This study analyzed the relationship between social network dynamics and initial help-seeking behaviors. The primary social network was reconstructed for the period beginning with initial observation of unusual behavior and ending with first psychiatric hospitalization. The social network's influence was analyzed based on the concept of social network cohesion, considering both structure and content of social ties. The results demonstrate that networks succeed in referring the family member to services and in maintaining a clinical follow-up to the degree that they are cohesive. When a network lacks cohesiveness, the onset and development of problem behaviors are less easily recognized. These findings confirm the importance of social and interactional contexts in decision-making processes leading to use of psychiatric services and specify the roles they play.
In Canada, the care provided by families occurs in an increasingly multiethnic context. Against this backdrop, the present qualitative study aims to explore the needs/expectations and solutions not only of (female) natural caregivers of an elderly relative hailing from Haiti (presented in terms of tracking cases) but also of remunerated home care providers - all with a view to developing a culturally sensitive service offering. As such, this study works from a conceptual framework centring on the negotiation of a common area of agreement between the stakeholders involved (i.e., natural caregivers and home care providers). To this end, focus groups and individual interviews were conducted among 15 caregivers and 37 home care providers. The three recurrent themes emerging from the data analysis concern, in context, the needs/expectations and solutions surrounding the experience of service use, barriers to use, and the relationships between natural caregivers and home care providers. The statements of both groups evidenced a consistency of views and have thus provided a basis for developing some recommendations acceptable to all stakeholders from the perspective of making culturally-based adjustments to the service offering.
Services for elders with severe mental illness (SMI) have major deficiencies, among them a lack of adequate psychosocial services. Some analysts have attributed this situation to "double stigmatization" targeting both ageing and mental illness in our societies. Using qualitative methods (23 semi-directed interviews, theme-based content analysis), our exploratory research aims to understand better the perceptions of psychosocial practitioners working in community and institutional settings about the elderly with SMI and their living situations. Our informants evoke living situations marked by a lack of support (isolation), of resources (financial precariousness/poverty) and of power (learned passivity), traits that are related not only to mental illness per se, but also to long term psychiatric institutionalization. For them, the current situation of elders with SMI is the end product of biographies in which life-course, illness-course and life in services and/or institutions join and, sometimes, become indistinguishable. Implications for psychosocial practices are discussed.
Health interventions are currently being revamped to address the specific needs of chronic illness and population aging. In this context, focus has increasingly turned to Alzheimer-type dementia, an illness that is considered to mobilize a large number of social actors into long-term involvement of varying intensity. Linkage problems between families and professional systems have been well documented, yet the reasons for this remain relatively unexplored. In this article, we outline how we used social network data and narrative methods to better understand the linkage processes between formal and informal care systems. We present the trajectories of four caregivers of people suffering from Alzheimer's disease who were able to establish relationships with resources outside the family. In each of the cases, the dimensions of trust and recognition were central to establishing and maintaining supportive relationships, and must therefore be understood in light of social network dynamics and the broader environment. Although preliminary, this study contributes to the state of knowledge on linkage problems by proposing "bottom-up" solutions that are client centered.