Search results for ‘Subject term:"older people"’ Sort:
Results 1 - 2 of 2
Relational practice as the key to ensuring quality care for frail older people: discharge planning as a case example
- Authors:
- WILLIAMS Sion, NOLAN Mike, KEADY John
- Journal article citation:
- Quality in Ageing, 10(3), September 2009, pp.45-55.
- Publisher:
- Pier Professional
- Place of publication:
- Brighton
Discharging frail older people from acute hospital settings has been an issue of concern for over 40 years and recent studies suggest that enduring problems remain. This paper explores the experiences of discharge from three different units: an acute surgical ward, an acute medical ward and a specialist ward for older people. Based on extensive data from interviews with older people, their family carers and ward-based staff, a grounded theory of the discharge experience is presented. This suggests that the quality of discharge hinges largely on whether the focus of efforts is on ‘pace’ (the desire to discharge older people as rapidly as possible) or ‘complexity’ (where due account is taken of the complex interaction of medical and wider social issues). When pace is the focus, ‘pushing’ and ‘fixing’ are the main processes driving discharge. However, when attention is given to complexity, far more subtle processes of ‘informing’ and ‘brokering’ are in evidence. These latter processes are conceived of as forms of ‘relational practice’ and it is argued that such practices lie at the heart of high quality care for older people.
Developing personal relationships in care homes: realising the contributions of staff, residents and family members
- Authors:
- WILSON Christine Brown, DAVIES Sue, NOLAN Mike
- Journal article citation:
- Ageing and Society, 29(7), October 2009, pp.1041-1063.
- Publisher:
- Cambridge University Press
Using a constructivist approach, the nature and types of relationships between residents, staff and family members were explored in three care homes in England using combined methods including participant observation, interviews and focus groups. The data collection and analysis occurred iteratively over 21 months and three types of relationships were identified: ‘pragmatic relationships’ that primarily focus on the instrumental aspects of care; ‘personal and responsive relationships’ that engage more fully with the particular needs of individual residents; and ‘reciprocal relationships’ that recognise the roles of residents, staff and family members in creating a sense of community within the home. This paper explores the contributions made by staff, residents and family members in the development of these relationships. The findings enhance our understanding of the role of inter-personal relationships in care home settings and of the factors that condition them. The implications for developing improved practice in care homes are also considered.