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Informal caregivers' experiences of formal support in a changing context
- Author:
- WILES Janine
- Journal article citation:
- Health and Social Care in the Community, 11(3), May 2003, pp.189-207.
- Publisher:
- Wiley
As the location of long-term care of elderly people moves to homes and communities, and responsibility shifts to families, understanding the experience of people in this situation is necessary to ensure that support is appropriate, accessible and effective. This paper explores informal caregivers' and recipients' relationships with formal support, drawing on thematic and narrative analysis of 30 in-depth interviews with self-identified family caregivers over a year in a mid-size city in Ontario, Canada. All but 6 had some interaction with formal support. The semistructured interviews explored caregivers' knowledge about and perceptions and experiences of accessing and using formal support. Interpretation reveals how confusion and lack of knowledge about services, inflexibility and lack of availability, and increasing pressure on the quantity and quality of publicly funded community-based resources combine to impact negatively on the experience of accessing and using formal support. Different ideas about relative roles and responsibilities of seniors, informal caregivers and 'family' in general, and the state both shape and are shaped by policies and the situated realities of formal support provision. Providing home care creates both opportunities and constraints for caregivers in interactions with formal support. Highlights the difficulties of interacting with publicly funded formal support as the costs of care are moved away from the state and onto families and individuals.
EPIC: an evaluation of a multi-disciplinary care management project; providing home support to frail elderly people; final report
- Authors:
- BLAND Rosemary, HUDSON Harriet
- Publisher:
- University of Stirling. School of Human Sciences. Department of Applied Social S
- Publication year:
- 1994
- Pagination:
- 24p.,tables,bibliog.
- Place of publication:
- Stirling
Describes an evaluation of the EPIC project. Look specifically at outcomes for users, carers and home care workers and at the practice of care management in the project.
Case management in community care: an evaluated experiment in the home care of the elderly
- Authors:
- CHALLIS David, DAVIES Bleddyn
- Publisher:
- Gower
- Publication year:
- 1986
- Pagination:
- 289p., tables, diags., bibliog
- Place of publication:
- Aldershot
Moral choices and responsibilities: the home-help service at the borderland of care management when older people consider relocation to a residential home
- Author:
- SODERBERG Maria
- Journal article citation:
- Ethics and Social Welfare, 14(4), 2020, pp.369-383.
- Publisher:
- Taylor and Francis
- Place of publication:
- Abingdon
The aim of this article is to reveal how care workers in the home-help services handle the process when older people’s relocation to a residential home is under consideration. Since the care workers are engaged daily in defining care receivers’ needs and yet have no formal influence on care decisions in Sweden, the focus is on how they solve this dilemma. In this inductive study, the theoretical framework is based on occupational alliances, relationship-based practice, and discretion. Thirty-three care workers in home-help services are included in open semi-structured interviews. Prominent features in the findings are that the care workers take their stand at the borderland of care management, when they know or try to find out what is right. The conclusions drawn are that care workers find ways to informally influence the decision-making process, quite contrary to the idea of approaches referred to as purchaser/provider models. The implications for social work policy and practice are that a distinction between assessment and intervention may not benefit the field of eldercare and should therefore be regarded as an area in need of thorough reconsideration. (Edited publisher abstract)
Development of integrated care pathways: toward a care management system to meet the needs of frail and disabled community-dwelling older people
- Authors:
- DUBUC Nicole, et al
- Journal article citation:
- International Journal of Integrated Care, 13(2), 2013, Online only
- Publisher:
- International Foundation for Integrated Care
The home care and services provided to older adults with the same needs are often inadequate and highly varied. Integrated care pathways (ICPs) can resolve these issues. The aim of this study was to develop the content of electronic ICPs to ensure the follow up frail and disabled community-dwelling older people in Canada. A rigorous process was applied according to a series of steps: identification of desirable characteristics and a theoretical framework; review of evidence-based practices and current practices; and determination of ICPs by an interdisciplinary task team. In order to prevent specific problems, maximize independence, and promote successful aging, the ICPs followed five phases: (1) needs assessment and assessment of risk/protection factors; (2) data-collection summary and goals identification; (3) planning of interventions from a client-centered view; (4) coordination, delivery, and follow-up; and (5) identification of variances, as well as review and adjustment of plans. Once computerized, these ICPs will facilitate the exchange of information as well as the clinical decision-making process with a perspective to adequately matching the needs of an individual person with resources that delay or slow the progression of frailty and disability. Once aggregated, the data will also support managers in organizing teamwork and follow-up for clients. (Publisher abstract)
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.
Letter from Sundsvall Sweden
- Author:
- LINDELOF Margareta
- Journal article citation:
- Community Care, 21.2.02, 2002, p.39.
- Publisher:
- Reed Business Information
The author looks at recent changes made in community care in parts of Sweden where district nurses have taken over from home care managers trained in social work.
Alice Johnson: case study research of collaborative practice within community care
- Authors:
- HIGHAM Patricia, SPOONER Anne-Karin
- Journal article citation:
- Health Care in Later Life, 3(2), 1998, pp.111-128.
This research-based case study of Alice Johnson, the pseudonym for an elderly Afro-Caribbean woman living in the UK, analyses the practice outcomes of a 'real life' situation. In order to identify the most helpful interventions, the research evaluated collaborative practice from the different perspectives of the service user and the care providers, using the care management of one elderly individual, Mrs Johnson, as a focus. Although no generalisations can be claimed from one example, the single case study design provided a valid analysis of collaborative practice outcomes in an elderly person from an ethnic and cultural minority and living in the UK, who received community care. The use of a research perspective based on a qualitative life history approach is an analytical tool that can contribute to increased practice expertise.
Brought in from the sidelines
- Author:
- HEPTINSTALL Derek
- Journal article citation:
- Care Plan, 4(1), September 1997, pp.13-16.
- Publisher:
- Positive Publications/ Anglia Polytechnic University, Faculty of Health and Social Work
Describes a project in South East London which has demonstrated that cost-effective care for older people with dementia can be provided in their own homes.
The practice of case management in domiciliary care for elderly people
- Author:
- CHARNLEY Helen
- Publisher:
- University of Kent. Personal Social Services Research Unit
- Publication year:
- 1987
- Pagination:
- 16p., diag.
- Place of publication:
- Canterbury
Case management was assessed in twelve Social Services Department's Area Offices, highlighting discontinuities in the systems and how effective management can improve the service provided.