Studies suggest that strict control of diabetes is dangerous for older adults with chronic illnesses. Since Veterans have a higher prevalence of diabetes and other chronic ailments, caregivers need a better understanding of how restrictive diabetes control may be detrimental. Furthermore, the critical role of caregivers in the management of diabetes supports the need to understand how they experience the help-seeking process. In order to develop effective programs and policies, researchers must understand what triggers caregivers to seek help. At this time, limited understanding exists on how help-seeking takes place among caregivers of Veterans.

This study utilized Grounded Theory and interviewed caregivers (N=25) of Veterans who were diabetic with other co-morbid illnesses. The recruitment of caregivers took place at the West Los Angeles Veterans Administration (VA). A semi-structured interview was used to understand the help-seeking process. The transcripts were analyzed to develop a theoretical model.

The study findings suggests that help-seeking is a complex phenomenon. Two themes emerged: (1) Knowing what you do not know and (2) Help means different things to different people. The first theme suggests that caregivers provide care to Veterans until they reach a crisis point in which their resources (instrumental and financial), physical and mental well-being are compromised. Therefore, caregivers experience a multitude of factors before they come to realize “what they don’t know”. The type of assistance the caregiver needs (informational, instrumental, emotional, spiritual or financial support) depends on how it is defined by the caregiver - “help means different things to different people”. Help-seeking, therefore, occurs based on what kind of assistance the caregiver needs. The study also shows that informal and formal networks are critical in facilitating the help-seeking process and provides insights into to two different types of caregivers (proactive and overwhelmed, passive and overwhelmed).

This study provides a foundation for understanding the help-seeking process of caregivers of Veterans and suggests that the VA needs to bring forth policy changes to reduce the risk for hypoglycemia and caregiving burden. Furthermore, the study findings can be used to develop social work interventions and encourage future research on understanding the phenomenon of help-seeking among caregivers.

Research on nonprofit organizations becoming more business-like in their structure and function has garnered considerable academic interest in recent years. This trend, also referred to as managerialism, has traditionally been explored from organizational or management perspectives, and much of the research on the topic has focused on examining the motivation behind for nonprofits embracing approaches and practices more commonly found in the for-profit sector. The purpose of this dissertation research was to expand the study of managerialism, specifically within social justice nonprofit organizations, by examining the environmental context within which these organizations exist to better understand how the organizational environment contributes to the emergence and operationalization of managerialist approaches and practices.

With this goal in mind, a case study of three social justice nonprofits in a large, metropolitan city in the United States was conducted. Interviews took place with 43 staff members whose positions ranged from frontline employees to CEOs. The data was analyzed using Constructivist Grounded Theory Analytic Techniques.

From the data emerged a conceptual model illuminating how organizations are affected by their internal and external environments, and the mechanisms that staff employ to manage these impacts. Specifically, the model shows how organizations exist in a relationship of dependency with external stakeholders, and that staff members engage in several response processes in order to manage this relationship. Furthermore, the data indicate that not only does managerialism emerge as a result of this relationship, it is also used as a way to respond to the challenges organizations face as a result of being dependent on external stakeholders. Implications of these findings on both research and practice are explored.