Mentoring Social Work PhD Students to Help Re-imagine Long-term Care.

This commentary explores the role of mentoring in creating the next generation of gerontological social work scholars through examining the mentoring of Dr. Rosalie Kane. We review how Rosalie exemplified some of key characteristics of an exceptional academic mentor based on communications with many of her former mentees, provide an account of her last formal mentoring relationship with a graduate student, and discuss how Rosalie's mentorship related to her hopes for re-imagining long-term care and the future of gerontological social work.

Bioarchaeological evidence of care provided to a physically disabled individual from Pachacamac, Peru.

This paper presents a bioarchaeology of care case study based on the skeletonized remains of an elderly female with a congenital condition that compromised both mobility and independence in undertaking certain basic tasks, and which generated requirements for long-term care in the form of both direct support and accommodation. The remains show evidence of bilateral cervical ribs, severe osteoarthritic destruction in the right shoulder joint, and a healed skull trepanation. The remains were recovered from a cemetery dating to the initial part of the Late Intermediate Period at the archaeological site of Pachacamac, Peru. The subject has been identified as belonging to an Ychsma ayllu. This paper applies the bioarchaeology of care methodology in considering the implications of care provision within the Ychsma socialcontext, and suggests that caregiving may have been a relatively common practice in this complex society. This case study is a good example of how the application of social theory through the bioarchaeology of care approach can enrich bioarchaeological studies.

Importance of long-term care of diabetic women starting in pregnancy.

Large scale, multi-center, controlled studies have demonstrated the importance of glycemic control, as indicated by HbA1c levels, in reducing the incidence and progression of diabetic complications. However, Yasue Omori, who began practicing medicine in Tokyo 60 years ago, in 1957, has the vantage point of long-term continuing care for women with type 2 diabetes, some for several decades. An internist who specializes in diabetic pregnancy, Dr Omori began caring for many of her patients during their pregnancies and continued to care for them following their deliveries, some now more than 50 years. Surprisingly, despite lack of optimal HbA1c levels, they have suffered relatively few diabetic complications. As reported in "The importance of nonstop treatment after delivery for pregnant women with type 2 diabetes" in Diabetes/Metabolism Research and Reviews, Omori and colleagues present a historical perspective that provides evidence that a long-term patient-care giver relationship following pregnancy can be valuable in reducing the onset and progression of diabetic complications.

'A disease that makes criminals': encephalitis lethargica (EL) in children, mental deficiency, and the 1927 Mental Deficiency Act.

Encephalitis lethargica (EL) was an epidemic that spread throughout Europe and North America during the 1920s. Although it could affect both children and adults alike, there were a strange series of chronic symptoms that exclusively affected its younger victims: behavioural disorders which could include criminal propensities. In Britain, which had passed the Mental Deficiency Act in 1913, the concept of mental deficiency was well understood when EL appeared. However, EL defied some of the basic precepts of mental deficiency to such an extent that amendments were made to the Mental Deficiency Act in 1927. I examine how clinicians approached the sequelae of EL in children during the 1920s, and how their work and the social problem that these children posed eventually led to changes in the legal definition of mental deficiency. EL serves as an example of how diseases are not only framed by the society they emerge in, but can also help to frame and change existing concepts within that same society.

The quintessential nursing population.

A past nursing model for 'chronically critically ill' patients provides lessons for health care today.As part of its Raise the Voice campaign to showcase nurses who are key players in transforming health care, the American Academy of Nursing has identified nurses they call edge runners-"practical innovators who have led the way in bringing new thinking and new methods to a wide range of health care challenges." This is the fourth in AJN's series of profiles of these nursing innovators. Read and be proud of what nurses can accomplish.

Negotiating user preferences, discrimination, and demand for migrant labour in long-term care.

The restructuring of long-term care for older people has been marked both by the role of the market and by the role of migrant labor. This article develops the analysis of these processes at the microlevel of the provision of care. It draws on data collected as part of a cross-national comparative study on the employment of migrant care workers in residential care homes and home care services for older people in England and Ireland. The article examines, first, the ways in which divisions of race, ethnicity, and citizenship shape the preferences of service providers/employers and some service users as regards who provides care. Second, it examines how the institutional context of quasi-markets in long-term care shapes the negotiation of demand for migrant labor, the racialized preferences of individual users, alongside the rights of care workers to non-discrimination. It is argued that market-oriented policies for personalization, as well as for cost containment, raise implications for divisions of race, ethnicity, and citizenship in the provision of long-term care. At the same time, those divisions point to the limits of framing care in terms of the preferences of the individual as opposed to the social relations in which care is embedded.

Care of older people in migration contexts: local and transnational arrangements between Peru and Spain.

Care arrangements for the elderly are becoming a main social process in contemporary societies due to socio-political and lifestyle changes over the last few decades. The family and the State play a basic role in the construction of care systems and in the establishment of strategies to access care resources. In the present context of migration, these resources interact at a transnational level, challenging family and State migratory regimes. These new realities need the recognition of basic international social rights, as the experiences of Peruvians living in a migration context in Spain show.

On Lok: a pioneering long-term care organization for the elderly (1971-2008).

On Lok is a pioneering nonprofit organization that has delivered services to the frail and elderly since its founding in 1971. The agency began as a grassroots effort focused on improving the health care available to older adults living independently in the community. Over its 40-year history, On Lok has evolved into a $70 million nonprofit human service organization with a national reputation for innovation as a leading provider of care to frail elderly. The agency has developed its own model of care that has been replicated in cities around the country. The history of On Lok represents the important impact that donor and community support plays in an organization's long-term success.

[Biographies following release from mental hospital, Glasgow 1875-1921]. / Auf und davon. Lebensläufe nach der Entlassung aus einer psychiatrischen Anstalt, Glasgow 1875-1921.

For a long time mental asylums were seen as hermetically sealed units for the long-term confinement of patients. The broad and excluding nature of these establishments was their most prominent feature. From the end of the last century socio-historical and patient-oriented research has questioned and revised these properties. The present essay is based on that research. Using the example of a pauper asylum in Glasgow between 1875 and 1921 the essay analyses the number of released patients, how they were released and how they lived after being released. The sources used were individual patient files of the asylum and the corresponding files of the pauper administration. Although the number of releases--especially of patients who had been cured--declined in the period of investigation, the rate of successful outcomes remained, at 20 to 30 per cent, clearly above that of comparable institutions of the 1910s. According to the files, the key factor in favour of a release was the ability for social re-inclusion. The files examined reveal three typical biographical patterns: reintegration, psychiatric care and social care. While the first group tended to disappear from the sight of physicians and carers, members of the other groups frequently reappeared in the records. Apparently, social services as well as the asylum were often used to help cope with temporary family crises. Once the situation improved, the patients in question left social care and were taken home by their families.

["Or should we be cured just to [..] be constantly confronted with the fact that we have to stay here forever [..]?" The view of psychiatric patients between illness, normalization and normality (1921-1937)]. / "Oder sollen wir etwa geheilt werden, um [...] uns immer- dar die Endlosigkeit unseres Aufenthalts hier vor Augen zu halten [...]?"--Eine Patientenperspektive in der Psychiatrie zwischen Krankheit, Normalisierung und Normalität (1921- 1937).

In German psychiatry, a distinct change occurred in the 1920s with regard to types of treatment. By introducing work therapy, early releases and psychiatric support outside the asylums the number of in-patients was to be reduced. As a consequence social approaches began to dominate psychiatric discourse. These approaches aimed at normalizing everyday life in the institutions and at implementing treatments that would allow patients to be reintegrated into society. Based on numerous documents on a patient who had spent the 1920s and early 1930s in a mental institution, the article adds a patient's view to the psychiatrists' perspective that has so far dominated the history of psychiatry of the Weimar Republic. The documents allow for an in-depth investigation of both the potential and the limitations of the approaches to psychiatric reform prevalent at the time. They illustrate, from a micro-perspective, the field of tension between psychiatric diagnosis, life in the asylum and integration into society that, in the case of this patient, became especially poignant with the patient's release at the time of the Third Reich sterilization laws.

Historical overview.

Lessons from the past, challenges for the future in family caregiving.

Historical evolution of assisted living in the United States, 1979 to the present.

PURPOSE: This article provides a historical overview of the emergence of assisted living in the United States over a 25-year period to identify goals and key concepts that underpinned the emerging form of care. DESIGN AND METHODS: The method is historical analysis based on records and my own personal experiences in conceptualizing and implementing assisted living in Oregon and nationwide. RESULTS: I identified four time periods: (a) 1979 to 1985, when a paradigm shift occurred on both the East and West coasts, motivated by distaste for nursing facilities and idealistic values regarding residential environments, service capacity, and consumer-centered care philosophy; (b) 1986 to 1993, when providers, consumers, and state governments became interested and four identifiable types of assisted living (hybrid, hospitality, housing, and health care) appeared, each of which informed the evolution of assisted living; (c) 1994 to 2000, a period of expansion, Wall Street money, dilution of the ideals, and emerging quality concerns; a crisis of confidence and a crossroads for assisted living; (d) 2000 to the present, a time of regrouping, slow-down in growth, and reexamination of earlier efforts to define and set standards for assisted living. IMPLICATIONS: Well-conceptualized and designed research may provide a mechanism to suggest practice, regulatory, and payment models. I recommend that researchers conduct studies from the values premises underlying the assisted living approach.

Hospitals, geriatric medicine, and the long-term care of elderly people 1946-1976.

This article investigates the development and interaction of the views of medical professionals and health officials on elderly care between 1946 and the early 1970s. It examines how the cultural and political context in which new ideas on the treatment of elderly people emerged in the early post-war period affected policy development in this area. The article argues that, in combination, the political and financial imperatives of health officials and the cultural prejudices of many in the medical profession created a situation in which progressive ideas about geriatric medicine and home care were used, not to improve the overall standard of care for elderly people, but to restrict their access to long-term medical and nursing care. The most important development in this respect, it will be argued, were efforts made by government from the mid-1950s to restrict the amount of provision for older people in hospitals, through the introduction of a geriatric bed norm. What lay at the heart of this question, the article concludes, was the reluctance of policy-makers to confront directly issues relating to the continuing care of old people with complex health problems. The reasons for this reluctance will be examined.

Historical highlights of long-term oxygen therapy.

The story of the development of oxygen and its role in mitigating the ravages of chronic stable hypoxemia have been fascinating. Today, over one million Americans receive home oxygen each day, usually for COPD, from one of the three available systems. The future requires less expensive, highly portable, and practical devices for use during all activities of daily living.