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Deciding to move into extra care housing: residents’ views
- Authors:
- BÄUMKER Theresia, et al
- Journal article citation:
- Ageing and Society, 32(7), October 2012, pp.1215-1245.
- Publisher:
- Cambridge University Press
In England in 2003, the Department of Health announced funding to support the development of extra care housing, and made the receipt of funding conditional on participating in an evaluative study. Drawing on data from residents in 19 schemes, this paper presents findings on the factors motivating older people to move to extra care housing, their expectations of living in this new environment, and whether these differ for residents moving to the smaller schemes or larger retirement villages. In total, 949 people responded, 456 who had moved into the smaller schemes and 493 into the villages. Of the residents who moved into the villages, 75% had not received a care assessment prior to moving in, and had no identified care need. There was evidence that residents with care needs were influenced as much by some of the attractions of their new living environment as those without care needs who moved to the retirement villages. The most important attractions of extra care housing for the vast majority of residents were: tenancy rights; flexible onsite care and support; security offered by the scheme; and accessible living arrangements. The results suggest that, overall, residents with care needs seem to move proactively when independent living was proving difficult rather than when staying put was no longer an option.
“It keeps me going” – older people's perception of well-being and use of complementary and alternative medicine (CAM)
- Authors:
- LORENC Ava, et al
- Journal article citation:
- Quality in Ageing and Older Adults, 13(2), 2012, pp.135-144.
- Publisher:
- Emerald
Significant proportions of older people appear to use complementary and alternative medicine (CAM). Common CAM treatments used by older adults include nutritional supplements, herbal medicine, spiritual healing, and chiropractic. The aim of this paper was to explore older peoples' decision making regarding CAM use and their perceptions and experiences of well-being. Qualitative focus groups were held at a community centre in southwest London with 37 volunteers aged over 61 years. Transcripts of the discussions were content analysed. Five themes emerged from the participants’ discussions of well-being: physical well-being; impact on activity; emotional issues; community and health services; and keeping positive. A range of CAM was used, most commonly mind/body or physical therapies. The main reason for CAM use was to ‘keep going’ and maintain well-being. ‘Keeping going’ is often promoted by CAM, including manipulative and exercise therapies. Conventional medicine was perceived as central to well-being, with CAM used to address its limitations. Decision making was rarely systematic; anecdotal information dominated, and disclosure to conventional practitioners was uncommon. Healthcare providers should consider exploring CAM use with older people and facilitating access to CAM information.
'Choice is a small word with a huge meaning': autonomy and decision making at the end of life
- Authors:
- SUTTON Eileen, COAST Joanna
- Journal article citation:
- Policy and Politics, 40(2), April 2012, pp.211-226.
- Publisher:
- Policy Press
The United Kingdom End-of-Life Care Strategy, published in June 2008, recommends the identification, documentation and review of people's preferences for care and highlights the importance of choice at an individual level. This article, drawing on qualitative data, reflects on the complex range of interconnected factors impacting on older people's preferences and decision-making processes at the end of life. Interviews were conducted with 23 people over the age of 65 from the Bristol area of England – 7 people were living in residential care facilities, 5 receiving palliative care, and 11 from the general population. Findings revealed that, as older people began to consider not only themselves but also the impact on loved ones when making decisions, the pertinence of a relational conceptualisation of autonomy was considered. The impact of structural issues on the realisation of preferences is also explored. Implications for theory and practice are discussed.
Dementia toolkit: information for staff
- Author:
- SOUTH WEST YORKSHIRE MENTAL HEALTH NHS TRUST
- Publisher:
- South West Yorkshire Mental Health NHS Trust
- Publication year:
- 2008
- Pagination:
- 38, 53p.
- Place of publication:
- Wakefield
This toolkit has been developed for staff working with people who have dementia and their carers within South West Yorkshire Mental Health NHS Trust (SWYMHT). It can be used to assist staff with planning care, reflecting on practice and decision making within clinical supervision or multidisciplinary team meetings. The dementia toolkit is designed to stimulate ideas about how to best care for people with dementia and their carers, identify skill or knowledge areas that need to be developed and find out what training is available, and become aware of what the research evidence suggests about a particular care approach. Sections cover challenging behaviour, communication, carer stress, the use of validation therapy, the use of structured exercise to improve mobility, cognitive stimulation and Reality Orientation Therapy and reminiscence therapy. Within the sections there are useful tools and case examples to show clearly how research has been used in practice. The section on training shows what is available for staff to improve their skills and is a useful tool in developing a personal development plan as part of the annual Knowledge and Skills Framework process.
The law and dementia: issues in England and Wales
- Author:
- JONES R.G.
- Journal article citation:
- Aging and Mental Health, 5(4), November 2001, pp.322-328.
- Publisher:
- Taylor and Francis
Reviews the proposals from the Lord Chancellor's Department for new Mental Incapacity law for England and Wales as they may impact on older people with dementia. Various concerns and issues are raised, particularly from the perspective of health care professionals, and the focus is the interface between such issues and the day-to-day clinical realities for a specialist team dealing with old people with dementia. A brief overview of where problems have arisen with the law in recent times is put in the context of the political/legal structures in England and Wales
Housing voices: using theatre and film to engage people in later life housing and health conversations
- Authors:
- BAILEY Cathy, et al
- Journal article citation:
- Housing Care and Support, 22(4), 2019, pp.181-192.
- Publisher:
- Emerald
Purpose: Quality, accessible and appropriate housing is key to older people’s ability to live independently. The purpose of this paper is to understand older people’s housing aspirations and whether these are currently being met. Evidence suggests one in five households occupied by older people in England does not meet the standard of a decent home. The Building Research Establishment has calculated that poor housing costs the English National Health Service £1,4bn annually (Roys et al., 2016). Design/methodology/approach: This paper reports on the findings of a participatory theatre approach to engaging with those not often heard from – notably, those ageing without children and older people with primary responsibility for ageing relatives – about planning for housing decisions in later life. The project was led by an older people’s forum, Elders Council, with Skimstone Arts organisation and Northumbria University, in the north east of England. Findings: Findings suggest there is an urgent need to listen to and engage with people about their later life housing aspirations. There is also a need to use this evidence to inform housing, health and social care policy makers, practitioners, service commissioners and providers and product and service designers, to encourage older people to become informed and plan ahead. Research limitations/implications: Use of a participatory theatre approach facilitated people to explore their own decision making and identify the types of information and support they need to make critical decisions about their housing in later life. Such insights can generate evidence for future housing, social care and health needs. Findings endorse the recent Communities and Local Government (2018) Select Committee Inquiry and report on Housing for Older People and the need for a national strategy for older people’s housing. Originality/value: Although this call is evidenced through an English national case study, from within the context of global population ageing, it has international relevance. (Publisher abstract)
Helping people choose adult social care in England: consumer survey findings
- Author:
- CARE QUALITY COMMISSION
- Publisher:
- Care Quality Commission
- Publication year:
- 2018
- Pagination:
- 10
- Place of publication:
- Newcastle upon Tyne
Reports on the results of a survey to explore people’s experiences when choosing a care home for either themselves or for a loved one. The survey sought views from over 1,000 adults who had been responsible for making a decision about a care home in England in the last three years. Survey questions covered how stressful they found the decision, what influenced their decision most, whether they were aware of the care home's Care Quality Commission (CQC) rating, and the most important factor when choosing a care home. Of those surveyed, 70 per cent stated that visiting the care home influenced them most when choosing a home, with 65 per cent having read the CQC report for the care home before making their decision. (Edited publisher abstract)
What do we know about the application of the Mental Capacity Act (2005) in healthcare practice regarding decision-making for frail and older people? A systematic literature review
- Authors:
- HINSLIFF-SMITH Kathryn, et al
- Journal article citation:
- Health and Social Care in the Community, 25(2), 2017, pp.295-308.
- Publisher:
- Wiley
In England and Wales, decision-making in cases of uncertain mental capacity is regulated by the Mental Capacity Act 2005. The Act provides a legal framework for decision-making for adults (16 and over) who are shown to lack capacity and where best interest decisions need to be made on their behalf. Frail older people with cognitive impairments represent a growing demographic sector across England and Wales for whom the protective principles of the Act have great relevance, as they become increasingly dependent on the care of others. However, while the Act articulates core principles, applying the Act in everyday healthcare contexts raises challenges for care providers in terms of interpretation and application. This paper presents a review of the published evidence documenting the use of the Act in healthcare practice, with particular reference to frail older people. The aim was to identify, review and critically evaluate published empirical studies concerned with the implementation and application of the Act in healthcare settings. A systematic approach was undertaken with pre-determined exclusion and inclusion criteria applied across five electronic bibliographic databases combined with a manual search of specific journals. This review reports on 38 empirical sources which met the inclusion criteria published between 2005 and 2013. From the 38 sources, three descriptive themes were identified: knowledge and understanding, implementation and tensions in applying the Act, and alternative perspectives of the Act. There is a need for improved knowledge and conceptualisation to enable successful incorporation of the Act into everyday care provision. Inconsistencies in the application of the Act are apparent across a variety of care settings. This review suggest staff need more opportunities to engage, learn and implement the Act, in order for it to have greater resonance to their individual practice and ultimately benefit patient care. (Publisher abstract)
Evidence, insight, or intuition? Investment decisions in the commissioning of prevention services for older people
- Authors:
- MILLER Robin, et al
- Journal article citation:
- Journal of Care Services Management, 7(4), 2013, pp.119-127.
- Publisher:
- Taylor and Francis
English adult social care commissioners are expected to make ‘evidence based’ decisions on how best to invest public sector funding. This study explores the types of evidence that commissioners use in relation to prevention services for older people and the other factors that influence their investment decisions. A study of local authority Directors of Adult Social Services (DASSs) was used to identify three local prevention interventions. Semi-structured interviews with leads for these interventions explored the evidence and other factors that influenced the investment process. Commissioners drew on a variety of published evidence, in particular that deriving from central government and its regional representative bodies, and third sector organizations with specialist knowledge. Local evidence was also generated through the undertaking of pilots and gathering of performance data. Alongside these ‘rational’ decision-making processes were strong political, personal, and relational dimensions related primarily to the influence of elected members and the hierarchical power of DASSs. Capturing experiential evidence and knowledge of service users and frontline practitioners, being clear about expected impacts and monitoring accordingly, and using recognized evaluation tools would provide further local evidence and enable better comparison and sharing across local authorities. (Publisher abstract)
Dementia 2014: a North East perspective: 'Think' piece
- Authors:
- SMITH Debbie J, OTTER Peter
- Publisher:
- Northern Rock Foundation
- Publication year:
- 2014
- Pagination:
- 5
- Place of publication:
- Newcastle upon Tyne
This ‘Think’ piece takes findings from the ‘Dementia 2014: a North East perspective’ report and highlights some of the more difficult issues relating to dementia, which need to be considered, teased out and addressed. The report provided an overview of the work being undertaken to support people with dementia and their carers by the statutory, independent, voluntary and education sectors. It highlighted progress made and gave a series of recommendations; setting this work against the English policy context. This document explores options and ways to: ensure full shared decision-making with people with dementia, improve information sharing, focus on outcomes for people with dementia as the measure of success, develop a workforce which is equipped to meet the needs of people with dementia, adopt best practice, maximise resources to develop the right care and support for people living with dementia, develop more joined up working at both a service and planning level, and identify regional dementia priorities. (Edited publisher abstract)