Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Caring for Vulnerable Children: Challenges of Mothering in the Australian Foster Care System

Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Caring for Vulnerable Children: Challenges of Mothering in the Australian Foster Care System

Article excerpt

Nurses have long been concerned with the health and well-being of vulnerable populations. Vulnerability can be conceptualised as the propensity of certain social groups to experience higher levels of morbidity and mortality when compared to the general population (Flaskerud & Winslow, 1998). Children (and young people) who reside in out-of-home care are a vulnerable population (Bruskas, 2008; Galehouse, Herrick, & Raphel, 2010; Webster & Temple-Smith, 2010). Compared to the general population, these children experience a higher incidence of physical, cognitive, developmental, emotional and behavioural issues (Carbone, Sawyer, Searle, & Robinson, 2007; Nathanson & Tzioumi, 2007). Such health issues are largely attributed to the children's experiences prior to entering care but have also been demonstrated to be exacerbated while in care (Kools & Kennedy, 2003; Nathanson, Lee, & Tzioumi, 2009; Nathanson & Tzioumi, 2007; Zhou & Chilvers, 2010). Given their health issues, these children, and their carers, likely have increased interaction with the health care system and, subsequently, nurses. Such interaction presents an opportunity for nurses to positively impact on this vulnerable group. In order to optimise this interaction nurses need to understand the complex issues faced by foster carers. This paper seeks to provide insight into the experiences of foster carers providing long-term care to children within the foster care system.

BACKGROUND

The child protection system in Australia is comprehensive, aiming to promote the health and well-being of children rather than merely respond to issues of abuse or neglect (Council of Australian Governments, 2009). This necessitates collaboration between various government departments and private organisations in the health, welfare, justice and education sectors to provide adequate support to vulnerable families and children. When early intervention is ineffectual or untenable, physical removal of children from an unsafe living situation to an alternate environment is sometimes necessary (Australian Institute of Health and Welfare, 2012). In 2011 there were some 37,648 Australian children in out-of-home care. The majority (73%) of these children were on long-term guardianship orders and nearly half of these children (45%) live with foster carers (Australian Institute of Health and Welfare, 2012). These data demonstrate the significant role that foster carers play in supporting Australian children in out-of-home care.

Foster carers play a fundamental part in maintaining child health and well-being, as they are responsible for the day-to-day parental tasks of care-giving, as well as providing a safe environment and negotiating access to resources (Bonfield, Collins, Guishard-Pine, & Langdon, 2010; Riggs, Augoustinos, & Delfabbro, 2009a). One of the key factors associated with optimal outcomes for children in foster care is the careful and deliberate selection of appropriate foster carers (Henderson & Scannapieco, 2006; Holland & Gorey, 2004; Sinclair & Wilson, 2003). Evidence suggests that foster carers have the capacity to improve the health and well-being of the children in their care (Schofield & Beek, 2005a, 2005b; Tarren-Sweeney & Hazell, 2006). Specifically, healthy attachment to a foster 'parent' has been found to facilitate healing, provide a sense of belonging and promote resilience for this vulnerable group of children (Riggs et al., 2009a; Schofield, 2002; Schofield & Beek, 2005a, 2005b). Therefore the need to attract and retain high quality and committed foster carers remains a high priority in Australia (Council of Australian Governments, 2009).

Recent literature suggests that foster carers may themselves be a vulnerable group (Blythe, Wilkes, & Halcomb, 2013). Foster carers have been found to experience heightened levels of anxiety (Farmer, Lipscombe, & Moyers, 2005), depression (Cole & Eamon, 2007) and stress (Wilson, Sinclair, & Gibbs, 2000) when compared to the general community. …

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