Role of community centers in promoting sustainable regional life of community-dwelling older adults with frailty

Japan’s long-term care insurance system, which is a formal service, focuses only on older adults requiring care and support. Therefore, to create supportive communities for frail older adults, appropriate measures have been taken to establish community centers within their walking distance. However, the specific functions of these centers largely remain unknown. Accordingly, this study is aimed at clarifying the role of community centers by analyzing their services and management systems. In February 2020, we conducted a questionnaire survey (36% response rate) and four semi-structured interviews in O city, which has 36 community centers (81.45㎢, 36.4% elderly population). Results from the questionnaires revealed that the most frequent users of the community center were in their 70s (61.5%); such centers tended to provide informal services, such as exercises and cafes. Meanwhile, 57.2% of community centers collaborate with formal service providers. Community centers tend to be operated together with parent facilities, such as hospitals and nursing homes(61.2%). The results of the onsite survey showed that, in three cases, the community centers were situated within 200 meters of the parent facility. The findings show that these community centers facilitated creation of a supportive community that provides informal services to the frail elderly. Furthermore, they are operated in cooperation with formal service providers, hospitals, and nursing care facilities and are located in close proximity to one another. To summarize, the community centers continue to play a role in providing seamless services to the frail elderly even as their physical functions evolve.

Family Caregivers and Support: Implications for Work Strain and Formal Service Use

In the US, many employed caregivers make professional adjustments, exacerbating already tenuous balances between work and life. Using the framework of the Stress Process Model (SPM), current research examines the sources of support (both formal and informal) and the contextual factors that facilitate or impede caregiver support. In this research, we examine whether and to what extent caregiver work strain is ameliorated by the presence of additional family caregivers and formal service use. This study utilizes data provided by the National Study of Caregiving (NSOC) data. Using panel methods for the pooled waves, we analyze the associations between work-strain and the number of additional caregivers with utilization of formal support (such as paid service support). Preliminary analyses align with the Stress Process Model as additional caregivers for each respective care-recipient is associated with lower levels of work strain. On the other hand, utilization of formal services (paid help and Medicaid funding) is positively associated with work strain. These findings suggest that the number of additional caregivers can reduce the negative impact of caregiving on work related strain among employed caregivers. That is, multiple caregivers may be more reflective of cooperative arrangements which offset work disruptions that occur with the onset of caregiving. In addition, formal sources may more frequently be used as a last resort to address caregiver burnout. Ongoing analyses are examining changes in the number of caregivers and its impact on disruptive work event, which could lead to financial outcomes for caregivers.

Steering the transition from informal to formal service provision: labor platforms in emerging-market countries

Services that are especially suited to being offered via online labor platforms, such as cleaning, driving and tutoring, are frequently performed in an informal way, especially in emerging-market countries. The informal economy is thus important for recruiting workers for labor platforms. Platform use, however, requires formal service provision, which workers in the informal economy often resist. Thus, labor platforms have to promote workers’ transition from informal to formal service provision. While recent studies have hinted at labor platforms’ fostering of formal economic activity, we know little about how such intermediation unfolds. We use a process lens and comprehensive qualitative data on labor platforms in Panama and Mexico to study how labor platforms steer workers to formal service provision. Detailing the interactive process of workers transitioning to formal service provision as triggered by labor platforms, we add to platform research and literature on intermediation between informal and formal economic activity.

Use of services by people living alone with cognitive impairment: A systematic review

Background and Objectives Formal supports and social services are essential to people living alone with cognitive impairment (PLACI) because they are at risk of negative health outcomes and lack cohabitants who may support them with cognitively demanding tasks. To further our understanding of this critical and worldwide issue, we conducted a systematic review to understand whether, and how, PLACI access and use essential formal supports and services. Research Design and Methods We searched six databases (PubMed, Embase, PsycINFO, CINAHL, Web of Science, and Sociological Abstracts) to identify quantitative and mixed-method literature on formal service use among PLACI. The initial search was conducted in 2018 and updated in 2020. Results We identified 32 studies published between 1992 and 2019, representing 13 countries, that met our criteria: 16 reported on health services and 26 on social services. Most studies compared PLACI with people with cognitive impairment living with others. Health service use was lower or similar among PLACI, as opposed to counterparts living with others. Most studies reported a higher use of social services (e.g., home services) among PLACI than those living with others. Overall use of essential home service among PLACI was higher in Europe than in the US, a country where large portions of PLACI were reported receiving no formal services. Discussion and Implications We identified wide variability among countries and major gaps in service use. Results for use of health services were mixed, although our findings suggest that PLACI may have fewer physician visits than counterparts living with others. Our findings suggest that varying policies and budgets for these services among countries may have affected our findings. We encourage researchers to evaluate and compare the influence of social policies in the wellbeing of PLACI. We also encourage policy makers to prioritize the needs of PLACI in national dementia strategies.

When the Day Goes Awry: Families Caring for Persons With Dementia

The daily lives of family caregivers of persons with dementia (PwD) often require that they manage multiple competing demands in a context of unpredictability. Memory and behavior changes associated with dementia can cause PwD to act in random and irrational ways that create stress and influence all aspects of caregivers’ everyday life. Supportive others, including informal helpers and formal service professionals, should provide relief to primary caregivers; however, help may not alleviate caregiver stress and can sometimes compound the burden of care. This symposium draws on daily diary surveys and face-to-face interviews to focus on four aspects of managing everyday care of PwD among family caregivers in rural areas. Brandy Renee McCann explores how caregivers’ vigilance on behalf of PwD care quality interacts with service use. Karen Roberto examines the ways in which caregivers manage PwD resistance to help, including their use of forceful care strategies. Rosemary Blieszner focuses on competing caregiver roles and demands that may contribute to or alleviate caregiver stress. Tina Savla addresses the unexpected, and often hidden, challenges involved in using formal services. Collectively, the four presentations provide in-depth insight into the complicated daily lives of families coping with dementia and the ways in which they meet the demands of full-time caregiving under often difficult and challenging circumstances. Discussant Steve Zarit considers the efficacy of these management strategies for various aspects of everyday care and offers suggestions for future research and person-centered programs and interventions to reduce health disparities among caregivers in rural areas.

Structural Transformation, Service Sector Growth and Poverty Alleviation: The Role of Formal–Informal Interaction and Rising Informal Wage

The motivation of this article is to develop a theoretical mechanism on the interaction between formal and informal sectors and rising informal wage, in the process of service sector growth. Based on empirical support for service sector growth, structural change, higher employment of labour in unorganised sector and rising informal wage in the Indian context, this article develops a theoretical model on the formal–informal interaction in labour employment using a trade-theoretic general equilibrium framework. The results show that with the expansion of capital-intensive, organised service sector, following capital investment in the country, the informal, non-traded intermediate sector, which supplies inputs to the formal service sector, expands with greater employment. The labour-intensive domestic sector of consumer services declines, with the result that the price of consumer services rises, leading to rise in informal wage rate.

PENGARUH SERVICE EXCELLENT TERHADAP KEPATUHAN FORMAL WAJIB PAJAK BADAN PADA KPP PRATAMA GRESIK

Introduction: The government has launched a program called Service Excellent to improve the quality of service to the community. Through this program, government officials are expected to provide the best service to the community through the skills, attitude, appearance, attention, action and responsibility and coordinated, as well as providingthe best solutions for the needs of the community. In the marketing world, this process is called Service Excellent. One of the government agencies that are running Service Excellent is the Tax Office PrimaryGresik. The Service Excellent formal compliance can affect corporate taxpayers effective Tax Office Primary Gresik.Methods: Service Excellent in Tax Office Primary Gresik can be measured by physical evidence, reliability, responsiveness, assurance and empathy. The technique of collecting data through questionnaires. The analysis method used is multiple linear regression and hypothesis testing to determine the effect formal service excellent adherence corporate taxpayers. Analysis of the data used include validity test, reliability test, normality test, multicollinearity test, heterocedastisity test, autocorrelation test, and hypothesis testing (t test partial and F test simultaneous).Results: The results of this study are variables simultaneously physical evidence, reliability, responsiveness, assurance and empathy influence the formal obedience corporate taxpayers, while only partial assuranceand empathy variables that influence the formal obedience corporate taxpayers.Conclusion and suggestion: Tax Office Primary Gresik should improve and pay more attention about variables simultaneously physical evidence, reliability, and responsiveness to achieve customer satisfactionwith service excellent.

Unmasking depression: Challenging structural oppression whilst recognising individual agency

Women living in rural Australia who are labelled as depressed, by either themselves or professionals, contend with spatial injustices of limited service provision that converge with the dominant constructions of mental health and knowledge authorisation. Informed by a feminist social constructionist standpoint, semi-structured interviews were conducted with 27 women living in rural New South Wales in Australia. This paper explores how rural women navigate experiences labelled as depression. The women’s stories conveyed an overwhelming sense of loss, abuse and betrayal, and the pathologisation of their experiences of structural violence and oppression is of significant concern. Yet, the women also showed agency by using to their best benefit multiple and often divergent explanations for their experiences of depression. While many accepted the diagnosis of their symptoms, most resisted a sole pathological cause and actively created individually meaningful narratives of their depression experiences. The language of ‘depression’ provided a passport for some, allowing access to formal supports that would have otherwise been unavailable or highly stigmatised. Rurality and the associated structural disadvantage, particularly in regard to service provision, was only marginally present in the women’s stories. The alternative narratives of healing uncovered challenge the centrality of formal service delivery to the wellbeing of a community. Further, while the pathologisation of structural oppression must be resisted, the women’s stories demonstrate the importance of not invisibilising the agency they demonstrate in this difficult and contested space.