnel in the institutions. The „belated modernisation“ of the correctional education in Germany took much more time than the modernisation of society in general.

Understanding the elevated risk of substance use by adolescents in special education and residential youth care: the role of individual, family and peer factors

Adolescents who attend special education for behavioural problems (SEB) and adolescents who live in a residential youth care institution (RYC) are characterised by behavioural disorders and problematic family backgrounds and have an increased risk for substance use. Though it is likely that the high rates of substance use in SEB/RYC settings might be inherent to the risk profile of these adolescents, little is known about the actual role the risk profile has in explaining substance use. The present study examined the extent to which the elevated risk of substance use in SEB/RYC can be explained by high levels of individual, family, and peer risk indicators that are known to characterise their risk profile. Self-report questionnaires from 531 adolescents in RYC (50 % male; mean age 14.7) and 603 adolescents in SEB (81 % male; mean age 14.1) were compared with information from 1,905 adolescents attending special education for students with learning disabilities (SEL) (56 % male; mean age 14.1). Results show that adolescents in SEB/RYC reported higher levels of daily smoking, weekly alcohol consumption, cannabis and hard drug use, as well as greater prevalence of individual, family and peer factors. Though individual, family and in particular peer risk indicators all explain some of the variance in substance use, the differences between adolescents in SEB/RYC compared with SEL remained significant and substantial, with the exception of heavy alcohol consumption. These findings suggest that deviant peer affiliation, in particular, plays a role in explaining high substance use levels in SEB/RYC and those factors relevant to the residential settings and special education schools might also contribute to substance use in these high-risk groups.

Improved Nutrition through School Food Programs

PEDIATRIC ANNALS 42:9 | SEPTEMBER 2013 Schools certainly face a difficult task when designing a menu that is not only healthful but also costeffective and appealing. With many students eating two of three daily meals at school, the type of foods eaten at school can drastically impact a child’s nutritional status, both positively and negatively. Consuming foods that are high in calories but low in nutrients can lead to malnutrition as well as to obesity and its related comorbidities. Choosing balanced meals can help to prevent excess weight gain and nutritional deficiencies and can provide kids with much needed energy to get through the demanding school day. Many students receive their meals at school as part of the National School Lunch Program (NSLP) or the School Breakfast Program. The NSLP is a federally assisted meal program operating in more than 100,000 schools and residential child care institutions.1 In 2011, the NSLP provided low-cost or free lunches to more than 31 million children each school day. The School Breakfast Program is a similar program operating in more than 89,000 schools and institutions.2 Recent legislation, such as The Healthy, Hunger-Free Kids Act of 2010, updated the meal pattern and nutritional standards for both programs based on the latest Dietary Guidelines for Americans, which increases the availability of fruits, vegetables, and whole grains in the school menu. All meals that are served as part of these government programs must meet federal requirements, although decisions about what foods to serve and how they are prepared are made by local school food authorities. Unfortunately, serving balanced meals does not ensure that students are choosing and consuming healthy meals. In addition, the millions of students who do not receive their food through these federal programs are often able to choose meals that are not required to meet any nutritional standards. To improve the likelihood that children are receiving and eating healthy foods at school, there should be a joint effort between the school and the parents. The 2005 Dietary Recommendations for Children and Adolescents suggest that parents and guardians should Improved Nutrition through School Food Programs

THE YOUTH VILLAGE: A MULTICULTURAL APPROACH TO RESIDENTIAL EDUCATION AND CARE FOR IMMIGRANT YOUTH IN ISRAEL

Migration, which has increased in the age of globalization, elicits a range of responses from the host countries, ranging from passive tolerance to active support of the newcomers. These responses affect many aspects of public life, most notably education, and the way immigrant youth are being either included or excluded. Residential care, which is known to be a powerful social instrument, is often used by societies for solving complex problems of children and young people. While many countries consider residential care an alternative of last resort, in Israel, these structural features of residential care institutions have been used for supporting young immigrants experiencing difficulties during the most crucial stage of the cross-cultural transition process. This paper presents the youth village, a unique Israeli residential educational model, highlighting the great potential of residential education and care programs for coping with the challenge of successfully integrating migrating youth. However, residential care methods and concepts are changing a lot and this influences how residential care programs are working with immigrant youth today.

Child welfare in Ghana: The relevance of children’s rights in practice

Summary When Ghana ratified the United Nations Convention on the Rights of the Child (UNCRC) it made a commitment to ensure compliance with the UNCRC by reviewing its children and youth social policies. Yet, to date, there is little empirical evidence that compares how children’s rights are perceived by professionals at the strategic and operational levels in Ghana. Thus, this article seeks to provide an insight by comparing the two professional levels. Drawing on in-depth interview data with government personnel who have strategic responsibilities of child care policies and with operational staff in a residential child care institution we analyse how the relevance of children’s rights is constructed by these two groups. Findings It is concluded that at both professional levels the concept of children’s rights is associated with legislation and institutions, rhetoric of rights and child participation. However, for many of the operational staff children’s rights appeared to be an abstract concept even though it was central to their daily work. Applications The study suggests that implementation of the UNCRC has so far remained largely at the policy level, as a result, very little has been accomplished to advance children’s rights in terms of changing the relationship between the State and children. It is therefore critical to organise more child rights training for professionals who are engaged in direct work with and/for children at all levels of the Ghanaian society to inform their practice. Further, the training needs to rectify the limitation and misconstrual of the concept of children’s rights to only child participation.

Assessing change in the behavior of children and adolescents in youth welfare institutions using goal attainment scaling

BackgroundEvaluating youth welfare services is vital, both because of the considerable influence they have on the development of children and adolescents, as well as owing to the extensive financial costs involved, especially for child residential care. In this naturalistic study we have undertaken to evaluate changes in various behaviors of young people who are in youth welfare institutions, not only by using standardized questionnaires, but also specifically modified goal attainment scales (GAS). These scales were meant to represent the pedagogical objectives of youth welfare professionals as well as the individual goals of the young people in care.MethodsGoal attainment scales were used to ascertain behavioral changes in 433 children and adolescents (age 6 to 18 years) in 25 youth welfare institutions (day care and residential care) in Germany. Social and individual goals were rated by young people and caregivers together on at least two occasions. In addition, to examine potential problems of children and adolescents, quality of life as well as mental health and behavior problems were identified by the caregiver and also by the youth using a self-report inventory.ResultsMany of the children and adolescents had experienced critical life events, problems in school, impaired quality of life, along with mental health and behavior problems (range: 41-87%). During their stay in day care or residential care institutions, children and adolescents showed some improvement in social goals (Cohen’s d = 0.14-0.44), especially those young people with deficits at the beginning, and with regard to mental health and problem behavior (d = 0.10-0.31). For individual goals, progress was even more pronounced (d = 0.75). Improvements to social goals were more pronounced if mental health and behavior problems decreased. This link to changes in behavioral and emotional problems was only ascertained to a limited extent for individual goals.ConclusionsYoung people residing in youth welfare institutions achieved individual and social goals and improved with regard to behavior problems. The applied goal attainment scales are well suited for measuring individual change in children and adolescents and constitute a relevant addition to established instruments. Furthermore, their advantages include cooperative goal setting, the assessment of goals by caregivers and young people, and congruence with the pedagogical objectives of professionals.

入所施設における他害行動などの行動問題を示す自閉症利用者への包括的支援

入所施設における他害行動などの行動問題を示す自閉症利用者への包括的支援

The Burningout of the Staffs Working in Residential Care Institution for Children and the Related factors

The Burningout of the Staffs Working in Residential Care Institution for Children and the Related factors

Analyzing Social Ties in Total Institutions

A common view is that an individual delinquent can be rehabilitated in a “home” in the countryside, away from his or her original urban social ties. An ironic result is new social ties with other juvenile delinquents as they spend a considerable amount of time together at a secluded institution. Drawing on ethnographic studies in residential care institutions, this article discusses two aspects to consider when analyzing social ties in such settings: the institutional prerequisites for and the everyday achievement of isolation and intimacy.

Institutional Care and Child Abandonment Dynamics: A Case Study in Antananarivo, Madagascar

A “social market” for children care is growing in developing world, in a context of philanthropic support and strong demand for international adoption. Moreover, impoverishment of many urban families results in a high demand for social aid that governments have trouble to provide. We have explored the circumstances leading to the placement of 764 children using a survey conducted among 40 residential care institutions in Antananarivo, capital city of Madagascar. One third of these children have been abandoned or orphaned. Stigmatizations against some children (born to unmarried mothers) and the refusal to care for step-children in newly reconstituted families seem to be key factors for abandonment. Some two-thirds of children are not abandoned and have at least one parent alive. Families place these children for economic reasons. If residential placement is the best solution for some children, it is important to question the relevance of child placement as a response to deep poverty, which makes up the majority of cases (the two-thirds). How are responses influenced by adoption demand? What responses should be promoted? How is residential placement embedded within the national policy for child protection? Our findings highlight the need for a more in-depth understanding of the dynamics of child abandonment in view of prevention actions. This paper has also raised the need for coordinated actions based on a real dialogue and consultation among all the stakeholders.

A decreasing trend in fall-related hip fracture incidence in Victoria, Australia

In Victoria, Australia, the age-standardised incidence of fall-related hip fracture hospitalisations decreased significantly by 25% over the period 1998/1999-2008/2009. Significant decreases in fall-related hip fractures were observed in males and females, across all 5-year age groups, in Australian-born and overseas-born Victorians, in all socio-economic quintiles and in community-dwelling older people. The study aim was to investigate trends in the incidence of fall-related and hip fracture hospitalisations among Victorians aged 65years and older overall and by age, gender, country of birth, socio-economic status (SES) and location of the event (home, residential care institution, etc.) over the 11-year period 1998/1999 to 2008/2009. Annual counts and age-standardised rates for fall-related hospitalisations among people aged 65years and older were estimated using Victorian hospital admissions data. The statistical significance of changes in trends over time were analysed using a log-linear regression model of the rate data assuming a Poisson distribution of cases. Although the age-standardised incidence of fall-related hospitalisations increased significantly by 13% (95% confidence interval [CI], 9% to 18%) in Victoria, the age-standardised incidence of fall-related hip fracture hospitalisations decreased from 600/100,000 in 1998/1999 to 467/100,000 in 2008/2009 - an estimated overall reduction of 25% (95% CI, -29% to -22%). By contrast, the age-standardised incidence of fall-related hospitalisations for fractures at other body sites either increased significantly or showed no significant change. Significant decreases in fall-related hip fractures were observed in both males and females, across all 5-year age groups, in both Australian-born and overseas-born Victorians, in all socio-economic quintiles and in community-dwelling older people but not in people living in residential care facilities. Despite the downward trend in the age-standardised incidence of fall-related hip fractures in Victoria, the burden of fall-related and hip fracture hospitalisations on health care systems and the community is set to escalate due to the ageing of the Victorian population.

Analysis of the circumstances of falls among elderly persons in residential care institutions

Analysis of the circumstances of falls among elderly persons in residential care institutions

Adolescências, autonomia e direitos sexuais: fragmentos de histórias de meninas abrigadas

A relação entre autonomia, adolescência e direitos sexuais levanta questões importantes para o cotidiano de instituições de acolhimento institucional. Adolescentes abrigadas que possuem vida sexual ativa nos interpelam sobre nossos valores morais no campo da sexualidade. Este artigo discute perspectivas de sexualidade e de exercício dos direitos sexuais entre meninas adolescentes em situação de acolhimento institucional a partir da noção de autonomia, desenvolvida nas instituições do Estado como estratégia de proteção.

The institutional set-up: an analysis of social pedagogues' accounts of treatment in everyday practice

Residential care institutions for children at risk are still a poorly understood institutional arrangement. Using complexity theory as a framework, the aim of this article is to analyse how social pedagogues at such institutions model the relationship between themselves and the children in care. Eleven focus-group interviews were conducted, based on a case vignette technique. The findings suggest a distinction between pedagogical coherence and obligation, implying that procedures for handling difficult episodes may exist independently of existing treatment programmes. The consequences for understanding institutional practices are outlined.

Substance use by adolescents in special education and residential youth care institutions

This study examined substance use rates and related background factors among adolescents in special education (SE) and in residential youth care institutions (RYC). Information on substance use from 531 adolescents in RYC, 603 adolescents in SE for students with behavioral problems (SEB) and 1,905 adolescents in SE for students with learning disabilities (SEL) was compared with information from 7,041 adolescents who attended mainstream education. Results show that substance use rates are particularly high among adolescents in RYC and in SEB. For example, 22% of the 12–13 years old in RYC and 16% in SEB was a daily smoker compared with 1% of their counterparts in mainstream education. Background factors, including age, ethnic background and family situation, partly explained the differences in substance use between mainstream education on the one hand and SE and RYC on the other hand, but differences between the groups remained substantial and significant. Several interaction effects were found in the relation between SE/RYC and substance use that were all in line with the risk paradox: some subgroups that are normally at lower risk for problem behavior are at higher risk when they are subjected to high-risk indicators. The elevated risk of substance use among adolescents in RYC/SE was in some cases particularly marked for those who would normally be at lower risk for substance use (girls in SEB for heavy alcohol drinking and cannabis use, ethnic minority adolescents and adolescents with a stable family situation in RYC for respectively heavy weekly alcohol drinking and daily use of tobacco). Results of this study have important implications for health education and intervention programs for adolescents in RYC and SE.