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This thesis is a study of the residential care for elderly people in Beijing, China. First, a set of statistical indicators are developed for mapping the spatial distribution of the elderly population and residential care facilities (RCFs). Secondly, in-depth, semi-structured interviews are used to understand the socio-cultural meanings of access, the decision making process in relocation, the well-being of elderly residents, as well as the challenges of residential care and social welfare reform. In total, 27 elderly residents, 16 family members, and five RCF managers were interviewed in six RCFs in Beijing. The constant comparative method is used to analyze all the transcribed interview materials. There are several major findings resulting from the research: the distribution of the elderly population and residential care resources is geographically uneven across the districts of Beijing and the supply of resources does not match the potential need. Elderly people and their family members choose residential care because of the shortage of community and home care resources and/or the advantages of residential care. The decision making process is a process of balancing geographical factors, quality of services, and financial affordability. Access to residential care is an interactive process influenced by geographical, economic, and social-cultural factors. The physical and socio-cultural environments of RCFs and individual’s sense of place play important roles in their adaptation and well-being after the relocation from the home to a RCF. Building up the active aging model with joint efforts from governments, society, RCFs, and individuals is helpful and effective for promoting the well-being of elderly residents in RCFs. At the end, the study also provides suggestions for the government, organizations, and RCFs on aspects such as administration, policy making, planning, volunteering, and management of RCFs to meet the challenges of residential care in China. The study confirms the importance of healthy living environments to the well-being of elderly residents. It also provides knowledge for understanding the reconfiguration of filial piety in decision making processes and utilization of residential care in current Chinese society. From a health geography perspective, this thesis is one of the first studies on residential care in China. / Thesis (Ph.D, Geography) -- Queen's University, 2010-04-30 12:15:57.972

The demand for home care increased dramatically in Canada in the past decade. This was because more patients were discharged from hospital, more emphasis was put on health care at the home and community levels, the continuing aging of the population, advancements in technology, and the adoption of a more cost-effective strategies. Though home care is still not a part of Canadian Health Act (CHA) and there are no national regulations for home care, people value the significance of home care. Home care is now one of the fastest growing sectors in Canada’s health care system. With a focus on the elderly population in the province of Ontario, this thesis uses data from the Canadian Community Health Survey (CCHS cycle 1.1, 2.1 and 3.1) to examine utilization patterns of home care considering social and geographical factors, the variation within home care service provision, and unmet home care need. The major findings of the thesis are that seniors with poorer health status, older age, female, with lower household incomes, marital status widowed/separated/divorced/single/never married, and living in urban areas are more likely to use home care. At the same time, seniors who are older, with poorer health status, and suffering from chronic condition are in a more vulnerable position to receive the home care they need. A large amount of responsibility was shifted to informal caregivers due to the budget constraints and the policy bias of the government. Access to home care is unequal on a geographical scale. Seniors living in rural and remote areas tend to have more unmet home care needs than seniors living in urban areas. People living in rural northern regions in Ontario have the least access to home care. Also, seniors living in urban areas have a greater chance of getting government provided care than those living in rural areas. Overall, under the current managed competition model of home care in Ontario, unequal accessibility, insufficient services, an excessive burden on informal caregivers are observed. / Thesis (Master, Geography) -- Queen's University, 2011-05-21 00:10:26.287

This study examined the societal factors and subjective beliefs that are hypothesized to be affecting the lives of trans persons accessing Ontario health care services. The purpose of this study was to uncover information pertaining to trans persons’ needs and fulfillments within Ontario’s health care system in order to discover what the specific health care needs of trans persons accessing health care services are as well as if they are alienated and/or systemically discriminated against when seeking medical attention. The research questions were addressed through a secure, anonymous, online questionnaire taking approximately 30 to 45 minutes to complete. A small sample of 18 to 26 individuals who identified as trans, living in Ontario and have accessed, or are currently accessing, Ontario health care services were recruited through relevant list-servs and website postings. Participants accessed a variety of open-ended and closed questions concerning sociodemographics, sexuality, health care access experiences, and health care needs. Qualitative results showed that access to Ontario health care is complicated by race, class and language for participants in this study. Experiences for trans persons with Ontario health care services varied from individual to individual; some reported no negative experiences at all, some have been refused services by the Center for Addiction and Mental Health’s Gender Identity Clinic, and some avoided health care services entirely due to discrimination from medical professionals. / Thesis (Master, Gender Studies) -- Queen's University, 2011-09-20 12:42:59.005

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Finding permanent homes for children with developmental disabilities (DD), whose parents have voluntarily relinquished their care, is a problem for social workers. Ontario adoption social workers at a biennial business meeting in November/04 (N = 49) were asked about possible solutions, using a questionnaire designed for this study; information was also collected on relevant experience and caseloads. Workers believed that: (1) a majority of parents who voluntarily relinquish the care of their child do so because of the burden of care and/or financial reasons; (2) subsidies would be more effective than open adoption in improving chances of adoption. Also, a significant number of these adoption workers did not have an experience with DD on which to base their casework decisions. / These findings highlight the need for specialist training on DD for social workers who deal with these children, and also the importance of subsidies for families who must care for them.

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This thesis provides an account of the discussions of the "team" concept in health care literature since the early 1920s. It is argued that by adopting a historical, social constructionist stance, this thesis makes an original contribution to the literature. The research consisted of an inductive analysis of the "team" literature aiming to typify the ways in which the "team" concept has been constructed and historical, national or professional differences which have occurred. Historically, claims about "teamwork" in health care have occurred in four phases: (1) a statement of basic issues and themes; (2) the emergence of ideas of flexibility and adaptability; (3) a period of optimism; and (4) the co-existence of positive, sceptical, and critical claims. The professional and national differences in claims-making activities are also discussed. The least challenged claims about, and recent re-evaluations of, the "team" concept are also discussed. (Abstract shortened by UMI.)

This research explores the experiences and needs of five young people with FASD in care. Data was gathered through personal interviews with youth in care, guided by an anti-oppressive research philosophy. The findings suggest that youth in care with FASD experience a myriad of challenges throughout their journeys in care with regard to placements, caregivers, and the transition to adulthood for which the impact for young people was difficult to understand. The high degree of secondary disabilities of FASD was found to be alarming in this group of young people. The study also found that those with more of an awareness of their disability had the capacity to speak to some of their support needs. All of the youth revealed strengths within themselves and reported having goals and dreams for their futures. A number of recommendations, which include input from participants, are highlighted, with the intention of providing some suggestions for best practice with our young people with FASD in care and policy changes within the systems working with this population.