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A commentary on the emerging literature on advocacy for older people
- Author:
- SCOURFIELD Peter
- Journal article citation:
- Quality in Ageing, 8(4), December 2007, pp.18-27.
- Publisher:
- Pier Professional
- Place of publication:
- Brighton
This article comments on emerging themes derived from recent official publications on older people's advocacy in the UK. There is an examination of relevant policy documents and the responses from service user groups. Discussion includes clarity in defining advocacy; the nature of the advocacy relationship; sustained and reliable financing of advocacy services; the uneven nature of provision; lack of inter-agency connectivity; the need to establish national standards for advocacy; problems of mental capacity; and advocacy for care home residents and for minority groups. The need for and direction of further research is proposed.
Helping older people in residential care remain full citizens
- Author:
- SCOURFIELD Peter
- Journal article citation:
- British Journal of Social Work, 37(7), October 2007, pp.1135-1152.
- Publisher:
- Oxford University Press
This paper examines how the moves to bring older people into deliberative democratic processes have tended to focus on those in their ‘Third Age’. Those in institutional settings, being in the ‘Fourth Age’, occupy a much more marginal position. This effective disenfranchisement is yet another reason why, for many, the move into residential care - a difficult transition for a variety of reasons - becomes regarded as the ‘last refuge’. It contributes to the sense of loss of identity, lowering of self-esteem and a reduced sense of personhood. This article accepts that there should be more effective involvement of care home residents in decision making about their personal care. However, there are dangers in adopting a too narrowly consumerist approach. This can reinforce a reductionist view of care home residents simply as ‘service users’ - a form of ‘othering’ in itself. As citizens and members of a wider community, they should be included in consultations about any community and wider political debates that affect them. Such a proposal implies a widening and deepening of advocacy services available to this group. As most older people in residential care are there following the intervention of a social care professional, then ensuring that they have access to advocacy must surely be a key task. This paper argues that this is frustrated by the lack of suitable services. Without a significant investment by the Government in independent advocacy services, not only is the social work task with one of social care’s core client groups rendered impossible, but the Government cannot deliver on its own agenda of empowerment, active citizenship and inclusion.
Reviewing residential care reviews for older people
- Author:
- SCOURFIELD Peter
- Journal article citation:
- Practice: Social Work in Action, 19(3), September 2007, pp.199-209.
- Publisher:
- Taylor and Francis
Since the introduction of care management in the early 1990s, older people in care homes are supposed to have their 'care packages' reviewed on at least an annual basis. The current system of reviewing needs to be understood in the context of an increasingly bureaucratised, deskilled and routinised system of statutory social care. By taking a very narrow consumerist approach to reviews, not only are both Review Officer and service user often alienated from the process, but the system can often add to rather than combat disempowerment. Care home residents are one of the most powerless groups in society with few opportunities to gain control over their living circumstances. The discussion raises the issue of whether residential care home reviews should always seek to involve independent advocates; as policy allows but seldom happens in practice. If this is the case, then this raises further issues of how to ensure such a service is available to all.
Issues arising for older people at the 'interface' of intermediate care and social care issues
- Author:
- SCOURFIELD Peter
- Journal article citation:
- Research Policy and Planning, 25(1), 2007, pp.57-67.
- Publisher:
- Social Services Research Group
In recent years both the Health Act 1999 and the Health and Social Care Act 2001 have paved the way for the integrated care trusts with the aim of bringing about more flexible, person-centred services for older people. Concern to avoid both unnecessary hospital admissions and so called 'bed-blocking' has led to the expansion of intermediate care services. The National Service Framework for Older People, published in 2001, further articulated these ambitions. Evaluations to date have indicated that, whilst further research is still needed to see whether all the goals have been effectively realised, intermediate care is associated with a range of perceived benefits. However, this paper highlights the fact that, on the ground there remain certain unresolved difficulties at the point where intermediate care ends and where social care begins that needed further consideration before it can be said that services are properly 'joined-up and 'person-centred'. Implications for both practice and policy are considered.