Facilitating independence: The benefits of a post-diagnostic support project for people with dementia.

Providing support in the form of information, advice and access to services or social events is promoted as beneficial for people newly diagnosed with dementia and their families. This paper reports on key findings from an evaluation of a post-diagnostic support pilot project in Scotland addressing local service gaps, namely information provision, emotional and practical support and maintaining community links. Twenty-seven participants (14 people newly diagnosed with dementia and 13 family carers) were interviewed at two time points: T1 shortly after joining the pilot project and T2 approximately six months later, to ascertain their views on existing services and the support offered by the pilot project. A comparative thematic analysis revealed that the project facilitated increased independence (associated with increased motivation and self-confidence) of people with dementia. The project illustrates what can be achieved if resources are targeted at providing individualised post-diagnostic support, particularly where there are service delivery gaps

Autonomous Motherhood and the Law: Exploring the Narratives of Canada’s Single Mothers by Choice

In the past three decades, single mothers by choice (SMCs) have emerged as a new and rapidly growing component of Canada\u27s single mother population. SMCs are women who choose to have a child, usually via some form of assisted conception, with the intention that they be their child\u27s sole parent. While SMCs are part of an increasing number of non-normative family configurations in Canada, they pose some unique social and legal questions. However, unlike some other non-normative families, such as lesbian and gay families, SMCs have received very little academic attention and almost none pertaining to the role of law in their lives. In an effort to fill this knowledge gap, this article presents the findings from a small interview-based study of Canadian SMCs that explored the ways in which the pre-conception decision-making and post-birth experiences of the mothers were shaped by law. Though the law was rarely an overt presence in the women\u27s lives, they identified three aspects of becoming and being an SMC that were nonetheless shaped by law: (i) the pre-conception period during which they were forced to navigate a largely unregulated fertility industry; (ii) when making decisions about the type of sperm donor with which to conceive; and (iii) once they had their child, the ways in which everyday activities were sometimes complicated by a legal system that assumes a two parent, biological family

Autonomous Motherhood in the Era of Donor Linking: New Challenges and Constraints?

The number of single mothers by choice (SMCs), that is, unpartnered women who choose to conceive a child that they intend to raise on their own; has grown rapidly in Australia, where they now represent the largest user group of clinic-based donor sperm. Despite the growing visibility of SMCs, constraints remain for women who wish to parent autonomously from a partner. This article explores a complex new challenge for Australian SMCs: whether to participate in the increasingly popular phenomenon of “donor linking,” defined as the process by which parents who use donated gametes to conceive seek access to the donor’s identity. Made possible by formal legislative pathways in three Australian states, as well as informal mechanisms such as DNA testing, the availability of donor linking arguably places additional pressure on SMCs to embrace dominant norms around gender, family, and fatherhood. Drawing on data from an interview-based study of twenty-five Australian SMCs, this article explores how autonomous mothers who conceive using donated sperm navigate the challenges and opportunities presented by donor linking. It is argued that while donor linking is popular among SMCs and may make it harder for them to resist dominant norms around parenting, family, and gender, the majority of those who engage in the practice are able to shape their experience in a way that preserves their autonomy

Well-being and expression of self in dementia: interactions in long-term wards and creative sessions.

This is a multi-method ethnographic study, grounded in symbolic interactionism and social constructionism, which seeks to explore the social worlds of people with dementia in institutional long-term care. Carried out over six months, it uses non-participant observation, Dementia Care Mapping, video-recording, focused conversations and extensive fieldnotes to document types of interactions that fourteen people with dementia received in everyday ward life and during weekly creative sessions facilitated by occupational therapy (OT) staff. Using Kitwood’s (1997) work on person-centred care and Sabat’s (2001) work on selfhood (Selfs 1-3) it identifies their responses to such interactions in terms of their well or ill-being and expressions of Self. The study shows that everyday staff interactions with participants, while sometimes positive, were more often limited in their potential for maintaining or increasing well-being. Sometimes staff interactions were abusive; causing participant ill-being. Participants expressed Selfs 1-3 verbally and visually, although some of these expressions were subtle, fleeting and fragile. During creative sessions, OT staff engaged in sustained positive interactions, raising participant well-being and facilitating Self-expression; a fragile expression of Self could become a robust expression of Self, a past Self could be reclaimed and a desired Self co-constructed. My findings suggest that, in their interactions during creative sessions, OT staff generally recognised and supported Self of participants, raising well-being. However, ward staff did not fully recognise and therefore could not support Self in their interactions with participants, resulting in participant ill-being. This is a crucial finding, which could partially explain the differences in interaction types I observed, and the corresponding differences in participant well-being and Self-expression. This thesis argues for integrating the selfhood and person-centred approaches into an innovative staff-training programme, in order to bring about transformational change in practice. This might encourage care staff to reach out, recognise and respond to aspects of Self as they carry out care; promoting more positive ways of interacting with their patients, increasing patient well-being and fostering staff satisfaction.NMAHP Research Training (Scotland) in partnership with NHS Education for Scotland (NES), Scottish Executive Health Department and the Health Foundation

Enforcing a Parent/Child Relationship at All Cost?: Supervised Access Orders in the Canadian Courts

Supervised access has become a key component of Canadian custody and access decision making in recent years, in large part due to a shift in attitudes towards post-separation contact between non-custodial parents, typically fathers, and their children. While the sole criterion upon which an access decision can be made is the “best interests of the child,” the increased emphasis on ensuring that children have “maximum contact” with each of their parents post-separation, and the particular focus on maintaining paternal contact, has meant that orders for “no access” have almost disappeared. In an effort to unpack the themes underlying supervised access decision making in Canada, this article analyzes two years of family law judgments from British Columbia and Ontario in which supervised access was ordered. It provides an overview of the types of families and factual situations that attract supervised access orders and analyzes the three themes that emerge from the cases

Equal Parents, Equal Children: Reforming Canada's Parentage Laws to Recognize the Completeness of Women-led Families

Lesbian couples and single women are choosing to become parents, typically via some form of assisted conception, at ever increasing rates. These two groups make up approximately thirty per cent of all clients of fertility clinics in Canada, and many more conceive at home using the sperm of known donors. Yet, when lesbian mothers and single mothers by choice (SMCs) are challenged in the courts- usually by a known donor asserting legal parentage and the rights associated with it- judges, who often have little statutory guidance, routinely undermine the stability and integrity of these women-led families in ways heterosexual couples are protected against. In this article, I argue that equality for lesbian and SMC families is best achieved via legislative reform that prioritizes intention over biology in the assisted reproduction context, akin to the recently introduced legal parentage provisions in British Columbia’s Family Law Act. The introduction of legislation of this type reduces judicial discretion and provides women-led families with the same level of pre-conception certainty heterosexual families have enjoyed for decades. In addition, I argue that in circumstances where legislative presumptions are not available, or where they fail to resolve the conflict, the best interests of the child test should be interpreted in a manner that is consistent with children’s section 15 Charter equality rights. This will ensure that all children enjoy the same level of family stability and security, independent of the composition of their family or their method of conception

Is It Time To Tell? Abolishing Donor Anonymity in Canada

Over the past two decades, a growing number of donor conceived people have spoken out about the impact of donor anonymity on their health and wellbeing. A significant number of legislatures have responded to these concerns by introducing laws that prospectively (and in one case, retrospectively) abolish donor anonymity. This article considers the increasing pressure on Canadian provinces to end anonymity and introduce registers which enable donor conceived people to access their donor’s identifying information. While the article does not endorse the genetic essentialism that is often a feature of advocacy in the field, it does argue that there are no longer grounds upon which Canada can justify the practice of prospective anonymity. Substantial evidence suggests that the wellbeing of future generations of donor-conceived people is best met by providing them with the option of accessing their donor’s identity. What has received less attention in the literature is what type of open disclosure model should be adopted. Decisions need to be made about issues such as whether legislation should be prospective or also retrospective in its operation, how many families a donor should be permitted to donate to, if and how donor offspring are to be notified of the nature of their conception, and how the expectations of participants are to be managed

Enforcing a Parent/Child Relationship at All Cost?: Supervised Access Orders in the Canadian Courts

Supervised access has become a key component of Canadian custody and access decision making in recent years, in large part due to a shift in attitudes towards post-separation contact between non-custodial parents, typically fathers, and their children. While the sole criterion upon which an access decision can be made is the “best interests of the child,” the increased emphasis on ensuring that children have “maximum contact” with each of their parents post-separation, and the particular focus on maintaining paternal contact, has meant that orders for “no access” have almost disappeared. In an effort to unpack the themes underlying supervised access decision making in Canada, this article analyzes two years of family law judgments from British Columbia and Ontario in which supervised access was ordered. It provides an overview of the types of families and factual situations that attract supervised access orders and analyzes the three themes that emerge from the cases