Search results for ‘Subject term:"older people"’ Sort:
Results 1 - 10 of 35
'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.
Care workers’ ambivalence towards family care partners: informal decision-making processes when older people consider relocation to a residential home
- Author:
- SODERBERG Maria
- Journal article citation:
- International Journal of Care and Caring, 4(4), 2020, pp.513-530.
- Publisher:
- Policy Press
The aim of this article is to reveal how care workers in the home-help service interpret the influence of family care partners when older people’s relocation to a residential home is considered. Based on interviews with 33 care workers, this article investigates how they use their discretion. The analysis shows that the care workers express ambivalence towards family care workers and that they informally influence decision-making processes despite prevailing care management systems. The conclusion drawn are that welfare ideas in transformation and diffuse areas of responsibility may not benefit either care workers, family care partners or a care receiver’s self-determination. (Edited publisher abstract)
Older adult and family member perspectives of the decision-making process involved in moving to assisted living
- Authors:
- KOENIG Terry L., et al
- Journal article citation:
- Qualitative Social Work, 13(3), 2014, pp.335-350.
- Publisher:
- Sage
The decision to move into assisted living (AL) can be viewed as a life-changing process for older adults and their families; and each may possess differing views of this process. This qualitative study examined the AL decision-making process as described by twenty-two older adult and family member dyads. Participants described emotional and logistical components related to the AL moving decision. Further, fifteen of twenty-two dyads expressed conflicting or differing views of the AL moving decision. Our discussion examines the need for future studies to explore the impact of family and older adult disagreements on the older adult’s AL adjustment; the necessity for community-based agencies and AL settings to provide social services over the duration of the decision-making process; and the importance of employing social workers skilled in family practice in the AL setting. (Publisher abstract)
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 use of family decision meetings when addressing caregiver stress
- Authors:
- BRODIE Kilolo, GADLING-COLE Charnetta
- Journal article citation:
- Journal of Gerontological Social Work, 42(1), 2003, pp.89-104.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This article focuses on the literature about Family Decision Meetings for relatives caring for older people sufering from Alzheimer's Disease. There is emphasis in this literature on the special problems faced by families in which the symptoms of the disease include troubling behavioral changes, as well as loss of cognitive abilities. particular attention is paid to the families who try to manage without agency-provided services, and without the partnership of agency staff. A number interventions are listed, with detailed description of the Family Decision Meeting and the value of this strategy for caregiving families. (Copies of this article are available from: Haworth Document Delivery Centre Haworth Press Inc., 10 Alice Street Binghamton, NY 13904-1580)
Care-related decision-making satisfaction and caregiver well-being in families caring for older members
- Authors:
- SMERGLIA Virginia L., DEIMLING Gary T.
- Journal article citation:
- Gerontologist, 37(5), October 1997, pp.658-665.
- Publisher:
- Oxford University Press
Examines the impact of structural variables (caregiver type, elder impairment) and family environment (adaptability, conflict, cohesion) on satisfaction with care-related decision making and caregiver well-being, Regression analysis results indicate that aspects of family environment such as adaptability and conflict are the best predictors of decision-making satisfaction. After caregiver type (adult child/spouse), family adaptability and decision-making satisfaction are the best predictors of caregiver depression.
Involvement of Japanese care managers and social workers in advance care planning
- Authors:
- HIRAKAWA Yoshihisa, et al
- Journal article citation:
- Journal of Social Work in End-of-Life and Palliative Care, 14(4), 2018, pp.315-321.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia
Successful advance care planning relies heavily on effective communication between the elderly and their families, care managers, and social workers. However, care managers and social workers are often not adequately prepared to conduct such discussion. The aim of the present study was to identify the specific challenges facing Japanese care managers and social workers when involvement in advance care planning. Two focus group discussions were held between August and November 2017, involving eleven care managers and three social workers employed at two long-term care facilities actively pursuing advance care planning initiatives. Four main themes were identified, through content analysis, as barriers and facilitators: client readiness, communication, variation-rich client individuality, and difficult-to-explain end-of-life options. This study revealed the importance of building rapport with the residents and their families in order to assess their readiness to discuss care options and preferences. Obstacles included lack of medical knowledge of care managers and social workers. Study findings suggested that a multi-disciplinary team, facilitated by care managers and social workers, was fundamental to achieving the goals of advance care planning. (Publisher abstract)
Older people and decision-making following acute stroke in China: ‘hiding’ as a barrier to active involvement
- Authors:
- WANG Yue, NOLAN Mike
- Journal article citation:
- Ageing and Society, 36(7), 2016, pp.1526-1554.
- Publisher:
- Cambridge University Press
Decision-making among older patients with stroke, their families and professionals has been extensively studied in a Western context, but there has been little prior work in China. The study reported here explored how decision-making took place between older people with stroke, their family carers and professionals in an acute care context in mainland China using a constructivist grounded theory approach. Data were collected through semi-structured interviews, participant observation and documentary analysis. Constant comparative analysis of the data was carried out. This paper focuses on the key social process of ‘hiding’ and its dynamic relationship with the core category ‘keeping the peace’. In order to meet the traditional Chinese cultural value of ‘maintaining harmony’, both family carers and professionals hid essential information from older stroke survivors who, as a consequence, were effectively precluded from playing an active role in major decisions. In understanding ‘hiding’, the paper draws upon both Chinese cultural values and ‘awareness context theory’ and in so doing questions the relevance to the Chinese context of key Western notions such as involvement in health-care decision-making. A better understanding of the experiences of decision-making processes between older people with stroke, their family carers and professionals in China will help professionals to provide the best possible support and care whilst promoting informed decision-making amongst all concerned.
The positive association of end-of-life treatment discussions and care satisfaction in the nursing home
- Authors:
- REINHARDT Joann P., BOERNER Kathrin, DOWNES Deirdre
- Journal article citation:
- Journal of Social Work in End-of-Life and Palliative Care, 11(3-4), 2015, pp.307-322.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia
With the progression of dementia, the need for families and health care providers to have discussions about end-of-life (EOL) treatments arises. EOL treatment decisions often involve whether or not medical interventions intended to prolong life—such as resuscitation, artificial nutrition and hydration, and use of antibiotics—are desired. It is unclear if family satisfaction with care in the nursing home may be associated with involvement in EOL treatment discussions. The frequency of discussions that family members reported having with health care team members regarding multiple life-sustaining treatments and symptom management for their relatives with advanced dementia were examined over a 6-month period along with the association of these particular discussions with care satisfaction over time. Results showed that greater frequency of discussion of EOL treatment wishes was positively associated with higher care satisfaction scores among family members of nursing home residents with dementia. When considered together, greater frequency of discussion of artificial hydration was uniquely associated with greater care satisfaction and increased care satisfaction over time. Social workers must ensure that EOL treatment discussions with older adults in the nursing home and their family members take place and that preferences are communicated among the various interdisciplinary health team members. (Publisher abstract)
‘We need to know what’s going on’: Views of family members toward the sexual expression of people with dementia in residential aged care
- Authors:
- BAUER Michael, et al
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 13(5), 2014, pp.571-585.
- Publisher:
- Sage
This paper reports on a study which explored the views and attitudes of family members towards the sexual expression of residents with dementia in residential aged care facilities in two states in Australia. Recruitment was challenging and only seven family members agreed to an interview on this topic. Data were analysed using a constant comparative method. Family were generally supportive of residents’ rights to sexual expression, but only some types of behaviours were approved of. There was an acknowledgement that responding to residents’ sexuality was difficult for staff and many families believed that they should be kept informed of their relative’s sexual behaviours and moreover be involved in decision making about it. Findings suggest the need for family education and a larger study to better understand the views and motivations of family carers and how these might impact on the sexual expression of the older person with dementia living in residential aged care. (Publisher abstract)