published_or_final_version / Social Work / Master / Master of Social Sciences

In South Africa prior to 1994, community-based care and support services were established for whites only. The majority of older African (black) persons received informal support from their adult children and relatives. This has waned over the years due to the social and economic changes that have put into doubt the continued viability of such support. The Older Persons Act of 2006 requires social workers to establish community-based care and support services for older persons. Hence, the study was conducted to understand the factors that influence social workers in establishing CBCSS for older persons in Bloemfontein in the Free State Province. A qualitative research method was undertaken to accomplish the goal of the study. Purposive and snowball sampling techniques were used to identify suitable participants. Face-to-face semi-structured interviews were conducted with fifteen social workers who provide services to older persons. The data was analysed through Tesch’s (cited by Creswell, 2009:186) eight steps of qualitative analysis and data verification was conducted following Guba’s (Kreftling, 1991) model. The major finding is that there is a need for social workers to specialise in older persons programmes (gerontology). For the programmes to be a success, it is recommended that the Department of Social Development (DSD) strive to retain social workers who are knowledgeable and experienced in older persons programmes. / Social Work / M.A. (Social Science)

Résumé.<p>Introduction.<p>Le premier chapitre de l’introduction expose les problèmes posés à la sécurité sociale par le vieillissement de la population et plus particulièrement par le développement de la dépendance des personnes âgées. Ces problèmes sont illustrés par l’évolution des dépenses en soins de santé pour les aides aux actes de la vie journalière en institutions d’hébergement des personnes âgées, et à domicile. <p>Le deuxième chapitre décrit les instruments d’évaluation qui sont étudiés dans la présente dissertation. En effet, en Belgique, le financement des soins à la dépendance est réalisé sur base d’une évaluation à l’aide d’une échelle de l’INAMI ;une allocation à la personne âgée peut être obtenue par les personnes âgées dont la dépendance est alors évaluée à l’aide de l’échelle de la prévoyance sociale que nous appellerons aussi APA. Nous les comparons à l’outil d’évaluation utilisé en France et dénommé AGGIR pour autonomie gérontologique, groupes iso-resources.<p>Méthodes et populations.<p>Méthodes.<p>Nous validons les trois instruments sur le plan du construit à l’aide la Classification Internationale du Fonctionnement (CIF) de l’OMS. La validité est évaluée de différentes manières :validité concurrentielle entre les trois instruments ;validité concomitante des trois instruments par comparaison aux temps de soins nécessaires par les méthodes de corrélation, leur capacité de discriminer des catégories de dépendance ;la fidélité des instruments est également étudiée. <p>Populations<p>Quatre enquêtes ont été réalisée :la première en institutions de personnes âgées, la seconde à domicile, la troisième à domicile et la quatrième en institutions de personnes âgées avec la collaboration de différents professionnels :infirmières soignantes, infirmiers conseils de mutualité et l’auteur de la dissertation.<p>Résultats.<p>La troisième partie de la dissertation expose les résultats démographiques et des tests de validation.<p>Discussion.<p>La quatrième partie évalue les résultats. L’échelle de l’INAMI est de conception ancienne pour son contenu. Sa validité est suffisante pour étudier les charges en soins de populations de patients mais insuffisantes pour l’évaluation des besoins individuels, car elle n’évalue pas les besoins pour les actes instrumentaux de la vie journalière.<p>L’échelle APA a une mauvaise validité de contenu ;sa validité de construit est la moins bonne des trois instruments étudiés. Sa fidélité est médiocre. Cette échelle est à déconseiller.<p>La grille AGGIR a une validité de contenu moderne et bonne, une bonne validité de construit et une bonne fidélité.<p>Conclusions.<p>Des trois instruments étudiés, la grille AGGIR est la plus performante et permet à la fois le financement des soins à des populations des patients et l’évaluation de critères d’éligibilité pour l’octroi d’avantages sociaux. / Doctorat en sciences médicales / info:eu-repo/semantics/nonPublished

This thesis reports on the perspectives and experiences of policymakers, advocates, agency supervisors, and experts in the field of gerontology, about the development of Aging and Disability Resource Centers (ADRC) programs and Options Counseling (OC). By examining the foundations upon which ADRCs and OC are built, this study sought to inform future research about the effectiveness of existing practice, increase understanding of best practices, and clarify whether these emerging services are accomplishing original goals. ADRCs and OC intend to address long-term care issues and healthcare needs by providing a single entry point to the social service system. ADRCs offer information, assistance, and OC to people of all ages, incomes, and disabilities, and promote long-term care options that honor independence and respect for the needs and preferences of individuals, their families, and caregivers. They are the latest iteration of policymakers' efforts to provide affordable home-and community-based care for older persons and their caregivers. A total of fifteen qualitative interviews were conducted and analyzed using grounded theory methods. Key persons interviewed included experts in the area of aging, aging policy, and aging. Participants were recruited through referrals suggested by Portland State University's (PSU) Institute on Aging (IOA) staff. In addition, several key experts known to the researcher through affiliation with PSU's IOA agreed to be interviewed. Snowball sampling was then used to locate additional key experts. Interview participants were classified as advocates, state decision makers, policy makers, or academicians. Advocates included national and state directors of agencies that promote the development and management of effective services to aging adults. State decision makers included state directors, ADRC directors and supervisors, and program analysts. Policy makers interviewed were national program directors responsible for shaping the future of developing programs to assist older adults. Academicians who participated in the study have been instrumental in developing and researching practices that promote well-being for the aging and the aged. These key experts were selected based on their knowledge and ability to inform the strengths, weakness, and development of ADRCs and Options Counseling. Many have been instrumental in health and aging policy and service development and research, and possess insider knowledge not available to the general public regarding attitudes and interests motivating the actors. Findings indicate that ADRCs and OC are designed to manage within existing social service systems. They can benefit some individuals by providing more options and support in accessing public and private services. It remains to be seen whether they have the capacity to ameliorate some existing system-level problems. Findings highlight program strengths and weaknesses, sustainability issues, and policymakers, state decision makers', and providers' commitment to sustaining ADRCs and OC.

The concept of population ageing is a development issue that has received much attention due to the demographic transition that is occurring globally, marked by declining levels of fertility and mortality. Therefore, the implications of population ageing for older persons within the context of Social Development was examined from the perspective of government and non government officials. The study was confined to older persons and the policies and programmes implemented by the Department of Social Development. The study employed an exploratory research design within a qualitative paradigm. Semi-structured interviews and a questionnaire were distributed to officials in the nine provinces. Thirty six questionnaires were received and qualitative methods of data analysis were used to analyse and interpret the data. The main finding of the study is that there is congruence in what government officials and the non government officials view as implications for older persons. Central to this is that the issue of ageing does not receive attention on the agenda of government. The top five priorities for older persons are healthy ageing, economic security, community/home based care services for older persons, having care and support systems for older persons and an improved quality of life/poverty alleviation. Based on the demographic determinants of population ageing, the findings are that there will be an increased demand for services for older persons which might place a strain on the social assistance and health care programmes. The issue of ageing was viewed positively as an opportunity by government officials and pessimistically as a challenge by NGO’s. The most common problems in old age is a reliance on the younger generation and or the state for their care and support, abuse, high levels of illiteracy and the burden of care for their children and grandchildren. The future older person is likely to be in better health and better educated than the older person of today if the necessary public investments are made now in these areas. The study makes recommendations for the adoption of a South African plan of action on ageing, inter-sectoral budgeting, development of specialised programmes, review of current policies and legislation for older persons, strengthening the partnership with the NGO sector and facilitating ageing mainstreaming within government programmes. / Sociology / M.A. (Social Development)

The concept of population ageing is a development issue that has received much attention due to the demographic transition that is occurring globally, marked by declining levels of fertility and mortality. Therefore, the implications of population ageing for older persons within the context of Social Development was examined from the perspective of government and non government officials. The study was confined to older persons and the policies and programmes implemented by the Department of Social Development. The study employed an exploratory research design within a qualitative paradigm. Semi-structured interviews and a questionnaire were distributed to officials in the nine provinces. Thirty six questionnaires were received and qualitative methods of data analysis were used to analyse and interpret the data. The main finding of the study is that there is congruence in what government officials and the non government officials view as implications for older persons. Central to this is that the issue of ageing does not receive attention on the agenda of government. The top five priorities for older persons are healthy ageing, economic security, community/home based care services for older persons, having care and support systems for older persons and an improved quality of life/poverty alleviation. Based on the demographic determinants of population ageing, the findings are that there will be an increased demand for services for older persons which might place a strain on the social assistance and health care programmes. The issue of ageing was viewed positively as an opportunity by government officials and pessimistically as a challenge by NGO’s. The most common problems in old age is a reliance on the younger generation and or the state for their care and support, abuse, high levels of illiteracy and the burden of care for their children and grandchildren. The future older person is likely to be in better health and better educated than the older person of today if the necessary public investments are made now in these areas. The study makes recommendations for the adoption of a South African plan of action on ageing, inter-sectoral budgeting, development of specialised programmes, review of current policies and legislation for older persons, strengthening the partnership with the NGO sector and facilitating ageing mainstreaming within government programmes. / Sociology / M.A. (Development Studies)

This paper describes a participatory action research project involving a group of the aged from the Makgoba community. The focus of this study was the establishment ofa service centre by the rural aged. In the course of this project, the researcher discovered how the rural aged were empowered through the participatory action research process. This process enabled the aged to accomplish their goals, and so to grow and develop. In particular, they improved their lives, and enhanced their self esteem and dignity. / Social Work / M.A. (Social Science : Mental Health)

This paper describes a participatory action research project involving a group of the aged from the Makgoba community. The focus of this study was the establishment ofa service centre by the rural aged. In the course of this project, the researcher discovered how the rural aged were empowered through the participatory action research process. This process enabled the aged to accomplish their goals, and so to grow and develop. In particular, they improved their lives, and enhanced their self esteem and dignity. / Social Work / M.A. (Social Science : Mental Health)