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Adapting the adaptations process: tackling the barriers within policy and practice
- Author:
- MCCALL Vikki
- Publisher:
- UK Collaborative Centre for Housing Evidence
- Publication year:
- 2022
- Pagination:
- 42
- Place of publication:
- Glasgow
This report gives insight to the fragmented policy landscape in Scotland around adaptations, with further experiences gathered from England, Wales and Northern Ireland. There are many good practice examples throughout Scotland, and key stakeholders emphasise the important role for adaptations in the impact they make in people’s lives. However, the current systems that supports home adaptations in Scotland are fragmented, overly complex, and bureaucratic. These challenges undermine the preventive potential that adaptations can offer to service users. The report presents the perspectives of key stakeholders on how we can tackle the barriers within policy and practice within the adaptations process. Adaptations involve health and wellbeing-related home and environmental modifications for social, private renters and home-owners. In Scotland and throughout the UK, there are various adaptations processes that support the access, assessment and delivery of adaptations for service users. The report offers a new process for understanding the adaptations process, presenting barriers attached to governance, need awareness, information and advice, assessment, funding, design, delivery, evaluation & performance monitoring. Adaptations to homes and wider environments are essential for supporting health, social care and wellbeing needs, preventing health crises and future proofing homes for a diverse and ageing population. The processes that support adaptations, however, are fragmented, difficult to understand, and involve clear divergence between both local authority area and tenure. The evidence offered in this report leads to a clear need for finding a common approach across Scotland for supporting adaptations. (Edited publisher abstract)
Health and place: how levelling up health can keep older workers working
- Author:
- INTERNATIONAL LONGEVITY CENTRE UK
- Publisher:
- International Longevity Centre UK
- Publication year:
- 2022
- Pagination:
- 31
- Place of publication:
- London
This study explores the link between levels of employment of older people and health in a place. The report finds that the higher the proportion of older people with poor health in a place, the less likely it is that any adults in that place will be in paid work. For example: older workers from the unhealthiest areas are 60% more likely to be out of work than those who live in the healthiest areas; women aged 50-74 living in the ‘healthiest’ areas of England and Wales were 5.6% more likely to be in paid work than those living in the 'unhealthiest' areas; men aged 50-74 living in the 'healthiest' areas of England and Wales were 7.1% more likely to be in paid work than those living in the 'unhealthiest'. The report shows that how we measure health in a place matters: links between health in a place and employment are stronger for self-rated health measures, compared with life expectancy figures or mortality indicators. Historically disadvantaged areas continue to struggle: areas where people left paid work at a younger age due to poor health in 1991 were much more likely to experience this trend in 2011 as well. This disproportionately affects people in manual occupations: they are much more likely to experience ill health, and they can expect four fewer years of healthy life beyond age 50, compared with workers in administrative or professional roles. There is a correlation between health in a place and younger people being in paid employment: for example, the probability of a woman aged 16 to 49 not being in paid work was 33.7% in the 'unhealthiest' areas compared with 26.3% in the 'healthiest' areas. Those working in professional occupations were more likely to be in work 10 years later than those working in elementary occupations or doing repetitive manual labour: this gap in employment outcomes was most marked for people living in 'unhealthy' areas. (Edited publisher abstract)
Developing a minimum data set for older adult care homes in the UK: exploring the concept and defining early core principles
- Authors:
- BURTON Jennifer Kirsty, et al
- Journal article citation:
- Lancet Healthy Longevity, 3(3), 2022, pp.e186-e193.
- Publisher:
- Elsevier
Reforms to social care in response to the COVID-19 pandemic, in the UK and internationally, place data at the heart of proposed innovations and solutions. The principles are not well established of what constitutes core, or minimum, data to support care home residents. Often, what is included privileges data on resident health over day-to-day care priorities and quality of life. This Personal View argues for evidence-based principles on which to base the development of a UK minimum data set (MDS) for care homes. Co-produced work involving care home staff and older people working with stakeholders is required to define and agree the format, content, structure, and operationalisation of the MDS. Implementation decisions will determine the success of the MDS, affecting aspects including data quality, completeness, and usability. Care home staff who collect the data need to benefit from the MDS and see value in their contribution, and residents must derive benefit from data collection and synthesis. (Edited publisher abstract)
Living longer: caring in later working life: examining the interplay between caring and working in later life in the UK
- Author:
- OFFICE FOR NATIONAL STATISTICS
- Publisher:
- Office for National Statistics
- Publication year:
- 2019
- Place of publication:
- London
As the UK population gets older, an increasing number of workers are providing care towards the end of their working life for family members. One in four older female workers, and one in eight older male workers, have caring responsibilities. In this article, we look further at the differences between men and women who work and care, and how who is being cared for drives the number of hours a carer provides and their ability to work. Nearly three in five carers in England and Wales are aged 50 years and over, and one in five people aged 50 to 69 years are informal carers – this is the most common age group for having caring responsibilities. A substantial proportion of older workers already balance work with caring responsibilities, particularly women: almost one in four (24%) female workers care, compared with just over one in eight (13%) male workers. There is also still a societal expectation for women, rather than men, to take on caregiving roles. Most of the care that men provide is to their spouse or parents, whereas women are more likely to provide care to a broader range of people including non-relatives. Overall, parents are the most common recipient of care by those of older working ages (29% of informal carers provide care to parents). People caring for parents are more likely to be in work than people caring for any other type of person. (Edited publisher abstract)
How do people with dementia make sense of their medications? An interpretative phenomenological analysis study
- Authors:
- LIM Rosemary H. M., SHARMEEN Taniya, DONYAI Parastou
- Journal article citation:
- International Journal of Geriatric Psychiatry, 37(2), 2022,
- Publisher:
- Wiley
Background: Managing medication is complex and multifaceted for people with dementia and their family carers. Despite efforts to support medication management, medication errors and medication-related hospital admissions still occur. This study investigated how people with dementia viewed and talked about their different medications and their medication taking. Methods: An interpretative phenomenological analysis (IPA) qualitative research design combining photo elicitation and in-depth interviews was used. People with a diagnosis of mild or moderate dementia took photographs of anything they viewed to be related to medication, with or without the help of family carers, over any two-day period. The photographs were then used as cues for subsequent in-depth interviews, which were analysed using IPA. Results: Twelve people with dementia were interviewed. Four themes encapsulated the experiences: (1) Medication as a lifeline, (2) Managing medications dominates daily lives and plans, (3) Struggling with uncertainty about the effectiveness of dementia medication and (4) Sense of ‘being’ and being in control. People with dementia viewed medication as a lifeline, especially donepezil, giving it preference over other daily medication they were using. Managing medications dominated the daily lives and plans of people with dementia and changed the way they viewed themselves and their life. People with dementia continually struggled with the imperceptible benefits of donepezil on their dementia, but despite such uncertainties, continued to take donepezil. Conclusions: This study provided unique insights into how people with dementia made sense of their medication. Healthcare professionals can use these insights to shape their practice around medication prescribing and advice in dementia. The findings are also useful to researchers looking to develop interventions to support medication management within the home setting. (Edited publisher abstract)
Ethnic health inequalities in later life: the persistence of disadvantage from 1993-2017
- Authors:
- STOPFORTH Sarah, et al
- Publisher:
- Centre for Ageing Better
- Publication year:
- 2021
- Pagination:
- 11
- Place of publication:
- London
This briefing presents the findings of recent research looking at ethnic inequalities in health in later life in the UK – specifically, how they vary with age; whether levels of inequality have changed over time; and to what extent they can be explained by socioeconomic inequality and self-reported experiences of racism and racial discrimination. The research shows that there are stark inequalities between the health status of different ethnic groups in the UK, with people from some ethnic minority backgrounds experiencing worse health than their White peers. The health status of different ethnic groups begins to diverge at around 30 years of age. From that age on, the gap in health between ethnic minority and White majority groups gets gradually larger and so is particularly pronounced in later life. At any given age after 30, Pakistani and Bangladeshi people experience the highest rates of poor self-rated health; their rates of poor health are equivalent to those of White people who are at least 20 years older. These ethnic health inequalities have persisted, unchanged, for almost 25 years. Ethnic health inequalities result from experiences of racism and racial discrimination which have a direct impact on health by causing physical and mental stress, and an indirect impact through their effect on socioeconomic status. (Edited publisher abstract)
Remote care technologies, older people and the social care crisis in the United Kingdom: a Multiple Streams Approach to understanding the ‘silver bullet’ of telecare policy
- Author:
- ECCLES Andrew
- Journal article citation:
- Ageing and Society, 41(8), 2021, pp.1726-1747.
- Publisher:
- Cambridge University Press
The policy announcement in November 2018 by the Secretary of State for Health and Social Care that: ‘from today, let this be clear: tech transformation is coming’ indicates that confidence in care technologies, so apparent over the past decade in policy circles, remains unabated. This article suggests, based on evidence of significant limitations in technological solutions to care needs, that this confidence is misplaced. The focus is on remote care technologies – primarily telecare – which involve the passive or real-time monitoring of recipients, the majority of whom will be older people. These information and communication technologies (ICT) have been heralded by politicians, policy makers and industry interests alike as a solution to the challenges of demographic change and social care demand. While the research evidence suggests telecare works well for some people, in some circumstances, there are also significant complexities in its use, challenges presented to care relationships, and conflicting interpretations around its efficacy and cost-effectiveness. These critical issues have been marginalised in the mainstream discourse around telecare policy. This article explores the dissonance between this policy and the available evidence, drawing on a Multiple Streams Approach to analyse the emergence of, and continued confidence in, telecare policy based on a congruence of views across policy interests. To the extent that social care for older people is now in crisis, the article argues that the discourse around telecare represents an example of ‘silver bullet’ thinking: that is, too much focus on a single policy solution to address complex problems. Accordingly, the crisis in social care has deepened, without alternative policy proposals being available to address it. The renewed push for ICT-based solutions to this crisis in social care ought therefore to be viewed with some concern. (Edited publisher abstract)
Interdependence, commitment, learning and love: the case of the United Kingdom's first older women's co-housing community
- Authors:
- ARRIGOITIA Melissa Fernandez, WEST Karen
- Journal article citation:
- Ageing and Society, 41(7), 2021, pp.1673-1696.
- Publisher:
- Cambridge University Press
Housing options for older people in the United Kingdom (UK) have been rather limited to remaining living ‘independently’ in one's own home and some variant of institutionally provided, pre-established and age-exclusive housing such as retirement communities, extra-care or sheltered housing. However, interest in alternative forms of housing and living which align more closely with the expectations of those currently entering later life is steadily growing. In this paper, we present some findings from original, mixed-methods research on the UK's only established example of senior co-housing, which also happens to be women only. Through thematic analysis, we explore two key questions about this important social experiment: (a) is this a model merely for the dedicated, activist and privileged few, as is often presumed; and (b) what might it tell us about post-traditional ageing. Is it merely a retirement lifestyle choice and identity project, grounded in logics of age denial, activity, choice, individualism and risk management? Our findings cannot be conclusive at this stage, but they do suggest a new model of later-life dwelling for the UK based on more collectivist values of inter-dependence, commitment, learning and, even, love. (Edited publisher abstract)
Briefing paper on the Tackling Loneliness Network – Older People’s Task and Finish Group
- Authors:
- INDEPENDENT AGE, ALZHEIMER'S SOCIETY
- Publisher:
- Independent Age
- Publication year:
- 2021
- Pagination:
- 22
- Place of publication:
- London
This briefing provides insight into the resilience of individuals experiencing loneliness and volunteer and organisations tackling loneliness during the pandemic. Coping with bereavement, loss of social contact, increasing anxiety and depression, a reduction in confidence and digital exclusion have all been raised as areas of concern for people in later life and the organisations that support them. The Network also heard from many about the challenges facing third sector organisations and the volunteer workforce that support people in later life who feel lonely. They are dealing with unprecedented demand and situations they could never have predicted, often without the resources to cope. Despite the introduction of COVID-19 vaccines, uncertain times lie ahead and many are deeply worried about what will happen over the coming months. The resilience of people in later life, and the volunteers and organisations who support them, is being tested like never before: more than three quarters of the latter have experienced an increase in need for their services. The report provides recommendations for Government, business and the voluntary sector on how to tackle the immediate impacts of COVID and address the structural factors that affect the experience of people in later life. (Edited publisher abstract)
Constructing and negotiating social participation in old age: experiences of older adults living in urban environments in the United Kingdom
- Authors:
- WOOLRYCH Ryan, et al
- Journal article citation:
- Ageing and Society, 41(6), 2021, pp.1398-1420.
- Publisher:
- Cambridge University Press
The age-friendly cities and communities movement has focused on how to better support older adults to age well within urban environments. Central to ‘ageing well’ and ‘active ageing’ agendas is ensuring that older adults can participate in meaningful forms of social participation. The benefits of social participation in old age have been well documented, and research amongst community-dwelling older adults has explored some of the neighbourhood qualities that facilitate or impede such forms of engagement. However, understandings of how older adults construct and negotiate social participation within everyday urban environments have been largely unexplored. To address this gap, we present results from 104 interviews conducted with older adults living in three cities and nine neighbourhoods in the United Kingdom (UK). The findings explore three themes generated from the research: ‘constructing meaningful social participation in old age’, ‘negotiating access to social participation’ and ‘navigating home and community’. Across these themes, the paper describes how experiences of social participation in old age involve a number of inter-connected physical, psychological and social processes experienced by individuals across a range of environmental settings including the home, outdoor spaces and community facilities. The paper concludes by discussing the implications of the findings for practice, specifically in the delivery of age-friendly communities. (Edited publisher abstract)