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Long-stay institutions have been considerably affected by the COVID-19 pandemic. We aimed to assess the mental health of clients and staff as well as quality and safety of care in long-stay institutions during the state-of-emergency in the Czech Republic in response to COVID-19 pandemic. We found a high prevalence of poor mental health outcomes in clients (46% poor well-being, 58% depression, 45% anxiety) and staff (17% poor well-being, 22% depression, 14% anxiety). In clients, COVID-19 health-related and economic worries were associated with depression (1.79, 95% CI = 1.14; 2.8 and 2.28, 95% CI = 1.27; 4.08 respectively) and anxiety (1.63, 95% CI = 1.11; 2.4 and 1.85, 95% CI = 1.2; 2.85 respectively) and in staff with any mental health outcome (1.92, 95% CI = 1.33; 2.77 and 1.75, 95% CI = 1.15; 2.66 respectively). Lack of information and communication from authorities, lack of protective equipment and logistic difficulties were reported as challenges. Delivery of care was mostly disrupted as well as admission and discharge processes. Other reported issues included lack of staff, lack of activities for patients or an increase in usage of restrictive measures. Best practices and key future measures were identified by each institution, a summary of which is presented in the article.

What is it like to grow up in an orphanage? What do residents themselves have to say about their experiences? Are there ways that orphanages can be designed to meet children's developmental needs and to provide them with necessities they are unable to receive in their home communities? In this book, detailed observations of children's daily life in a Cambodian orphanage are combined with follow-up interviews of the same children after they have grown and left the orphanage. Their thoughtful reflections show that the quality of care children receive is more important for their well-being than the site in which they receive it. Life in a Cambodian Orphanage  situates orphanages within the social and political history of Cambodia, and shows that orphanages need not always be considered bleak sites of deprivation and despair. It suggests best practices for caring for vulnerable children regardless of the setting in which they are living.  

How do parents weigh police presence and police activity in their assessments of a neighborhood’s suitability for raising children? How do place-bound institutions relate to neighborhood frames? This article introduces located institutions as a way of articulating how certain institutions—here, the police—become a lens through which parents make meaning of places and thus express preferences for particular neighborhoods or communities. By drawing from 73 interviews with a diverse sample of parents in Cuyahoga County, Ohio, this article shows how parents draw on their perceptions of the police as an attractive amenity or a public nuisance as a way of articulating neighborhood frames and making sense of their residential preferences. More broadly, this article envisions the perception of institutions as a key mechanism that shapes neighborhood frames and residential preferences.

ObjectivesThe primary objective of this study was to collect baseline data on the number of children living in residential care institutions in Cambodia. The secondary objective was to describe the characteristics of the children (eg, age, sex, duration of stay, education and health). The data were intended to guide recent efforts by the Government of Cambodia to reduce the number of children living in residential care institutions and increase the number of children growing up in supportive family environments.SettingData were collected in Cambodia across 24 sites at the commune level. Communes—administrative divisions roughly equivalent to counties—were selected by the National Institute of Statistics using a two-stage sampling method.DesignGovernment lists and key informant interviews were used to construct a complete roster of institutions across the 24 communes. All identified institutions were visited to count the number of children and gather data on their basic characteristics. The rate of children in residential care in the selected communes was calculated as a percentage of total population using a Poisson model. This rate was applied to all districts in Cambodia with at least one reported residential care institution.ParticipantsA total of 3588 children were counted across 122 institutions. A child living in a residential care institution was defined as anyone under the age of 18 years who was sleeping in the institution for at least four nights per week during the data collection period.ResultsThere are an estimated 48 775 children living in residential care institutions in Cambodia. The vast majority of children have a living parent and are school-aged. More than half are between 13 and 17 years of age.ConclusionsNearly 1 of every 100 children in Cambodia is living in residential care. This raises substantial concerns for child health, protection and national development.

Aggressiveness is prevalent in old age, and to adapt treatments and diminish the accompanying damage to the self and others, it is important to understand aggressiveness predictors. Poor emotional awareness, impulsivity, and emotion dysregulation are potential mechanisms influencing aggressiveness. The present study examines whether alexithymia, emotion dysregulation, and impulsivity influence aggressiveness in older adults; and whether the effect of alexithymia is conditioned by emotional dysregulation and impulsivity after controlling for probable confounders. The sample consisted of 326 Portuguese older adults (63.2% female) aged 60-96 years from residential care homes and the community. Participants completed report instruments measuring alexithymia, emotional dysregulation, impulsivity, and aggressiveness. Results of the mediation analysis showed that older adults who had more alexithymia tended to report higher levels of emotional dysregulation and impulsivity, which in turn accounted for higher reported aggressiveness. All these effects were independent of cognitive functioning and depressive symptoms. This study suggests the relevance of evaluating and intervening on alexithymia, impulsivity, and emotion dysregulation to reducing aggressiveness in older people.

Many studies have provided evidence for the effectiveness of Internet-based stand-alone interventions for mental disorders. A newer form of intervention combines the strengths of face-to-face (f2f) and Internet approaches (blended interventions). The aim of this review was to provide an overview of (1) the different formats of blended treatments for adults, (2) the stage of treatment in which these are applied, (3) their objective in combining face-to-face and Internet-based approaches, and (4) their effectiveness. Studies on blended concepts were identified through systematic searches in the MEDLINE, PsycINFO, Cochrane, and PubMed databases. Keywords included terms indicating face-to-face interventions (\"inpatient,\" \"outpatient,\" \"face-to-face,\" or \"residential treatment\"), which were combined with terms indicating Internet treatment (\"internet,\" \"online,\" or \"web\") and terms indicating mental disorders (\"mental health,\" \"depression,\" \"anxiety,\" or \"substance abuse\"). We focused on three of the most common mental disorders (depression, anxiety, and substance abuse). We identified 64 publications describing 44 studies, 27 of which were randomized controlled trials (RCTs). Results suggest that, compared with stand-alone face-to-face therapy, blended therapy may save clinician time, lead to lower dropout rates and greater abstinence rates of patients with substance abuse, or help maintain initially achieved changes within psychotherapy in the long-term effects of inpatient therapy. However, there is a lack of comparative outcome studies investigating the superiority of the outcomes of blended treatments in comparison with classic face-to-face or Internet-based treatments, as well as of studies identifying the optimal ratio of face-to-face and Internet sessions. Several studies have shown that, for common mental health disorders, blended interventions are feasible and can be more effective compared with no treatment controls. However, more RCTs on effectiveness and cost-effectiveness of blended treatments, especially compared with nonblended treatments are necessary.

The number of US adults ages sixty-five and older who are living with dementia is substantial and expected to grow, raising concerns about the demands that will be placed on family members and other unpaid caregivers. We used data from the 2011 National Health and Aging Trends Study and its companion study, the National Study of Caregiving, to investigate the role of dementia in caregiving. We found that among family and unpaid caregivers to older noninstitutionalized adults, one-third of caregivers, and 41 percent of the hours of help they provide, help people with dementia, who account for about 10 percent of older noninstitutionalized adults. Among older adults who receive help, the vast majority in both community and residential care settings other than nursing homes rely on family or unpaid caregivers (more than 90 percent and more than 80 percent, respectively), regardless of their dementia status. Caregiving is most intense, however, to older adults with dementia in community settings and from caregivers who are spouses or daughters or who live with the care recipient.

Informal care, or care provided by family and friends, is the most common form of care received by community-dwelling older adults with functional limitations. However, less is known about informal care provision within residential care settings including residential care facilities (for example, assisted living) and nursing homes. Using data from the Health and Retirement Study (2016) and the National Health and Aging Trends Study (2015), we found that informal care was common among older adults with functional limitations, whether they lived in the community, a residential care facility, or a nursing home. The hours of informal care provided were also nontrivial across all settings. This evidence suggests that informal caregiving and some of the associated burdens do not end when a person transitions from the community to residential care or a nursing home setting. It also points to the large role that families play in the care and well-being of these residents, which is especially important considering the recent visitor bans during the COVID-19 epidemic. Family members are an invisible workforce in nursing homes and residential care facilities, providing considerable front-line work for their loved ones. Providers and policy makers could improve the lives of both the residents and their caregivers by acknowledging, incorporating, and supporting this workforce.

With the extensive long-term care services for older people, the Nordic countries have been labelled ‘caring states’ as reported (Leira, Welfare state and working mothers: the Scandinavian experience, Cambridge University Press, Cambridge, 1992). The emphasis on services and not cash benefits ensures the Nordics a central place in the public service model (Anttonen and Sipilä, J Eur Soc Policy 6:87–100, 1996). The main feature of this ideal model is public social care services, such as home care and residential care services, which can cover the need for personal and medical care, as well as assistance with household chores. These services are provided within a formally and professionally based long-term care system, where the main responsibility for the organization, provision and financing of care traditionally lays with the public sector. According to the principle of universalism (in: Antonnen et al. (eds), Welfare state, universalism and diversity, Elgar, Cheltenham, 2013), access to benefits such as home care and residential care is based on citizenship and need, not contributions nor merit. Also, care services should be made available for all and generally be used by all, with no stigma associated. Vabø and Szebehely (in: Anttonen (ed), Welfare State, universalism and diversity, Edward Elgar Publishing, London, 2012)) further argue that the Nordic service universalism is more than merely issues of eligibility and accessibility, in that it also encompasses whether services are attractive, affordable and flexible in order to meet a diversity of needs and preferences. However, recent decades have seen a continuous tendency towards prioritization of care for the most frail, contributing to unmet need, informalization of care and privatization in the use of topping up with market-based services. These changes have raised questions about increasing inequalities within Nordic long-term care systems. We investigate in the article what effect changes have for equality across social class and gender, for users and informal carers. The article is based on analysis of comparable national and international statistics and a review of national research literature and policy documents.

Previous research indicates worse outcomes for children and young people in out-of-home care compared to their peers. To improve the quality of current residential care, research is needed to deepen our understanding of the key factors and mechanisms that explain the effectiveness of residential care on child level. The aim of this study is to evaluate the short-term (i.e., during care) effectiveness of residential care as a child welfare intervention by different service providers. The study includes two pre-specified primary child-level outcomes 1) psychosocial functioning, assessed through the Strengths and Difficulties Questionnaires (SDQ) including both total difficulties scores and subscales and 2) attainment of individual goals of the child. Secondary outcome measures include improved experiences of emotional warmth and safety (CEWSS-A). Further associations between key characteristics of the residential care unit, the child and outcomes are assessed. The data consist of longitudinal survey data collected from 12-17-year-old children and staff in a total sample of public and private residential care units offering specialized care in three wellbeing services countries in Finland. The baseline (T0) data is collected between 1.4.2025-31.8.2026 with a follow up of 6 and 12 months for each child (T1 and T2). The data is primarily analysed with linear mixed models. Findings explore the short-term effectiveness and change mechanisms of residential care as \"service as usual\" to understand how it should be organised and produced to improve its ability to meet aims during care. The study design embraces the complexity and changeability on different levels of the residential care setting.