Search results for ‘Subject term:"older people"’ Sort:
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Older people and permanent ccare: whose decision?
- Author:
- DWYER Sandra
- Journal article citation:
- British Journal of Social Work, 35(7), October 2005, pp.1081-1092.
- Publisher:
- Oxford University Press
This paper looks at decision making when older people enter permanent care, and focuses on power issues. The recent past is reviewed and related to aspects of the current picture. Dementia and capacity are a specific focus. The complexities of the work for practitioners, together with their sometimes difficult working environments, engender a climate which can be counter productive to protecting the self-determination of older people.
Moving on? A handbook on modelling the whole system for delayed discharges in Tayside
- Author:
- AUDIT SCOTLAND
- Publisher:
- Audit Scotland
- Publication year:
- 2005
- Pagination:
- 24p.
- Place of publication:
- Edinburgh
During 2004 Audit Scotland led a project with the Tayside Partnership and ISD to develop a whole systems model for Tayside to help tackle its delayed discharges from hospital. This handbook aims to share this approach with Scotland’s NHS and council partnerships wishing to develop their own whole systems thinking. The Tayside model does not provide a solution to the problem of delayed discharges in Tayside. It is an interactive tool to inform and help planning and decision-making in relation to delayed discharges. The handbook describes how stakeholders were involved in building the whole systems model, how the model is used to plan services for older people.
Caregivers' use of spirituality in ethical decision-making
- Author:
- KOEING Terry L.
- Journal article citation:
- Journal of Gerontological Social Work, 45(1/2), 2005, pp.155-172.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This qualitative study examined ethical dilemmas faced by female caregivers of frail elders as well as the dominant role of caregivers' spirituality in addressing these dilemmas. Dilemmas are difficult decisions that involve conflicting values, e.g., freedom versus safety. In-depth interviews were conducted with thirteen ethnically diverse caregivers recruited from a home health agency and its parent hospital. Purposive sampling was used to obtain variation among research participants. Focus group interviews of home health staff, key informant caregivers, and interviewees provided guidance for the research design, reflection on findings and development of implications. In order to deal with ethical dilemmas, all caregivers used spirituality as (1) a philosophy of life, e.g., “This is what you do when you're family,” (2) an aid to decision-making, e.g., through the use of prayer; and/or, (3) a way to transcend dilemmas, e.g., “no choice is hard.” Implications include the importance of caregiverdriven assessment, professional self-reflection, and sustained formal services for caregivers. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Factors affecting long-term-care residents' decision-making processes as they formulate advance directives
- Authors:
- LAMBERT Heather C., et al
- Journal article citation:
- Gerontologist, 45(5), October 2005, pp.626-633.
- Publisher:
- Oxford University Press
This study describes factors contributing to the decision-making processes of elderly persons as they formulate advance directives in long-term care. This study was qualitative, based on grounded theory. Recruitment was purposive and continued until saturation was reached. Nine residents of a long-term-care facility in Canada were interviewed by use of a semistructured format. The results found that elders based their decisions primarily on information gathered from personal experiences with death and illness. They obtained very little information from professionals or the media. Major factors considered by elders as they weighed information included spiritual, emotional, and social considerations. The authors conclude that decision making for advance directives is a highly personalized process. The approach of health professionals when assisting with end-of-life decision making should be planned with these contributing factors in mind, so that the services offered to the individuals in this population best meet their needs.
Assessing the nursing and care needs of older adults: a patient-centred approach
- Author:
- TAYLOR Helen
- Publisher:
- Radcliffe
- Publication year:
- 2005
- Pagination:
- 124p.
- Place of publication:
- Oxford
This book focuses on patient needs together with aspects of law, ethics and decision making theory. It uses and evidence-based approach with case studies and clinical scenarios to help the application of theory into practice. The guidance is applicable to professionals in residential, community, hospital and primary care settings. Contents include: assessment tools; why assessment of an older adult might be difficult; defining "registered nursing care" and "nursing needs"; the role of decisions and judgements as part of the assessment process; making an accurate assessment; sources of information in the assessment process; ethical, professional and legal requirements to involve adults in decisions about their care.
Factors affecting the labour market participation of older workers: qualitative research
- Authors:
- IRVING Pat, STEELS Jennifer, HALL Nicola
- Publisher:
- Corporate Document Services; Great Britain. Department for Work and Pensions
- Publication year:
- 2005
- Pagination:
- 206p., bibliog.
- Place of publication:
- Leeds
This study aims to expand knowledge and understanding about factors influencing participation in, and withdrawal from, the labour market. Also, to explore the retirement process fully and to examine the barriers to continued labour market participation by older workers (aged 50 to 69). Research aims and objectives were to: provide an understanding of the relationships between the different factors that affect people’s retirement decisions ; explore the factors associated with people leaving the labour market prior to reaching state pension age; explore the barriers to continued labour market participation and identify what support people need to remain in work ; to identify what the Government could do to enable and encourage people to work for longer and to promote work opportunities for those not actively seeking work; and to explore general attitudes towards work and training for people aged 50 to 69.
Measuring the values and preferences for everyday care of persons with cognitive impairment and their family caregivers
- Author:
- WHITLATCH Carol J.
- Journal article citation:
- Gerontologist, 45(3), June 2005, pp.370-380.
- Publisher:
- Oxford University Press
This study describes the development and psychometric properties of a 24-item scale to be used in both research and practice settings that assesses the everyday care values and preferences of individuals with cognitive impairment and the perceptions of family caregivers about their relative's values and preferences for care. The Values and Preferences Scale was developed on the basis of previous measures used with cognitively intact samples with additional items generated by the authors in consultation with an advisory committee of practitioners, researchers, family caregivers, and persons with cognitive impairment. A total of one hundred and eleven individuals with mild to moderate cognitive impairment and their family caregivers were interviewed for the study taken from population samples in San Francisco in the USA. Results of a factor analysis determined that the Values and Preferences Scale can be divided into two domains or subscales for persons with cognitive impairment and their family caregivers (i.e., Environment–Social Network and Personal Autonomy). These domains were found to have good internal consistency for both the individuals and their caregivers. Evidence of their psychometric properties compared with measures of depression, quality of life, and involvement in decision making was also found. These findings suggest that persons with cognitive impairment are able to express values and preferences about care they currently receive or will need in the future. Further application and testing of the Values and Preferences Scale should prove useful to practitioners who assist those with cognitive impairment and their caregivers with daily care decisions and the development of care plans.
Decision making in long-term care approaches used by older adults and implications for social work practice
- Authors:
- NAKASHIMA Mitsuko, et al
- Journal article citation:
- Journal of Gerontological Social Work, 43(4), 2005, pp.79-102.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This article reports findings from a qualitative study of approaches to long-term care decision making used by older adults (N = 52) who continued to reside long-term in the community following nursing facility pre-admission screening. Older adults used different approaches to decisionmaking (autonomous, collaborative, and delegated)while seeking the most appropriate care setting. Factors such as mental capacity, the role of family caregivers, and self-advocacy skills influenced the choice of decisionmaking approach. Findings also illustrate how older adults moved through multiple pathways in order to reach their eventual long-term residence. These findings are discussed in terms of their implications for clinical practice and research. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580)
The same old process?: older people, participation and deliberation
- Author:
- BARNES Marian
- Journal article citation:
- Ageing and Society, 25(2), March 2005, pp.245-259.
- Publisher:
- Cambridge University Press
Opportunities for older people to take part in decision making about public policies and services are expanding in the United Kingdom and elsewhere. This paper considers the potential of older people's participation in policy processes for both transforming the policy process and for achieving socially just outcomes. It argues that the way in which such participation takes place, in particular the nature of the deliberative processes, affects both who will feel able to take part and the capacity to develop new policy discourses which can challenge official perspectives and assumptions. It draws from critical perspectives on deliberative democracy to provide a theoretical framework. This work emphasises the importance of story telling and forms of exchange designed to offer recognition to others, as well as the rational argument more usually associated with deliberation on matters of public policy. The argument is illustrated with examples of participation initiatives that have involved ‘active’ older people and those who are users of social care services. Different styles and processes of exchange are distinguished in the three case studies. In one, active facilitation enables individual stories of ageing and of service use to be woven into collective narratives that offer an alternative vision of care services. In another, a strong emphasis on ‘greeting’ enables conflicting views to be expressed without participants falling out. In the third, styles of exchange familiar in formal debate limit the development of an alternative discourse. The conclusion suggests that attention needs to be given to the process of participation as well as to outcomes.
Decision-making capacity: the core of self-neglect
- Authors:
- DONG XinQi, GORBIEN Martin
- Journal article citation:
- Journal of Elder Abuse and Neglect, 17(3), 2005, pp.19-36.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Self-neglect in the elderly is a pervasive public health issue that affects 1.2 million elderly each year. In working with self-neglect cases, ethical issues are often raised that challenge all professionals. Professional and family's wishes to remove obstacles to the wellbeing of an elderly may be directly in opposition to the individual's wishes. The core of many ethical dilemmas resides in the question of the individual decision-making capacity. Issues surrounding decision-making capacity are complex with many confounding factors. This article uses case-discussion, to explore fundamental ethical issues of decision-making capacity relating to self-neglect and strategies are offered to resolve these dilemmas. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).