The care of an ageing and disabled group in a veterans' hospital : an appraisal of the Domiciliary Care Programme provided by the Department of Veterans' Affairs in Vancouver
Bibliographic record
Abstract
This study makes an appraisal of a special example of institutional care for aged and disabled persons, namely, the specific group of veterans in Vancouver who, under present D.V.A. regulations, are regarded as being "totally disabled" and in need of domiciliary care. Chronic illness of long duration is one of the principal characteristics, though not the only one, of this group, and of their various disablements. The appraisal of this group, in relation to the domiciliary care programme, is made in the light of modern concepts of treatment and rehabilitation, but gives special attention to the contributions in understanding and relationship which can be made by the social worker. In the welfare field, veterans are a special group because of their liability to disablement and to other possible causes of "premature ageing" which may have resulted from war service. They are a special group also because of the unusual number of facilities and opportunities for recovery and re-adjustment which have been provided for them. Domiciliary care is one of these special services, exclusively designed for veterans who require total care on a more or less permanent basis. Re-establishment of veterans with lesser handicaps already has been demonstrated on a vast scale since the end of the last war. But problems evidently remain for the type of veteran who is aged, whose disablements are of an extreme nature, and who, in spite of a superior treatment service, has not changed his total disability status. Lessons for other aged and disabled groups in the civilian population can be drawn from the present type of study. The material of the investigation includes, first, a review of the general provisions of domiciliary care for Class-Six patients, based on over one hundred district files and a similar number of medial social service files. Detailed personal information was also obtained in interviews with many of the patients. Discussions were held with doctors and departmental administrators, and needs and services were discussed with staff members acquainted with the Class-Six patient. The basic method of using this material was to review psycho-social aspects of the status and attitudes of individual cases, to delineate basic social and emotional problems, and to appraise the domiciliary care programme in terms of its ability to meet these problems. Social work practice and rehabilitation possibilities both reveal many gaps in the present programme, which is primarily designed to provide physical care. Case studies indicate that many of the critical factors in the older patient's adjustment are psycho-social as well as physical; yet little or no definitive treatment is given for psycho-social disorders. Recommendations, on the basis of these findings, include a method of classification and segregation of Class-six patients in groups, and the creation of rehabilitation-treatment services on an individualized basis. The role of the social worker is outlined in relation to the broader functions of the clinical team.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.006 | 0.002 |
| Scholarly communication | 0.004 | 0.001 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".