Social Work - Theses
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ItemUnderstanding aged care use by older Chinese-speaking immigrants in Australia( 2016)The world’s population is ageing rapidly, so how to provide quality health and aged care to an increasing elderly population has become a critical issue facing many countries. In Australia, one in four persons is born overseas. With a significant number of older people from diverse ethnic backgrounds, it is even more challenging to provide quality care that can meet their specific cultural needs. Evidence suggests that older people from culturally and linguistically diverse (CALD) backgrounds are more likely to be socially and financially disadvantaged and to under-use aged care services. However, there is a lack of detailed information on individual ethnic groups in relation to their specific care needs and service utilisation. This thesis sought to examine the characteristics of older Chinese-speaking immigrants, particularly those who migrated at an older age, and explore the experiences of aged care service use by this population in Melbourne, Australia. The Andersen Behavioural Model was the analytic framework utilised to understand factors associated with aged care use by this population, focusing on the concepts of predisposing, enabling, and need factors. This model was applied using an intersectionality perspective, highlighting how the interaction of various differences among older Chinese-speaking immigrants created unique experiences of ageing and aged care use. An interviewer-administered survey was conducted with 120 older Chinese-speaking immigrants between December 2009 and January 2011. Participants were recruited from four metropolitan areas in Melbourne using a quota sampling method to ensure representativeness. The study found that older Chinese-speaking participants used significantly more social support services and significantly less allied health and home care support services, compared with older Australians. The use of aged care services was best explained by predisposing and enabling factors, rather than need factors. Filial piety (a predisposing factor) and the availability of family carers (an enabling factor) were found to have negative effects on use of aged care services, while other enabling factors such as social support, adaptation of Australian culture, retention of Chinese culture, and awareness of existing services were found to be positively associated with aged care use. Having a lower score on activities of daily living (a need factor) was also found to increase the likelihood of using aged care services. The findings suggest that older Chinese-speaking Australians who are relatively recently arrived immigrants have a greater need for social support services. To improve the uptake of aged care services, policy makers and service providers need to better understand the effects of filial piety and family resources on aged care use, as well to encourage them to strengthen links with both local Chinese communities and the wider Australian society. This study contributes to a greater understanding of the influence of culture and recency of immigration on aged care use by the older Chinese-speaking population in Australia, and assists service providers and practitioners in better planning and delivery of culturally appropriate aged care services.
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ItemCommunity aged care management an exploratory study( 2015)This is a study of 30 community aged care managers from three employer sectors local government, health service, and non-government organisation, conducted in Victoria, Australia. It aims to firstly explore their demographic profile, education, employment, professional development, and networking opportunities, and secondly, to identify their key management responsibilities and experience of implementing community aged care. Data was collected via a mail-out questionnaire and face-to-face interview. Findings indicated that their responsibilities were human resource and financial management, and strategic planning. Budget responsibility was substantial with the majority responsible for budgets ranging from $5 to $20 million. There were three pathways to management: coming up through the ranks, moving on from nursing, allied health or social work, and moving on from service coordination or program management. Transition to management and learning to manage, were intertwined and were a significant rite of passage for each manager. Both informal and formal learning were seen to be complimentary, and necessary, and most managers had a management qualification. Learning needs reflected their three key responsibilities. Acquiring environmental knowledge, including information about government policies and funding, and the service system, was also important. Seven case studies demonstrate how these managers used their role to actively create community aged care service system structure and capability.
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ItemGreat expectations: a policy case study of four case management programs in one organisation( 2007)Four different case management programs delivered by UnitingCare Community Options (UCCO) in the eastern suburbs of Melbourne were examined against the expectations of case management as a policy solution to a range of perceived policy problems at the micro-, meso- and macro-levels. The micro-level expectations were related to client and family experiences of the service system and outcomes. At the meso-level expectations were focused on perceived service delivery problems such as poor matching of services to the needs of ‘complex’ clients including a lack of integration, flexibility and responsiveness to clients’ needs and preferences. Perceived macro-level policy problems were concerned with a variety of issues including increasing rates of institutionalisation, increasing costs to governments, lack of economic efficiency and the desire to create market or quasi-market conditions in the community care service delivery sector. (For complete abstract open document)