People With Dementia In Hong Kong Social Work Essay

People With Dementia In Hong Kong Social Work Essay Nowadays, day care, or nursing home is one of centers of providing stimulation to participants with dementia and scheduling relief to caregivers. However, day care did little to resolve continuing care issues that resume upon the individual returning home while it provided tremendous relief during the hours of service. So, family caregivers still provide extraordinary, uncompensated care, predominantly in the home setting (Lavretsky et al., 2010).   Unfortunately, caregivers are often placed at great risk for negative outcomes that also compromise the well-being of the patients with dementia and heighten their risk for placement in institutional settings. As a result, caregiver needs are overlooked in most clinical and service settings, which may exacerbate the issue of care of people with dementia. Challenges of family caregivers 1. Biological perspectives Caregivers of people with dementia must manage their loved-ones activities of daily living, such as dressing, toileting, and eating. Physically, caregivers are faced with demands involving assistance with daily activities and increased daytime dysfunction compared to non-caregiving controls (McKibbin et al., 2005). Besides, sleep disturbances have deleterious effects on family caregivers health, which is also documented as being predictive of heightened risks, including cardiovascular disease (Rose et al., 2008). At the same time, fatigue may contribute to the depletion of caregivers decision to institutionalize their demented spouse (Vitaliano et al., 2003). 2. Psychological perspectives The stress of caregiving in dementia has been highlighted in numerous studies, often described as an on-going stress process (Schulz Martire, 2004). At the beginning, loved one has been diagnosed with dementia, leaving many with a sense of dread, uncertainty, fear, and shame (Gorina et al., 2006). Moreover, in one study, caregivers expressed their concerns about a lack of knowledge on the cause of illness, on the treatments available for their relative, and on the types of services available and how to access those services (Wong et al., 2003). In addition, they feel frustration when having difficulty managing drug compliance and medical follow-ups, positive symptoms, such as bizarre behaviors, excessive and uncontrollable emotions, and negative symptoms of their relatives with mental illness, such as idling at home and lying in bed all the time (Wong, 2000). Later, grief might occur in response to loss of personal freedom, worry about the future, changes in roles and role conflict, and disruptions in functioning (Holly Mast, 2009). Compared with Western culture, the sense of familial responsibility among Chinese caregivers in Hong Kong exacerbates the stress of caregiving in dementia (Wong, 2000). Social perspectives Social costs are being borne by caregivers with relatives suffering from chronic mental illness (Lowder et al., 2005). Many studies have found that family members, particularly the caregivers, experience an increase in family conflicts, limited friendship and social life, financial difficulty, change in daily routines (Wong et al., 2002; Schulz Martire, 2004; Wong, 2006).Moreover, Hong Kong caregivers scored significantly higher in social costs than the Australian caregivers (Wong et al., 2002). Considering the challenges of family caregivers above, the purpose of this article is to explore the potentiality of supporting to caregivers of people with dementia in Hong Kong, in consideration of the well-being of the patients, especially of themselves. Current situation in Hong Kong Services provided in Hong Kong In Hong Kong the service provided for caregivers of dementia people is holistic. Social Welfare Department has hotline services as well as family services centers to offer counseling, support, and referral services to carers. And the carers support cernter in it and in Caritas Hong Kong also provide support services for those who need to take care of the elderly at home. Scope of service in such kind of centers are mianly skill-training and educational programs, self-help and mutual support groups, resouce corner, couseling and referral services, information giving, demonstration of rehabilitation-aid equipment and social recreational activities (GovHK, 2006). Although there are holistic intervention programs for the caregiver of dementia person in Hong Kong, we find that those programs maily focus on how to better care for the dementia people. After analyzing the challenges faced by family caregivers above, it is necessary to put emphasis on the carers as well. Secondly, prevention programs or services for carers of people with dementia which is diagnosed at the first stage are mentioned little. However, the prevention is important for carers as they may know the difficulties early and have the psychological preparation for all the possible challenges in order to provide better service for patients or supportive strength for themselves. Thirdly, the majority of intervention programs aim at primary caregivers. Nevertheless, according to the systemic family perspective (Yan, 2003), family is ecological. Although the primary caregiver is responsible for the daily care of the dementia elder, all family members will experience stresses. In ord er to establish a new equilibrium of family dynamics, roles and relationships, power and boundary restructuring are needed to be adjusted to the changing situation. Therefore, family as a system to be considered when an intervention plan is adopted is necessary and helpful to maintain a harmony and consolidate environment. 2. Policies supported Prior to World War 2, no community-based psychiatric service was available for people with mental illness in Hong Kong. These individuals were put into asylums run by charitable organizations, such as Tung Wah services (Yip, 1998). During 1960s and 1970s, very few community-based facilities, such as half-way houses and sheltered workshops for mentally ill persons were established (Wong, 2006). In 1982, the incident that an acutely psychotic person went into kindergarten, injured, and even killed a number of children created a scare in the community. As a consequence, the Hong Kong government took more responsibility in financing social and vocational rehabilitation services. In the early 1990s, psychiatric inpatient and community rehabilitation services have undergone many changes (Wong, 2006). However, there are several limitation of the mental health care system and policies. First of all is lack of direction and coordination of service. Whereas various political, social, and cultural conditions may have shaped the development and setting of different priorities in different countries, the Hong Kong SAR government still has not established an overall mental health policy to guide the development of mental health services in Hong Kong, even though various mental health acts have been legally endorsed in such countries as the United States, and Canada. Secondly, delivery of mental health services is inadequate. In Hong Kong, the dominant service delivery mode is still largely office-based, with a nine-to-five working schedule. Very few services operated on the weekends and after office hours. Therefore, when caregivers need professional help, their relative with chronic mental illness who is passive to treatment may not be able to receive timely interventions. Thirdly, ther e is a lack of community rehabilitation services. Currently, four government subsidized resource centers are available, but three of these four centers have been funded by the Social Welfare Department of Hong Kong only since October 2003. Moreover, lack of use of informal care is also a limitation. In Hong Kong, only several government-subsidized relative resource centers exist along with a few self-help groups with small memberships. The mental health care system has not fully utilized the resources available from these informal and networks (Wong, 2006). Finally, resources are lack for caregivers of people with dementia. At present, most of the resources in mental health care have been put into services for people with serious mental illness, such as schizophrenia, and very few resources have been devoted to establishing services for caregivers of people with mental illness, especially with dementia, within the misunderstanding of dementia as a normal phenomenon among the elderly . Moreover, some social workers may not have the clinical knowledge and skills in mental health to perform psychiatric assessment and counseling for caregivers and their relative with illness. Strategies on how to do prevention and intervention When to intervene? According to Rabins (1994), prevention can be categorized into three types: primary prevention, in which a disorder is prevented from occurring; secondary prevention, in which an intervention is provided early when the disorder is identified; and tertiary prevention, in which morbidity occurs, but long-term consequences of disorder are diminished after appropriate intervention (Rabins, 1994). A primary-prevention strategy would aim at families at risk and most current caregiver-intervention studies are secondary- prevention studies. They focus on individuals who have sought help from an organization. Identifying individuals who are at great risk of developing impairment due to social, financial, physical, intrapersonal, or interpersonal resources limit early in the course of caregiving could improve the use of existing services and prevent them from exacerbating more serious problems. Tertiary prevention, that is to minimize the morbidity of individuals who have clearly developed undesirable outcomes because of caregiving (Rabins, 1994). Based on the three phases, different interventions are used. Prevention programs can be applied to the family members with elderly people who might become possible patients or the caregivers of dementia people who have been diagnosed at an early stage. Public education programs about dementias can be useful to those families with elderly people. Also, people need to be encouraged to communicate with dementia patients or their caregivers to understand the possible challenges they may meet which also can be a way to support the existent caregivers. Besides, psycho-education group is another good way to help caregivers which offers support, knowledge and skills training. For the intervention plans, they are mostly applied to the carers who have already faced the difficulties and felt challenged for themselves as well as the patients during the caring. They may encounter the problems from biological and psychological perspectives. Moreover, they face the challenges of lacking family supp ort as well as social support which make them feel suffering. As a result, the following part will introduce the intervention plan for carers of dementia elderly. Different aspects to intervene a. Biological aspect It can be counterproductive for family members to continue caring for their relatives when they are under bad healthy situation, so it is necessary for family caregivers to recharge their energy by taking a break from caring for their relatives. They should be encouraged and helped to establish more fulfilling and interesting social lives or they can choose a relaxer such as aerobics, massage, watching movies with friends (Stehman, Strachan, Glenner, Glenner, Neubauer, 1996). Moreover, some skills such as Body scan (Stehman, et al., 1996) can calm the caregiver down when he or she feels stressful or has tight tension. Regular body examination is necessary for the carers as well. b. Psychological aspects According to psychological problems of caregivers, the most serious points are distress, low self-efficacy which can lead to depression and anger during the caring process (Gallagher-Thompson, 1994). When counseling with the carers, listening is valuable to them as they always need someone to listen to their feelings and experience which is a way of release (Marshall Tibbs, 2006). Moreover, using psycho-educational intervention programs can be helpful in which two programs were developed. One is Increasing Life Satisfaction, the one that focused on handling depression by increasing the frequency of engagement in pleasant activities, and the other one is Coping with Frustration which aims at anger-management skills and reducing the frequency as well as intensity of anger feelings (Gallagher-Thompson, 1994). Both of the two programs are developed from cognitive-behavioral perspective. And the duration can be last 10 sessions at three-month intervals between every three sessions. Secondly, other caregiver training programs which provide support to enhance positive emotion are always needed. The training shares two major goals: to improve caregivers ability to cope with the stress of caregiving and to empower caregivers by developing problem-solving strategies (Kaplan, 1996). The ability of solving problems when caring often relates to the cognitive status and will influence the stress level. Another pivotal aim is to increase the self-efficacy of carers. Since self-efficacy of caregivers relates to their physical and mental health and high level of depression may lead to low self-efficacy and more burden to caregivers, it is particularly significant to enhance the self-efficacy of caregivers (Fortinsky, Kulldorff, Kleppinger, Kenyon-Pesce, 2009). In a word, efficient intervention to help caregivers improve their problem-solving skills and thus enhance self-efficacy and reduce the stress as well as negative emotion such as guilty or anger is important when considering the psychological aspect. c. Family support As mentioned before, balanced family dynamics and support from other members are benefit to both the patient and the caregiver. Intervention programs that attempt to help the family members develop proper attitudes toward their relatives, acquire basic information on the day-to-day management of their relatives, improve communication skills are found to be useful. Indeed, it is necessary for the worker to see family members as partners and resources in the care of people with dementia disease. Family therapy (Marshall Tibbs, 2006) is traditionally practised in dysfunctional families and usually it is useful when families are under stress. Viewing dementia as a family problem rather than a problem for a single person, or the person and the carer, can be very constructive. In the family system, normally there are some subsytems such as siblings relationship, parent-child relationship, and marital relationship. And when one of the members have demetia problem, conflict or argument arises under the stressful environment. Under this circumstances, better communication and intimate relationship help to cope with the crisis (Quinn Herndon, 1986). The family had a clear but flexible boundary, which allowed other systems come in to provide assistance. The family members were also flexible in adjusting different roles and positioning in the family to achieve stability. So having family counseling, and involve all the possible members to discuss and share with each other is importa nt. Under the agreement, the members can support each other and the burden or emotional problem can be eased. d. Social support Caregiver support groups throughout the community to help people better cope with complex issues is necessary like the groups provided by Alzheimers Community Care (Caregiver Support Groups, 2010). Besides, it concludes one special service called 24-hour crisis line to provide crisis intervention. Such kind of intervention is quite useful because it will stabilize and coordinate emergency resources and advocate for the patient and caregiver. Moreover, it ensures the patient to achieve the optimum level of functioning, enabling the patient to remain in the least restrictive setting. Educational support group is an intervention used by the majority of the programs. The objectives are to help caregivers develop knowledge about dementia and the process of caring for someone with the disease; to assist caregivers to learn about the resources and services available to them and to support them in their experience of caregiving and in their need for self-care. Small groups of less than fifteen people can be offered to deepen and personalize the knowledge gained through the seminars. Caregivers feel more at ease to raise their concerns and questions. Moreover, workers can have the time to address concerns and issues selected from them. Enhanced Home and community services (EHCCS) program provided by Social Welfare Department of Hong Kong and Carer support Group organized by Hong Kong Alzheimer`s Disease Association offer such kind of platform for carers. Caregivers can get professional resources and emotional support from the sharing of experienced carers. Besides, resp ite care (Lawton, 1994) allows caregiver to be temporarily relieved of the responsibility for care. It qualifes as a broad generalized intervention because it supplies the wherewithal of time for the caregiver to do whatever he or she wishes-a ture open-ended intervention. Moreover, case management services provided by community help caregivers to negotiate the social services or health care system. Through this way, multiple professionals can be gethered to support and meet the needs of caregivers and patients. At last, social workers also can help through home visiting and offering couseling. During the helping process, communication skills and techniques such as nomalization, attending and miracle questions are needed to encourage caregivers to share and express their negative emotions and thus to assess the caregivers problem and help. When doing the couseling, music and art therapy can be an opportunity for carers to enjoy and improve the quality of life. 3. Suggestion for policies First of all, the provision of psychiatric care involves such different departments as health care, social services, education, and vocational training, and involves different professionals such as psychiatrists, occupational therapists, psychologists, and social workers. Different operation units have their own sets of criteria and procedures for accepting service user. It is easy to appreciate the difficulties and confusion family members face when accessing the mental health care system. Therefore, a systemic, comprehensive health care policy should be established, which provide the family caregivers with information on the various services available and secure the services for his or her relative. Secondly, since a large number of mentally ill individuals live with their family, and some these family members have taken up the caring roles, the government has the responsibility to provide resources and funding to support these family members. In essence, if family members can adequately perform their caring roles, it may reduce the chance of their relatives relapse and consequently fewer hospitalizations will occur. Finally, in order to increase the familys functioning of caring the dementia people in Hong Kong, the government needs to administer more resources to agencies that provide individual and group counseling for caregivers of people suffering from serious and mild psychiatric illness. Conclusion

Strategic Analysis of Pepsi :: Business Case Studies

The growing demand for more healthy goods has naturally delayed several sectors of the beverages industry. While consumers have turned to bottled water and juices rather than carbonated drinks in the soft drinks market, consumers concern over alcohol consumption has affected demand in the alcoholic drinks sector. This trend has affected the alcohol sector much more than the soft drinks sector with the exception of wine consumption because it is being proved by scientists that it may reduce the risk of heart disease with a moderate consumption. While there are only few new markets to expand into, the market for soft drinks is globally well exploited. There are few factors that suggest trivial forecast for growth. However, demand continues to grow. Before the end of the current decade, the soft drinks market is expected to surpass the alcoholic beverages market, which constantly has shown lower growth than the beverage industry market in general. While product innovation has stimulated some growth within the industry during the 1990s by introducing new plastic bottles, innovation is slowing within the soft drinks industry recently. Since1997, in terms of market value, the global beverages market grew by 1.7% in 2002 to reach a value of $1,060 billion, and an increase of 16.6% in the global beverages market is predicted by the year 2007 to reach a value of $1,236 billion. In terms of market volume, the global beverages market grew by 3.4% in 2002 to reach a volume of 551 billion liters, and an increase of 20.5% is forecasted by 2007 to reach a volume of 664 billion liters. Even though all sectors of the beverage market are generally dominated by big companies, the soft drinks market is quite different in terms of its competitive position. The soft drinks market is dominated by two global giants: Coca-Cola and PepsiCo. Even though innovation and brand extension strategies have played big role in the recent years within the soft drinks sector between major competitors, market leader Coca-Cola is still concentrating its efforts on the traditional carbonated drinks market with respectable success. It is absolutely difficult for new start-up companies to enter the soft drinks market because it requires a huge financial resources as well as logistical infrastructure that need to rely on. The most important asset for all of the top current players continues to be the brand, and this is where Coca Cola really have the edge.

Aig Bailout & Stakeholder Analysis

AIG Bailout & Stakeholder Analysis In September 2008, the American International Group, AIG, the largest insurance company in the United States, suffered from the bad debts incurred insuring mortgage-backed securities. As a result, within a matter of three months, AIG reported a startling quarterly loss of $61. 7 billion, largest in the U. S corporate history. Instead of watching this global insurance giant fall on its keens, the U. S. government has decided to lend a helping hand by bailing out AIG. However, this generosity isn’t without a cost.Seven months and four bailout programs later, the American taxpayers are stuck with a bill for the amount of $182 billion, in return for 79. 9% equity stake of the failing company. Soon after the bailout fund was received, the board of directors at AIG announced that the company will continue to reward its senior management and traders with the contractual $165 million bonus, the same group of people that caused the AIG collapse and gl obal credit crisis in the first place. Personal, I am completely disgusted with this particular decision.How can any of the executives and traders be able to spend a penny from this bonus pool knowing what their action have caused. Just like Cousin Robin, millions had lost their life time savings due to someone else’s greed and irresponsibility. However, at the same time I have no choice but to agree with the government’s decision on bailing out AIG and indirectly looking out for its employees and shareholders. The following is my argument based on the impact from several stakeholders if the government had not done so. Investors:The first immediate impact of the AIG bankruptcy will be its investors. Although AIG is widely regarded as world’s No. 1 insurance corporation, many had not realized that AIG is also the world’s largest credit insurer for many major corporations as well as the largest issuers on credit related derivative products such as Credit De fault Swap or CDS. During the second and third quarter of 2008, the credit rating on many mortgage security firms were downgraded when mortgage default rating reached its all time peak and firms were failing to meet their debt obligations.Consequently, as a credit insurer, AIG were obligated to pay investors the contractual swap payment. However, since firms were defaulting at an astonish rate, it was almost impossible for AIG to come up with any of the payments. Without any payment, most of the investors weren’t able to meet their own legal obligation and this transcended down to a vicious cycle and eventually turned into a global crisis. Now, when AIG received the government bailout package, its immediate action was to pay its clients and alleviated the pressure of any firm that was involved before things got worse.Goldman Sachs for one was the biggest beneficiary from this bailout as the firm was facing many uncertainties of its own. Average Consumers/General Public: The a verage consumers may not realize this, but AIG cannot fail. Not only does it play a major role in the U. S. economy, it plays a crucial role in our daily lives. It impacts anyone who owns a home, car, insurance, or even a student loan. The AIG statistics are overwhelming. The company has 74 million customers around the globe. 0 million of those clients are American based. AIG operates in more than 130 countries. Prior to the current market conditions, the company backed more than $298 billion in assets globally. Just its quarterly loss along had sent the world market into an abyss, the Dow lost 300 points and Asian market toppled to a new low. The answer is fairly simple, the average consumers like myself have so much invested in AIG that we cannot see it fail.The implication on it defaulting will be far worse than losing 75% of our retirement fund. Employees & Shareholders: I will need to bring employees and shareholders into the same category here since most of the AIG employees a re its shareholders. These two groups are probably on the worse end of the deal than anyone else. The bailout package is a very good indication that the government is nationalizing AIG as it holds 80% of its shares, a move that wiped out most of the shareholder’s value.On the other hand, many had yet to realize that before the bailout, AIG was on the blink of â€Å"extinction†, which will result unemployment and an empty retirement portfolio. With the bailout, employees like Robin can safely say â€Å"I am still employed. † And to those who are optimistic can even say, if the bailout does workout in the years to come and AIG is successfully restructured under the economy reforming, their portfolio will be back to its fair market value, maybe even more. It is reasonable to assume that anyone who is on the same boat as Cousin Robin will be disgruntled.On the other hand, when we dissect the situation in further depth, one will realize that the AIG bailout will rest ore economic stability, prevent future collapse of large institutional investors, support the financial community, not to mention restore consumer confidence. Thus, as one of the millions U. S. taxpayers, I will have to disagree with Robin and certainly applaud the government’s decision on handing out the AIG bailout. ——————————————– [ 1 ]. http://www. onlineforextrading. com/blog/aig-bailout-again/ [ 2 ]. http://www. onlineforextrading. com/blog/aig-bailout-again/

No Duty Rules Rape Victims And Comparative Fault

The Victim A Victim is described as a person who is killed, harmed or injured due to a crime, accident, or some other action or event. A victim is also described as someone who has been tricked or duped. These definitions perfectly describe a victim of rape. A victim is not only harmed from a rape crime, but is also tricked into thinking that justice will occur. This is not the case. Fifty percent of people feel as if rape is the victims fault and never the rapist fault. Why is society so willing to blame the victim of an unlawful sexual act that violates the victim mentally and physically, instead of dealing with this social issue? In 1999, a law was introduced in Columbia. Bublick, in her article Citizen No-Duty Rules: Rape Victims and Comparative Fault., explains how this law blames victims for their own rape. The law is considered to be a rape victim’s rape case to be ‘comparative fault’. This means that the victim is blamed for the rape case. 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