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Enhancing the quality of care in residential and nursing homes: more than just a professional responsibility
- Author:
- NOLAN Mike
- Journal article citation:
- Journal of Elder Abuse and Neglect, 10(1/2), 1999, pp.61-77.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This article highlights a range of issues considered essential to improving the quality of care received by older people in residential and nursing home settings. It is argued that improving such care represents a societal as well as a professional responsibility and that remedial action is needed at a number of levels. Five 'routes' to achieving quality are outlined, and it is suggested that these are not simply alternatives but that each requires attention if genuine progress is to be made.
Assessment: identifying the barriers to good practice
- Author:
- NOLAN Mike
- Journal article citation:
- Health and Social Care in the Community, 4(2), March 1996, pp.77-85.
- Publisher:
- Wiley
Although much has been written about the concept of assessment, there is still no clear consensus on the characteristics of good practice. Moreover, recent studies have highlighted the fact that frameworks for assessment are often heavily influenced by particular professional perspectives, and consequently the holistic assessment of need envisaged in the National Health Service (NHS) and Community Care Act 1990 has yet to emerge. This paper identifies some of the contradictions inherent in the practice guidance relating to assessment and discusses the results of early evaluations of the implementation of the new assessment process. A possible model to structure this process is outlined and suggestions made as to the benchmark of good assessment practice.
Older people and decision-making following acute stroke in China: ‘hiding’ as a barrier to active involvement
- Authors:
- WANG Yue, NOLAN Mike
- Journal article citation:
- Ageing and Society, 36(7), 2016, pp.1526-1554.
- Publisher:
- Cambridge University Press
Decision-making among older patients with stroke, their families and professionals has been extensively studied in a Western context, but there has been little prior work in China. The study reported here explored how decision-making took place between older people with stroke, their family carers and professionals in an acute care context in mainland China using a constructivist grounded theory approach. Data were collected through semi-structured interviews, participant observation and documentary analysis. Constant comparative analysis of the data was carried out. This paper focuses on the key social process of ‘hiding’ and its dynamic relationship with the core category ‘keeping the peace’. In order to meet the traditional Chinese cultural value of ‘maintaining harmony’, both family carers and professionals hid essential information from older stroke survivors who, as a consequence, were effectively precluded from playing an active role in major decisions. In understanding ‘hiding’, the paper draws upon both Chinese cultural values and ‘awareness context theory’ and in so doing questions the relevance to the Chinese context of key Western notions such as involvement in health-care decision-making. A better understanding of the experiences of decision-making processes between older people with stroke, their family carers and professionals in China will help professionals to provide the best possible support and care whilst promoting informed decision-making amongst all concerned.
Towards 2012: homelessness support project report to COSLA, ALACHO and the Scottish Government
- Authors:
- NOLAN Mike, MCLEAN Iain
- Publisher:
- Scotland. Scottish Government
- Publication year:
- 2008
- Pagination:
- 83p.
- Place of publication:
- Edinburgh
The ALACHO Project was established to provide dedicated support to councils to achieve the national homelessness target to abolish priority need by 2012. To conduct the project, two officers were seconded from council homelessness teams to the Scottish Government under the joint supervision of the Government, COSLA and the Association of Local Authority Chief Housing Officers (ALACHO). The report is the outcome of visits to Homelessness Teams throughout Scotland. It includes suggested actions for development by interested parties into an Action Plan. The report should be seen in the wider framework of the Scottish Government’s policies and actions relating to housing including the Concordat between the Scottish Government and COSLA, the Housing Supply Task Force, the ‘Firm Foundations’ consultation document, the consultation to revise ‘Scottish Planning Policy 3: Planning For Housing’ and the revised Homelessness Monitoring Group. The issues and barriers discussed are grouped under supply, prevention, support, legislative change and guidance and monitoring.
'Making the move': relatives' experiences of the transition to a care home
- Authors:
- DAVIES Sue, NOLAN Mike
- Journal article citation:
- Health and Social Care in the Community, 12(6), November 2004, pp.517-526.
- Publisher:
- Wiley
Despite a growing awareness of the significance of helping a relative to relocate to a care home as a key phase in the caregiving career, relatively few studies in the UK have explored this experience in depth. The research on which the present paper is based sought to better understand experiences of nursing home placement from the viewpoint of relatives. The study was informed by a constructivist perspective. Data were collected in 37 semi-structured interviews involving 48 people who had assisted a close relative to move into a nursing home. Data analysis revealed three phases of the transition from the relatives' perspective: 'making the best of it'; 'making the move'; and 'making it better'. The relatives' experiences across these phases were understood in terms of five continua, reflecting the extent to which they felt they were: operating 'under pressure' or not; 'working together' or 'working alone'; 'supported' or 'unsupported', both practically and emotionally; 'in the know' or 'working in the dark'; and 'in control of events' or not. This paper reports on the findings which relate to the second phase of the transition, 'making the move', which relates to experiences around the time of relocation to the care home environment. The findings suggest that health and social care practitioners have enormous potential to influence relatives' experiences of nursing home entry. Experiences are enhanced if family carers perceive that they are able to work in partnership with care staff in order to ease the transition for the older person.
Partnerships in family care: understanding the caregiving career
- Authors:
- NOLAN Mike, et al
- Publisher:
- Open University Press
- Publication year:
- 2003
- Pagination:
- 333p.,bibliogs.
- Place of publication:
- Maidenhead
This book considers how family and professional carers can work together more effectively in order to provide the highest quality of care to people who need support in order to remain in their own homes. It adopts a temporal perspective looking at key transitions in caregiving and suggests the most appropriate types of help at particular points in time. It draws on both empirical and theoretical sources emerging from several countries and relating to a number of differing caregiving contexts in order to illustrate the essential elements of 'relationship-centred' care.
Gauging quality in constructivist research: the Aldre Vaste Sjuharad model revisited
- Authors:
- NOLAN Mike, et al
- Journal article citation:
- Quality in Ageing, 4(2), August 2003, pp.22-27.
- Publisher:
- Pier Professional
- Place of publication:
- Brighton
The Aldre Vaste Sjuharad Centre in West Sweden has as its main goal the promotion of partnerships between older people and their families. In pursing these goals the Centre adopts a broadly constructivist method to research that is 'authentic and meaningful' to those that take part. This paper assesses the quality of the resultant research.
'Making the best of things’: relatives' experiences of decisions about care-home entry
- Authors:
- DAVIES Sue, NOLAN Mike
- Journal article citation:
- Ageing and Society, 23(4), July 2003, pp.429-450.
- Publisher:
- Cambridge University Press
Despite the growing awareness of the significance of helping a relative to relocate to a care home as a key phase in the care-giving career, relatively few British studies have explored this experience in depth. Informed by a constructivist perspective, this study sought a better understanding of nursing home placements from the viewpoint of relatives. Data were collected in 37 semi-structured interviews involving 48 people who had assisted a close relative to move into a nursing home. Analysis revealed three perceived phases to the transition: ‘making the best of it’, ‘making the move’ and ‘making it better’. The relatives' experiences through these phases had five perceived elements, all of which were continua, from absent to very strong, reflecting the extent to which they were felt. They were: operating ‘under pressure’ or not; ‘in the know’ or ‘working in the dark’; ‘working together’ or ‘working alone’; ‘in control of events’ or not, and ‘supported’ or ‘unsupported’ both practically and emotionally. This paper reports findings about the first phase of the transition, ‘making the best of it’, and documents the experiences of decision-making about nursing home placements. It is argued that health and social care practitioners have enormous potential to influence whether or not helping a relative to move into a nursing home is perceived as a positive choice.
Training together: a challenge for the future
- Authors:
- NOLAN Mike, KEADY John
- Journal article citation:
- Journal of Dementia Care, September 1996, pp.10-13.
- Publisher:
- Hawker
The rise in status of dementia care and respect for its expert practitioners throws the issue of training into the spotlight. The authors open the debate with this overview of current deficits in professional education.
Assessment and community care: are the reforms working?
- Authors:
- CALDOCK Kerry, NOLAN Mike
- Journal article citation:
- Generations Review, 4(4), December 1994, pp.2-4,7.
- Publisher:
- British Society of Gerontology
Assessment has a pivotal role in the community care reforms, with an emphasise on more 'holistic' assessment practices. This article considers some of the lessons that can be learned from the early evaluation of assessment practice undertaken since the planning and implementation of the reforms. Draws from three local studies to highlight common problems in assessment practice.