Dementia: the International Journal of Social Research and Practice, 16(1), 2017, pp.46-66.
Publisher:
Sage
Elder-clowns are a recent innovation in arts-based approaches to person-centred dementia care. They use improvisation, humour, and empathy, as well as song, dance, and music. The authors examined elder-clown practice and techniques through a 12-week programme with 23 long-term care residents with moderate to severe dementia in Ontario, Canada. Analysis was based on qualitative interviews and ethnographic observations of video-recorded clown-resident interactions and practice reflections. Findings highlight the reciprocal nature of clown-resident engagement and the capacity of residents to initiate as well as respond to verbal and embodied engagement. Termed relational presence, this was achieved and experienced through affective relationality, reciprocal playfulness, and coconstructed imagination. These results highlight the often overlooked capacity of individuals living with dementia to be deliberately funny, playful, and imaginative. Relational presence offers an important perspective with which to rethink care relationships between individuals living with dementia and long-term care staff.
(Edited publisher abstract)
Elder-clowns are a recent innovation in arts-based approaches to person-centred dementia care. They use improvisation, humour, and empathy, as well as song, dance, and music. The authors examined elder-clown practice and techniques through a 12-week programme with 23 long-term care residents with moderate to severe dementia in Ontario, Canada. Analysis was based on qualitative interviews and ethnographic observations of video-recorded clown-resident interactions and practice reflections. Findings highlight the reciprocal nature of clown-resident engagement and the capacity of residents to initiate as well as respond to verbal and embodied engagement. Termed relational presence, this was achieved and experienced through affective relationality, reciprocal playfulness, and coconstructed imagination. These results highlight the often overlooked capacity of individuals living with dementia to be deliberately funny, playful, and imaginative. Relational presence offers an important perspective with which to rethink care relationships between individuals living with dementia and long-term care staff.
(Edited publisher abstract)
Subject terms:
older people, dementia, person-centred care, arts, intervention, therapies, care homes;
Journal of the American Medical Directors Association, 23(2), 2022, pp.311-314.
Publisher:
Elsevier (for the American Medical Directors Association)
The COVID-19 pandemic presented significant challenges to face-to-face communication with people residing in post-acute and long-term care (PALTC) settings. Telemedicine is an alternative, but facility staff may be overburdened with the management of the equipment. This paper introduces the use of a mobile HIPPA-compliant telepresence robot (MTR) to bridge this barrier, which may be beneficial to reimagine options for PALTC in the future.
(Edited publisher abstract)
The COVID-19 pandemic presented significant challenges to face-to-face communication with people residing in post-acute and long-term care (PALTC) settings. Telemedicine is an alternative, but facility staff may be overburdened with the management of the equipment. This paper introduces the use of a mobile HIPPA-compliant telepresence robot (MTR) to bridge this barrier, which may be beneficial to reimagine options for PALTC in the future.
(Edited publisher abstract)
British Journal of Social Work, 51(8), 2021, pp.2872-2891.
Publisher:
Oxford University Press
In a national and international context where there is a concern about the effectiveness of social care services for children and families to address chronic, enduring social problems and where there are finite resources available, the concept of social innovation in social work policy and practice to address need in new ways is receiving increased attention. Whilst an attractive term, social innovation in child and family services is not without its challenges in terms of conceptualisation, operationalisation, implementation and evidencing impact. This article reports on the development and evaluation of the Early Intervention Support Service (EISS), a newly designed family support service in Northern Ireland set up as part of a government-supported innovation and transformation programme that aims to deliver a voluntary, targeted, flexible and time-limited service to families experiencing emergent problems. Using the EISS as a case study, the challenges, benefits in terms of addressing policy imperatives and future direction of social innovation in social work practice are reflected upon.
(Edited publisher abstract)
In a national and international context where there is a concern about the effectiveness of social care services for children and families to address chronic, enduring social problems and where there are finite resources available, the concept of social innovation in social work policy and practice to address need in new ways is receiving increased attention. Whilst an attractive term, social innovation in child and family services is not without its challenges in terms of conceptualisation, operationalisation, implementation and evidencing impact. This article reports on the development and evaluation of the Early Intervention Support Service (EISS), a newly designed family support service in Northern Ireland set up as part of a government-supported innovation and transformation programme that aims to deliver a voluntary, targeted, flexible and time-limited service to families experiencing emergent problems. Using the EISS as a case study, the challenges, benefits in terms of addressing policy imperatives and future direction of social innovation in social work practice are reflected upon.
(Edited publisher abstract)
Subject terms:
innovation, case studies, social work, early intervention, family support, childrens social care, intervention, evaluation;
The purpose of this guide is to help the reader, and the organisations they work with, to understand what Good Help is, the behaviour change evidence that underpins it, and what it looks like in practice; and to develop new ideas or adapt offers of help, which can be tested out in organisations or local communities. Good Help supports people to adapt behaviours to reach their goals by: understanding what matters to them individually, building on their strengths and celebrating successes; understanding the importance of their relationships and harnessing social connections; recognising practical barriers to change and adapting environments to overcome them; providing opportunities to learn new skills and access tailored information at a time that feels right for them; tracking how behaviours change over time and being prepared for challenges and setbacks. The guide is divided into two main sections. The first section, Eight characteristics of Good Help, aims to help understand the behaviour change evidence and generate ideas for applying Good Help in your organisation or local community. For each characteristic, the guide offers: a description of the characteristic and why it matters; the behaviour change theory and evidence behind it; examples of the characteristic in practice; a checklist to assess whether your idea includes the core components; common pitfalls that might arise when developing and implementing ideas. Section two, Good Help case studies, aims to illustrate how Good Help characteristics have been applied and embedded into practice. Within each case study, the guide presents: a description of what the organisation or programme does; the Good Help characteristics that have been embedded and how this has been done; what practitioners and organisations can do to implement Good Help. This section has been structured using the COM-B model, and outlines what is needed at an organisational level and a practitioner level.
(Edited publisher abstract)
The purpose of this guide is to help the reader, and the organisations they work with, to understand what Good Help is, the behaviour change evidence that underpins it, and what it looks like in practice; and to develop new ideas or adapt offers of help, which can be tested out in organisations or local communities. Good Help supports people to adapt behaviours to reach their goals by: understanding what matters to them individually, building on their strengths and celebrating successes; understanding the importance of their relationships and harnessing social connections; recognising practical barriers to change and adapting environments to overcome them; providing opportunities to learn new skills and access tailored information at a time that feels right for them; tracking how behaviours change over time and being prepared for challenges and setbacks. The guide is divided into two main sections. The first section, Eight characteristics of Good Help, aims to help understand the behaviour change evidence and generate ideas for applying Good Help in your organisation or local community. For each characteristic, the guide offers: a description of the characteristic and why it matters; the behaviour change theory and evidence behind it; examples of the characteristic in practice; a checklist to assess whether your idea includes the core components; common pitfalls that might arise when developing and implementing ideas. Section two, Good Help case studies, aims to illustrate how Good Help characteristics have been applied and embedded into practice. Within each case study, the guide presents: a description of what the organisation or programme does; the Good Help characteristics that have been embedded and how this has been done; what practitioners and organisations can do to implement Good Help. This section has been structured using the COM-B model, and outlines what is needed at an organisational level and a practitioner level.
(Edited publisher abstract)
Subject terms:
objectives setting, strengths-based approach, skills, social networks;
This story book is an attempt to humanise and shine a light on the lived experience of people working in mental health systems in the UK. It is the second story book produced by Living Well UK sites; pioneering places creating new systems of support for better mental health and wellbeing. In this book, we hear from the people designing, testing and leading Living Well UK systems: what has Living Well UK been like for them, as a process for responding to local mental health needs in new and better ways? What has it felt like? What has been valuable for them? What challenges have they faced? One of the clear messages that comes through in this book is the critical importance of giving time and space to work through change. Genuine change requires time to think, try out and learn. Key insights include: great mental health support is enabled by passionate individuals and the sense of purpose, meaning and commitment they bring to their work; the experience of collecting and sharing stories provides emotional connection and empowers people and teams, drawing them together around a shared vision for change; innovation and transformation are enabled when there is equality of voice and when all contributions are valued; the shared experience of co-designing and prototyping a new service builds trust and nurtures the relationships needed across organisations for system change; developing shared practice and co-producing new tools with people with lived experience is key to positive change; a more holistic way of understanding and supporting people is being developed that challenges and overcomes inhibiting mindsets; growing and sustaining new ways of working requires collaborative leadership.
(Edited publisher abstract)
This story book is an attempt to humanise and shine a light on the lived experience of people working in mental health systems in the UK. It is the second story book produced by Living Well UK sites; pioneering places creating new systems of support for better mental health and wellbeing. In this book, we hear from the people designing, testing and leading Living Well UK systems: what has Living Well UK been like for them, as a process for responding to local mental health needs in new and better ways? What has it felt like? What has been valuable for them? What challenges have they faced? One of the clear messages that comes through in this book is the critical importance of giving time and space to work through change. Genuine change requires time to think, try out and learn. Key insights include: great mental health support is enabled by passionate individuals and the sense of purpose, meaning and commitment they bring to their work; the experience of collecting and sharing stories provides emotional connection and empowers people and teams, drawing them together around a shared vision for change; innovation and transformation are enabled when there is equality of voice and when all contributions are valued; the shared experience of co-designing and prototyping a new service builds trust and nurtures the relationships needed across organisations for system change; developing shared practice and co-producing new tools with people with lived experience is key to positive change; a more holistic way of understanding and supporting people is being developed that challenges and overcomes inhibiting mindsets; growing and sustaining new ways of working requires collaborative leadership.
(Edited publisher abstract)
Subject terms:
intervention, staff views, Covid-19, mental health services, service development;
British Journal of Social Work, 51(7), 2021, pp.2554-2570.
Publisher:
Oxford University Press
Turning rhetoric into reality and fully embracing the principles and practice of the Care Act 2014 in innovative, citizen-focused and creative ways has been a journey constructively embraced in Birmingham over the last two years. This has been a journey with critical learning points which incorporate theoretical reflection, managerial and practitioner innovation and an emphasis on citizen-focused co-production. This article considers the context, examines the nature of the change process and appraises the findings from the eighteen-month evaluation. All of these learning points and the process of change itself are eminently transferrable to other Local Authorities operating in the four countries which comprise the UK as well as to the international arena.
(Edited publisher abstract)
Turning rhetoric into reality and fully embracing the principles and practice of the Care Act 2014 in innovative, citizen-focused and creative ways has been a journey constructively embraced in Birmingham over the last two years. This has been a journey with critical learning points which incorporate theoretical reflection, managerial and practitioner innovation and an emphasis on citizen-focused co-production. This article considers the context, examines the nature of the change process and appraises the findings from the eighteen-month evaluation. All of these learning points and the process of change itself are eminently transferrable to other Local Authorities operating in the four countries which comprise the UK as well as to the international arena.
(Edited publisher abstract)
Subject terms:
local authorities, co-production, change management, asset based approach, evaluation, organisational learning, innovation, strengths-based approach, person-centred care, case studies;
International Journal of Integrated Care, 21(3), 2021, Online only
Publisher:
International Foundation for Integrated Care
Introduction: Three peak organisations in Queensland, Australia partnered with consumers and other health and social sector partners to co-design and pilot the first known integrated, health navigation model to improve outcomes for children and young people in care in Australia. Description: An Organisational Learning theoretical lens has been used to present a narrative case study of findings structured as key learnings from the Navigate Your Health pilot to inform quality improvement, scalability and program sustainability. A developmental evaluation was completed whereby semi-structured interviews, focus groups, surveys, chart reviews, database excerpts and economic modelling was completed alongside project documentation analyses to create an evaluation framework. Discussion: Findings highlighted the agency partners’ drive to foster a more integrated and person-centred approach to care. The pilot’s aim of improving health outcomes for a vulnerable population were achieved through a co-designed process which provided additional insights regarding partnerships, improvement, scalability and sustainability. Conclusion: Inter-agency responses to system fragmentation provide significant organisational learning opportunities. System integration is achievable through strengthened partnerships that can be sustained beyond a pilot phase to improve health outcomes for vulnerable/priority populations.
(Edited publisher abstract)
Introduction: Three peak organisations in Queensland, Australia partnered with consumers and other health and social sector partners to co-design and pilot the first known integrated, health navigation model to improve outcomes for children and young people in care in Australia. Description: An Organisational Learning theoretical lens has been used to present a narrative case study of findings structured as key learnings from the Navigate Your Health pilot to inform quality improvement, scalability and program sustainability. A developmental evaluation was completed whereby semi-structured interviews, focus groups, surveys, chart reviews, database excerpts and economic modelling was completed alongside project documentation analyses to create an evaluation framework. Discussion: Findings highlighted the agency partners’ drive to foster a more integrated and person-centred approach to care. The pilot’s aim of improving health outcomes for a vulnerable population were achieved through a co-designed process which provided additional insights regarding partnerships, improvement, scalability and sustainability. Conclusion: Inter-agency responses to system fragmentation provide significant organisational learning opportunities. System integration is achievable through strengthened partnerships that can be sustained beyond a pilot phase to improve health outcomes for vulnerable/priority populations.
(Edited publisher abstract)
Subject terms:
case studies, child protection, children, integrated care, interagency cooperation, joint working, looked after children, outcomes;
NEJM Catalyst Innovations in Care Delivery, 2(3), 2021,
Publisher:
Massachusetts Medical Society
Place of publication:
United States
As part of the national response to Covid-19 in nursing homes, a federal strike team initiative: (1) offered technical assistance and recommendations to facilities experiencing large outbreaks; (2) identified innovative actions taken to safeguard the residents, visitors, and staff; and (3) explored opportunities to strengthen federal, state, and local guidance and support. Between July and November 2020, federal teams visited 96 nursing homes in 30 states. These facilities faced challenges related to staffing, personal protective equipment supplies, Covid-19 testing, and infection prevention and control (IPC) measure implementation. Promising practices included actions taken at the facility level to bolster IPC, as well as system-level support from health departments, health care coalitions, and quality improvement partners. Addressing a novel emerging infectious pathogen such as SARS-CoV-2, the pathogen that causes Covid-19, requires both guidance and education for best practices, along with robust surveillance and a culture of collective accountability across health care settings, including nursing homes.
(Edited publisher abstract)
As part of the national response to Covid-19 in nursing homes, a federal strike team initiative: (1) offered technical assistance and recommendations to facilities experiencing large outbreaks; (2) identified innovative actions taken to safeguard the residents, visitors, and staff; and (3) explored opportunities to strengthen federal, state, and local guidance and support. Between July and November 2020, federal teams visited 96 nursing homes in 30 states. These facilities faced challenges related to staffing, personal protective equipment supplies, Covid-19 testing, and infection prevention and control (IPC) measure implementation. Promising practices included actions taken at the facility level to bolster IPC, as well as system-level support from health departments, health care coalitions, and quality improvement partners. Addressing a novel emerging infectious pathogen such as SARS-CoV-2, the pathogen that causes Covid-19, requires both guidance and education for best practices, along with robust surveillance and a culture of collective accountability across health care settings, including nursing homes.
(Edited publisher abstract)
Subject terms:
innovation, nursing homes, Covid-19, infection control, good practice;
To prevent and reduce the transmission of the coronavirus to vulnerable populations, the World Health Organization recommended the restriction of visitors to nursing homes. It was recognised that such restrictions could have profound impact on residents and their families. Nonetheless, these measures were strictly imposed over a prolonged period in many countries; impeding families from remaining involved in their relatives’ care and diluting the meaningful connections for residents with society. It is timely to explore the impact of public health measures on people living in nursing homes from an ethical perspective. In order to foreground the ethical dimensions of the implications of visitor restrictions in nursing homes, the researchers compiled an ethical case that reflects some recent experiences of nursing homes residents and their families, in the Irish Republic. This paper describes a series of events encountered by a woman and her family during the first wave of the pandemic in 2020 and we deploy an ethical decision-making tool to guide and structure the analysis. This case analysis draws attention to ethical principles that are relevant to explicating the ethical duties and obligations that arise in relation to the interests, well-being, and safety of residents and their families, as well as nursing home staff and the wider community during a pandemic. These include the right of autonomy, trust, minimising harm, and proportionality. This paper concludes that a number of different strategies should be adopted by nursing homes and relevant regulatory bodies. This includes honest, regular communication between the nursing home staff, the resident and their family. Central to communications is the resident’s wishes, their current clinical status and the all-important wider public health obligations. National strategies include mass vaccination, the timely provision of guidance documents and interventions from regulatory bodies that are patient-centred, adaptable, and cost effective.
(Edited publisher abstract)
To prevent and reduce the transmission of the coronavirus to vulnerable populations, the World Health Organization recommended the restriction of visitors to nursing homes. It was recognised that such restrictions could have profound impact on residents and their families. Nonetheless, these measures were strictly imposed over a prolonged period in many countries; impeding families from remaining involved in their relatives’ care and diluting the meaningful connections for residents with society. It is timely to explore the impact of public health measures on people living in nursing homes from an ethical perspective. In order to foreground the ethical dimensions of the implications of visitor restrictions in nursing homes, the researchers compiled an ethical case that reflects some recent experiences of nursing homes residents and their families, in the Irish Republic. This paper describes a series of events encountered by a woman and her family during the first wave of the pandemic in 2020 and we deploy an ethical decision-making tool to guide and structure the analysis. This case analysis draws attention to ethical principles that are relevant to explicating the ethical duties and obligations that arise in relation to the interests, well-being, and safety of residents and their families, as well as nursing home staff and the wider community during a pandemic. These include the right of autonomy, trust, minimising harm, and proportionality. This paper concludes that a number of different strategies should be adopted by nursing homes and relevant regulatory bodies. This includes honest, regular communication between the nursing home staff, the resident and their family. Central to communications is the resident’s wishes, their current clinical status and the all-important wider public health obligations. National strategies include mass vaccination, the timely provision of guidance documents and interventions from regulatory bodies that are patient-centred, adaptable, and cost effective.
(Edited publisher abstract)
Subject terms:
Covid-19, case studies, family members, ethics, nursing homes, residents;
...unsuccessful citizen and provider collaboration, the recent literature has begun to focus on the causes of co-destruction. This paper investigates how the barriers that may arise during the co-production of a new social service with family carers can be identified and interpreted. Methods: To investigate this topic, this study undertook a single case study - a longitudinal project (Place4Carers (Graffigna et
(Edited publisher abstract)
Background: Co-production has been widely recognised as a potential means to reduce the dissatisfaction of citizens, the inefficacy of service providers, and conflicts in relations between the former and the latter. However, the benefits of co-production has begun to be questioned: co-production has often been taken for granted, and its effects may not be effective. To understand and prevent unsuccessful citizen and provider collaboration, the recent literature has begun to focus on the causes of co-destruction. This paper investigates how the barriers that may arise during the co-production of a new social service with family carers can be identified and interpreted. Methods: To investigate this topic, this study undertook a single case study - a longitudinal project (Place4Carers (Graffigna etal., BMJ Open 10:e037570, 2020)) intended to co-produce a new social care service with and for the family carers of elderly patients living in rural and remote areas. The researchers organised collaborative co-assessment workshops and semi-structured interviews to collect the views of family carers and service providers on the co-production process. A reflexive approach was used in the analysis for collecting the opinions of the research team that participated in the co-production process. Results: The analysis revealed four main co-production barriers: lack of trust, lack of effectiveness of engagement, participants’ inability (or impossibility) to change and the lack of a cohesive partnership among partners. Despite these findings, the project increases carers’ satisfaction, competence and trust in service providers by demonstrating the positive effects of co-production. Conclusions: This article confirms that co-creation and co-destruction processes may coexist. The role of researchers and service providers is to prevent or remedy co-destruction effects. To this end, this article suggests that in co-production projects, more time should be spent co-assessing the project before, during and after the co-production process. This approach would facilitate the adoption of adjustment actions such as creating mutual trust through conviviality among participants and fostering collaborative research between academia and organisations that are not used to working together.
(Edited publisher abstract)
Subject terms:
service development, case studies, co-production, prevention, rural areas, carers, informal care, user participation;