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Older carers and carers of people with dementia: improving and developing effective support
- Authors:
- LARKIN Mary, HENWOOD Melanie, MILNE Alisoun
- Journal article citation:
- Social Policy and Society, 21(2), 2022, pp.242-256.
- Publisher:
- Cambridge University Press
The policy drive to support carers is a longstanding national and international priority. Research about the design and delivery of support for carers is critical to the underpinning evidence base. Through a timely exploration of a third sector perspective, the UK-based study discussed in this article provides insights into approaches to, and the commissioning of, support for older carers and carers of people with dementia. The study highlights the importance of: embedding carers' perspectives in service developments; the provision of both generic and targeted support which adopts a nuanced and tailored approach; titrating the delivery of information and advice at a pace to match carers' needs; capturing quantitative and qualitative dimensions in service evaluation; and increased quantity and longevity of funding. Such insights not only complement existing research but are also generalisable to other countries at a similar stage in the development of carer support. (Edited publisher abstract)
New horizons in supporting older people's health and wellbeing: is social prescribing a way forward?
- Authors:
- HAMILTON-WEST Kate, MILNE Alisoun, HOTHAM Sarah
- Journal article citation:
- Age and Ageing, 49(3), 2020, p.319–326.
- Publisher:
- Oxford University Press
Older people’s health and care needs are changing. Increasing numbers live with the combined effects of age-related chronic illness or disability, social isolation and/or poor mental health. Social prescribing has potential to benefit older people by helping those with social, emotional or practical needs to access relevant services and resources within the local community. However, researchers have highlighted limitations with the existing evidence-base, while clinicians express concerns about the quality of onward referral services, liability and upfront investment required. The current article provides a critical review of evidence on social prescribing, drawing on the RE-AIM Framework (Glasgow et al., 1999) to identify questions that will need to be addressed in order to inform both the design and delivery of services and the evolving research agenda around social prescribing. The authors emphasise the need for researchers and planners to work together to develop a more robust evidence-base, advancing understanding of the impacts of social prescribing (on individuals, services and communities), factors associated with variation in outcomes and strategies needed to implement effective and sustainable programmes. They also call on policymakers to recognise the need for investment in allied initiatives to address barriers to engagement in social prescribing programmes, provide targeted support for carers and improve access to older adult mental health services. The article concludes that social prescribing has potential to support older people’s health and wellbeing, but this potential will only be realised through strategic alignment of research, local level implementation and national policy and investment. (Edited publisher abstract)
Early intervention in dementia care in an Asian community: lessons from a dementia collaborative project
- Authors:
- SEABROOKE Viniti, MILNE Alisoun
- Journal article citation:
- Quality in Ageing, 10(4), December 2009, pp.29-36.
- Publisher:
- Pier Professional
- Place of publication:
- Brighton
The number of older Asians in the UK, and therefore at risk of developing dementia is increasing. The emerging need to address early diagnosis is especially prominent in areas where Asian communities are long established. Set up under the auspices of the South East Dementia Services Collaborative, this pilot project aimed to raise awareness of memory problems and facilitate access to early intervention for older Asians in North West Kent. Using an evaluation methodology adopted by the Collaborative and working through a multi-agency steering group, the project identified an appropriate primary care practice, established a link with a specially trained Asian nurse and devised a set of project materials. By inviting older Asian patients with memory problems to make an appointment with the nurse, and enclosing a culturally relevant information leaflet, older people were encouraged to come forward. The project outcomes include significantly increased referral rates from black and minority ethnic communities to specialist services and greater awareness of dementia-related issues in both primary care and Asian care services. Overall, the evaluation suggests that by engaging with a committed primary care practice it is possible to engage a hitherto marginal group of older people in early intervention in dementia and raise awareness about its benefits.
Integrating older people’s mental health services: community mental health teams for older people: a commentary and resource document
- Authors:
- LINGARD Jayne, MILNE Alisoun
- Publisher:
- Great Britain. Department of Health
- Publication year:
- 2004
- Pagination:
- 98p., bibliog.
- Place of publication:
- London
The document aims to provide a resource for senior managers and Community Mental Health Teams seeking to achieve integration in assessment and care management processes as part of the implementation of the NSF for Older People Standard Seven.
Carers of older relatives in long term care: support needs and services
- Authors:
- MILNE Alisoun, HATZIDIMITRIADOU Eleni, CHRYSSANTHOPOULOU Christina
- Journal article citation:
- Generations Review, 14(3), July 2004, pp.4-9.
- Publisher:
- British Society of Gerontology
Reports on a study which aimed to explore the roles and support needs of carers whose relative is placed in long-term care; identify the range and types of services available; and explore was to support carers more effectively. It draws on evidence from a pilot study conducted in 2002/03 in one area of South East England, and a supplemental literature review.
Exemplar models and support for older carers and carers of people with dementia: informing commissioning
- Authors:
- HENWOOD Melanie, LARKIN Mary, MILNE Alisoun
- Publisher:
- Melanie Henwood Associates
- Publication year:
- 2018
- Pagination:
- 78
This scoping report identifies models of support for older carers and carers of people with dementia. The report was commissioned by NHS England in support of its Commitment to Carers programme. The scoping carried out a review of the literature and also identified examples from the third sector using an online survey and interviews. The results found the most frequently identified models of support related to peer support and befriending, educational/coping support and resilience development. High proportions of responding organisations indicated that they were also providing support for carers in BAME and LGBT communities, though largely indicative of an inclusive approach to services rather than responding to specific needs. Specific models of support for carers of people with younger onset dementia were relatively absent. The analysis focuses on the main cross-cutting themes, and in particular these concerned: information and practical help (including sub-themes of: beyond diagnosis; signposting; locally based community support; respite; carer hubs, and dementia hubs); relationships (including sub-themes of: peer support; co-dependency; and organisational relationships); model development (including contracts and tendering), and outcomes. The report identifies areas that offer the most promising directions for future development are: building carer resilience; reducing carer isolation and loneliness; living a life beyond diagnosis; reimagining respite; and space and scope to expand. (Edited publisher abstract)
The role and influence of micro-cultures in long-term care on the mental health and wellbeing of older people: a scoping review of evidence
- Authors:
- MIKELYTE Rasa, MILNE Alisoun
- Journal article citation:
- Quality in Ageing and Older Adults, 17(3), 2016, pp.198-214.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to explore evidence about the role played by micro-cultures in long-term care (LTC) settings in shaping residents’ mental health and wellbeing. Design/methodology/approach: A scoping review on micro-cultures in LTC, including database search of academic and grey literature using pre-determined combinations of key terms and specific inclusion/exclusion criteria. The review followed the methodological framework of Arksey and O’Malley (2005). Findings: Micro-cultures (localised, distinctive cultures of a small group of people) in LTC are complex, multi-faceted and multi-directional; they include social dynamics as well as structural and environmental factors. Although much work has been done on the nature of micro-cultures, limited work has focused on LTC for older people. Initiatives to promote the mental health and wellbeing of residents rarely consider micro-cultures in any holistic way; they tend to be taken into account either as part of a contextual backdrop, or as a uni-directional process often equated with the concept of “care culture” or “organisational culture”. Originality/value: The role played by micro-cultures in influencing the mental health and wellbeing of older people living in LTC settings is significantly under researched. The findings of this review suggest that their complexity and multidimensionality challenges researchers. However if the authors are to develop interventions that promote the mental health and wellbeing of residents it is important to invest in work to explore their nature and systemic influence. (Publisher abstract)
Early intervention and dementia care: innovation and impact
- Authors:
- SEABROOKE Viniti, MILNE Alisoun
- Journal article citation:
- Quality in Ageing and Older Adults, 15(1), 2014, pp.34-45.
- Publisher:
- Emerald
Purpose: This study aims to systematically evaluate the impact and effectiveness of two early intervention services in NW Kent. Design/methodology/approach: Data were gathered via evaluation questionnaires for both projects; these included quantitative post-intervention data and qualitative comments. Data on referrals to secondary care and a specialist third sector organisation were also collected for the primary care project. Findings: Findings from the primary care project indicate that targeting a specific age cohort of patients can be effective in terms of: early identification of dementia-related concerns, the provision of support, appropriate referrals to secondary care, and increased referrals to a third sector dementia service. At the end of the project most practitioners felt they were better informed about dementia, more committed to facilitating early diagnosis, and had gained confidence in using a screening tool (the General Practitioner Assessment of Cognition Test). Evidence from evaluating the Carers Group suggests that attendance helped members manage emotional difficulties, increased understanding of dementia, and enhanced coping skills. They also felt less isolated and knew how to access support services. Practical implications: The projects offer two models of intervention: how a proactive third sector agency can work with primary care professionals to enhance commitment to dementia case finding and the provision of group support to relatives of those in receipt of a recent dementia diagnosis. Originality/value: The study provides insights into early intervention in dementia care how to evaluate impact of effectiveness. (Publisher abstract)
Living with dementia in a care home: capturing the experiences of residents
- Author:
- MILNE Alisoun
- Journal article citation:
- Quality in Ageing and Older Adults, 12(2), 2011, pp.76-85.
- Publisher:
- Emerald
The purpose of this paper is to consider the experiences and perspectives of residents with dementia living in a care home. The paper reviews current sources of evidence about 'the care home experience'’, including material drawn from: research instruments, interviews, observational methods and phenomenological research which aims to capture the lived experiences of residents. Research that is attempting to capture the lived experiences of residents further adds to the understanding of quality of life (QoL) and quality of care. Specifically, residents prioritise non-disease-related domains of QoL, which is somewhat different than those identified by relatives, care home staff and ‘‘objective’’ measures. Not only is it evident that residents are able to describe aspects of their situation but they appear to retain a sense of self and identity. There is a distinctive need for assessment of QoL amongst residents with dementia that places their subjective view of this concept at its core.
What will people think
- Authors:
- SEABROOKE Viniti, MILNE Alisoun
- Journal article citation:
- Mental Health Today, April 2004, pp.27-30.
- Publisher:
- Pavilion
- Place of publication:
- Hove
Outlines a research project undertaken in the Dartford and Gravesham area of north west Kent to explore the service-related needs of Asian older people with dementia and their carers. The study was conducted from February 2002 to January 2004, based at a local dementia care charity, and funded by the Mental Health Foundation. Qualitative approaches were used to collect data about existing services and the views and perceptions of key stakeholders including: 7 GPs, 32 health professionals and service managers, 7 carers and 230 members of the local Asian community.