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The role of care homes in end of life care. Briefing 2: place and cause of death for permanent and temporary residents of care homes
- Author:
- NATIONAL END OF LIFE CARE INTELLIGENCE NETWORK
- Publisher:
- Public Health England
- Publication year:
- 2017
- Pagination:
- 14
- Place of publication:
- London
This briefing paper describes recent trends in the demographics of people who receive end of life care in a care home, presenting data on the place and cause of death for permanent and temporary residents of care homes. It also provides analyses of variation by geographical region. It reports that nearly two thirds (62 per cent) of people who died in care homes have dementia or Alzheimer’s disease as an underlying or contributory cause of death. It is the second of two briefings produced by National End of Life Care Intelligence Network to describe the important role that care homes play in the care of people at the end of life. (Edited publisher abstract)
Imagined bodies: architects and their constructions of later life
- Authors:
- BUSE Christina E., et al
- Journal article citation:
- Ageing and Society, 37(7), 2017, pp.1435-1457.
- Publisher:
- Cambridge University Press
This article comprises a sociological analysis of how architects imagine the ageing body when designing residential care homes for later life and the extent to which they engage empathetically with users. Drawing on interviews with architectural professionals based in the United Kingdom, the authors offer insight into the ways in which architects envisage the bodies of those who they anticipate will populate their buildings. Deploying the notions of ‘body work’ and ‘the body multiple’, this analysis reveals how architects imagined a variety of bodies in nuanced ways. These imagined bodies emerge as they talked through the practicalities of the design process. Moreover, their conceptions of bodies were also permeated by prevailing ideologies of caring: although the authors found that they sought to resist dominant discourses of ageing, they nevertheless reproduced these discourses. Architects’ constructions of bodies are complicated by the collaborative nature of the design process, where the authors' find an incessant juggling between the competing demands of multiple stakeholders, each of whom anticipate other imagined bodies and seek to shape the design of buildings to meet requirements. The findings extend a nascent sociological literature on architecture and social care by revealing how architects participate in the shaping of care for later life as ‘body workers’, but also how their empathic aspirations can be muted by other imperatives driving the marketisation of care. (Edited publisher abstract)
Supporting people at the start of their care home journey: a warm welcome
- Author:
- WALES. Welsh Government
- Publisher:
- Welsh Government
- Publication year:
- 2017
- Pagination:
- 8
- Place of publication:
- Cardiff
This document provides suggestions on how people who work in a care home can provide a welcome pack for their residents. It aims to help care home staff provide clear information for people covering the issues that matter to them most, and explaining what they can expect from life in a care home. Suggestions for areas to cover include: respecting cultural identity and diversity, communication, social interaction, hobbies and interests; involving family and the local community; practical arrangements for day-to-day living; health care; costs; and making a complaint. (Edited publisher abstract)
Creating a positive dining experience for care home residents
- Author:
- WALES. Welsh Government
- Publisher:
- Welsh Government
- Publication year:
- 2017
- Pagination:
- 6
- Place of publication:
- Cardiff
This document provides advice to help care homes make the most of meal times for their residence. It looks at ways of ensuring that mealtimes are an enjoyable experience for older people living in a care home, that offer more choice and an opportunity for involvement and social interaction. (Edited publisher abstract)
Investigating perceptions of disgust in older adult residential home residents
- Authors:
- LAFFAN A.J., et al
- Journal article citation:
- Aging and Mental Health, 21(2), 2017, pp.206-215.
- Publisher:
- Taylor and Francis
Objectives: As people become increasingly physically dependent as they make the transition into older age, they may lose the ability to control bodily functions. Problems with eating, voiding and washing can be linked with feelings of disgust and, given the necessity for some of being assisted with intimate care activities, it has been suggested that self-focused disgust and concerns over the disgust of others may become important preoccupations in older people, with the potential to further impair their quality of life. Method: In a mixed-methods study, feelings of disgust in 54 physically dependent older adults living in residential homes were investigated. Participants completed measures of disgust sensitivity, mood, and two new scales assessing feelings of self-disgust and perceived other-disgust related to intimate care activities. Six of the residents who reported high levels of self-disgust also participated in semi-structured interviews. Results: Results indicated that disgust was uncommon. Where present, self-disgust was related to perceptions of others’ feelings of disgust and general disgust sensitivity. These results were benchmarked against 21 community-dwelling older adults, who reported believing they would feel significantly more disgusting if they were to start receiving assistance. A thematic analysis identified the importance of underlying protective factors, the use of strategies and carer characteristics in ameliorating feelings of disgust. Conclusion: The results are discussed with reference to the disgust literature, with recommendations being made for ways in which self-disgust can be minimised in those making the transition to residential homes. (Publisher abstract)
Recognising and preventing delirium
- Authors:
- NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE, SOCIAL CARE INSTITUTE FOR EXCELLENCE
- Publishers:
- National Institute for Health and Care Excellence, Social Care Institute for Excellence
- Publication year:
- 2017
- Pagination:
- 4
- Place of publication:
- London
A quick guide to help care home managers and their staff to recognise the symptoms of delirium and to understand what they can do to prevent it. The guide covers: risk factors for delirium, recognising delirium, preventing delirium, and sharing information with the person and their family. The guide will be useful for staff training. (Edited publisher abstract)
Person-centred care for older people in care homes
- Author:
- SOCIAL CARE INSTITUTE FOR EXCELLENCE
- Publisher:
- Social Care Institute for Excellence
- Publication year:
- 2017
- Pagination:
- 30
- Place of publication:
- London
This resource covers the implications of delivering person-centred care for older people in residential care and nursing homes. It summarises information, advice and guidance to support care home owners and managers in developing a person-centred (or personalised) approach to care in their homes. Sections cover: leadership; developing a person centred culture across the whole organisations; meeting the needs of individual residents; involving families and carers; developing better services for care homes; and partnership working with health, social care and the voluntary and community sector. Each section includes a checklist for owners and managers to consider in order to ensure that a person-centred culture is adopted across the whole organisations. (Edited publisher abstract)
Is late-life dependency increasing or not? A comparison of the Cognitive Function and Ageing Studies (CFAS)
- Authors:
- KINGSTON Andrew, et al
- Journal article citation:
- Lancet, 390(10103), 2017, pp.1676-1684.
- Publisher:
- Elsevier
Background: Little is known about how the proportions of dependency states have changed between generational cohorts of older people. This study aimed to estimate years lived in different dependency states at age 65 years in 1991 and 2011, and new projections of future demand for care. Methods: this population-based study, compared two Cognitive Function and Ageing Studies (CFAS I and CFAS II) of older people (aged ≥65 years) who were permanently registered with a general practice in three defined geographical areas (Cambridgeshire, Newcastle, and Nottingham; UK). These studies were done two decades apart (1991 and 2011). General practices provided lists of individuals to be contacted and were asked to exclude those who had died or might die over the next month. Baseline interviews were done in the community and care homes. Participants were stratified by age, and interviews occurred only after written informed consent was obtained. Information collected included basic sociodemographics, cognitive status, urinary incontinence, and self-reported ability to do activities of daily living. CFAS I was assigned as the 1991 cohort and CFAS II as the 2011 cohort, and both studies provided prevalence estimates of dependency in four states: high dependency (24-h care), medium dependency (daily care), low dependency (less than daily), and independent. Years in each dependency state were calculated by Sullivan's method. To project future demands for social care, the proportions in each dependency state (by age group and sex) were applied to the 2014 England population projections. Findings: Between 1991 and 2011, there were significant increases in years lived from age 65 years with low dependency (1·7 years [95% CI 1·0–2·4] for men and 2·4 years [1·8–3·1] for women) and increases with high dependency (0·9 years [0·2–1·7] for men and 1·3 years [0·5–2·1] for women). The majority of men's extra years of life were spent independent (36·3%) or with low dependency (36·3%) whereas for women the majority were spent with low dependency (58·0%), and only 4·8% were independent. There were substantial reductions in the proportions with medium and high dependency who lived in care homes, although, if these dependency and care home proportions remain constant in the future, further population ageing will require an extra 71 215 care home places by 2025. Interpretation: On average older men now spend 2·4 years and women 3·0 years with substantial care needs, and most will live in the community. These findings have considerable implications for families of older people who provide the majority of unpaid care, but the findings also provide valuable new information for governments and care providers planning the resources and funding required for the care of their future ageing populations. (Edited publisher abstract)
Older people's housing, care and support needs in Greater Cambridge 2017-2036
- Authors:
- ARCHER Tom, et al
- Publisher:
- Sheffield Hallam University. Centre for Regional Economic and Social Research
- Publication year:
- 2017
- Pagination:
- 93
- Place of publication:
- Sheffield
This report presents the findings of research into the housing, care and support needs of older people in Greater Cambridge. The study combines modelling of future demand and supply of older people's housing with assessments of current policy and practice aimed at meeting the requirements of this population. The model identifies a requirement for 3,422 units of specialist housing in Greater Cambridge in 2016, against an actual supply of 3,280 units, and indicates significant shortfalls in the supply of age-exclusive housing and residential and nursing care. It also suggests that there is a gap in provision of sheltered accommodation while extra care housing is approximately supplied at the right level at present. However, if it is decided that extra care should meet a greater proportion of needs (e.g. a proportion that would otherwise be met in residential care), then this could significantly change how many units of extra care are required. The model recommends that by 2035, the supply of specialist housing will need to be 80 per cent higher than present, at 6,163. This equates to an annualised rate of development of approximately 140 new units through that period, before any additional units are required to account for reductions to the stock. Rather than accepting these projected supply figures as static, the report argues that policymakers should see them as the basis for more informed policy making. This requires understanding how the demand and supply of housing for older people is affected by various other interventions outside the housing realm. Over time, and as the model is re-run, new patterns and trends will emerge to which policy-makers will need to respond. (Edited publisher abstract)
Explaining the fees gap between funding types in the English care homes market
- Authors:
- ALLAN Stephen, GOUSIA Katerina, FORDER Julien
- Publisher:
- University of Kent. Personal Social Services Research Unit
- Publication year:
- 2017
- Pagination:
- 47
- Place of publication:
- Canterbury
This paper quantitatively assesses the economic reasons behind the difference in prices paid by care home residents in England. It is generally believed that the price paid by private payers is higher than that paid for publicly-supported residents, and this is often attributed to the market power wielded by local authorities as the dominant purchaser in local markets. Using data on local authority expenditure for residential and nursing home care together with overall care home price data for 2008 and 2010, the authors create local authority-level estimates of average self-funded prices. The estimates, based on a number of assumptions, suggest that the average self-funder price for England is in the range of £609-£663 per week, and that the average self-funder price is £170-£196 per week greater than the average price paid by local authorities. The results show that the reasons for this gap in fees is caused by greater market power of both local authorities and care home providers, and that higher care home quality also accounted for some of the difference in fees. The paper also found that the effect of the market power of providers and the local authorities depend on one another. In areas where there are lots of care homes (high competition) the local authority has a much greater impact on the difference in fees, whereas in areas with less competition between care homes the impact of the local authority on the fees gap is reduced. (Edited publisher abstract)