Search results for ‘Subject term:"older people"’ Sort:
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Older and bolder: involving older people in health and community care; a report of the workshop on 16th and 17th September 1996
- Author:
- LABYRINTH TRAINING AND CONSULTANCY
- Publisher:
- Labyrinth Training and Consultancy
- Publication year:
- 1996
- Pagination:
- 8p.
- Place of publication:
- Haworth
Papers from a workshop on involving older people in health and community care services.
Shared decision-making preferences in mental health: does age matter? A systematic review
- Authors:
- BURNS Lauren, DA SILVA Ana L., JOHN Ann
- Journal article citation:
- Journal of Mental Health, 30(5), 2021, pp.634-645.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Background: Research to date suggests older adults prefer a passive involvement in the clinical decision-making process; however, the empirical evidence underlying this claim in the mental health context is yet to be reviewed systematically. Aims: To understand whether older adults desire involvement in mental health-related clinical decisions. Method: A systematic review was conducted to identify primary research that explored mental-health decision-making preferences of people with a mean age of over 55 from January 1990 through to December 2018. Results: Three independent studies of varying design and quality were included. Study settings were in the USA, Germany, and the UK. A preference for shared decision-making was seen in two studies, while a preference for active decision-making was identified in one. Conclusions: In contrast to other reviews on clinical decision-making, this review focused on mental health-related decisions of older adults. The evidence suggests older adults desire involvement in mental health-related clinical decisions. Given the political drive to empower patients and the need to ensure evidence-based clinical practice, more high-quality research regarding the shared decision-making preferences and outcomes of older adults with mental ill-health is needed. (Edited publisher abstract)
Engaging caregivers in health-related housing decisions for older adults with cognitive impairment: a cluster randomized trial
- Authors:
- ADELKPEDJOU Rheda, et al
- Journal article citation:
- Gerontologist, 60(5), 2020, pp.947-957.
- Publisher:
- Oxford University Press
In a two-arm pragmatic cluster randomized trial with home care teams working in health centers in the Province of Quebec, the researchers randomized health centers to receive training in interprofessional SDM (intervention) or not (control). Eligible caregivers had made a housing decision for a cognitively impaired adult aged 65 years or older who was receiving services from a home care team. The primary outcome was the proportion of caregivers reporting an active role in decision making. The researchers performed intention-to-treat multilevel analysis. Results: the researchers consecutively enrolled a random group of 16 health centers and recruited 309 caregivers, among whom 296 were included in the analysis. In the intervention arm, the proportion of caregivers reporting an active role in decision making increased by 12% (95% CI −2% to 27%; p = .10). After removal of an influential cluster outlier, the proportion increased to 18% (95% CI: 7%–29%; p < .01). Discussion and implications: Training home care teams in interprofessional SDM increased caregiver involvement in health-related housing decisions for cognitively impaired older adults. (Edited publisher abstract)
Factors affecting user participation for elderly people with dementia living at home: a critical interpretive synthesis of the literature
- Authors:
- HAUGEN Per Kristian, SLETTEBO Tor, YTREHUS Siri
- Journal article citation:
- European Journal of Social Work, 22(6), 2019, pp.974-986.
- Publisher:
- Taylor and Francis
Professional caregivers are expected to facilitate user participation for people with dementia. At the same time, an increasing number of elderly people with dementia are now being cared for at their homes. Research is scarce on user participation for people with dementia, especially for people with dementia who live at home. This article aims to systematically and critically review the factors affecting user participation for elderly people with dementia living at home from the viewpoint of the patients, family caregivers, professional caregivers and researchers. A systematic literature search and critical interpretive synthesis were conducted. The search yielded 1,957 articles. In total, 112 full-text articles were retrieved, of which 27 met the inclusion criteria. Five broad analytical themes were identified during the analysis: individual characteristics, professional caregiver characteristics, decision characteristics, relational characteristics and organisational characteristics. The results show that the value placed on user participation can differ between family caregivers and professional caregivers. People with dementia still experience stigmatisation, preventing user participation, and relations with both family and professional caregivers play a key role in enabling user participation for people with dementia. (Edited publisher abstract)
Person-centredness in the community care of older people: a literature-based concept synthesis
- Author:
- WILBERFORCE Mark
- Journal article citation:
- International Journal of Social Welfare, 26(1), 2017, pp.86-98.
- Publisher:
- Wiley
‘Person-centredness’ is a ubiquitous term, employed in modern care services to signify policies and practices that attend to the uniqueness of each individual user. Despite being highly regarded in older adult community care services, there is much ambiguity over its precise meaning. Existing reviews of person-centredness and its attributes have tended to focus on the medico-nursing literature, neglecting other interpretations, such as those relevant to community social care. A new literature-based concept synthesis reported here identified 12 common attributes within the broad themes of ‘understanding the person’, ‘engagement in decision-making’ and ‘promoting the care relationship’. The review also contrasts how these attributes are applied across different interpretations of person-centredness. The article argues that not all attributes necessarily pull in the same direction, and that older adults may require them to be delivered in different ways than they are to younger people. Thus, a ‘one-size-fits-all’ approach should be discouraged in community care. (Publisher abstract)
Ageing Well in Wales: introduction to co-producing age-friendly environments with older people in Wales
- Author:
- AGEING WELL IN WALES
- Publisher:
- Ageing Well in Wales
- Publication year:
- 2015
- Pagination:
- 7
This guide is designed as an introduction to the rationale and practice of coproducing age-friendly environments with older people. It makes the case for why it is essential to make older people equal partners at every stage of developing age-friendly environments and presents an overview of the core principles that need to be taken into account when developing such an approach. These are: older people are involved in the entire process from beginning to end; they feel safe to speak and be heard; issues relevant to older people are addressed; the decision making process is clear; the skills and experience of older people are central to the process of change; the meetings, materials and infrastructure are accessible to older people; and progress is evaluated through looking at real changes in the lives of older people and agreeing how this can be measured. (Edited publisher abstract)
Moving beyond patient and client approaches: mobilizing ‘authentic partnerships’ in dementia care, support and services
- Authors:
- DUPUIS Sherry L., et al
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 11(4), July 2012, pp.427-452.
- Publisher:
- Sage
The notion of a client-centred or person-centred approach was first introduces in the 1940s. Over the past several decades, however, the true intent behind its original relational approach has been lost, settling instead on well-intended but often paternalistic approaches that place patients or clients at the centre of care, but rarely, if ever, actively involve them in decision-making. This is no more apparent than in the case of people living with Alzheimer's disease who, due to the stigma and misunderstanding surrounding dementia, are often assumed to lack the capacity to be involved in their own care and the care of others. Drawing on the experience of the authors, working directly with persons with dementia, family members and professionals, and systematic research on a number of mutual partnership initiatives, this paper present an alternative approach, one that views persons with dementia as equal partners in the context of dementia care, support and formal services.
Care planning at home: a way to increase the influence of older people?
- Authors:
- BERGLUND Helene, et al
- Journal article citation:
- International Journal of Integrated Care, 12(3), 2012, Online only
- Publisher:
- International Foundation for Integrated Care
The purpose of care-planning meetings is for professionals to co-ordinate the planning of future care, in interaction with the older person. The meeting generally takes place in the hospital, prior to discharge. The purpose of this research was to investigate whether the organisation of care-planning meetings has an impact on the opportunity for the older person to influence the decision-making processes. The study was part of a larger project including a comprehensive continuum-of-care model conducted in a city on the west coast of Sweden. As part of this study, 19 care-planning meetings were audio-recorded; 10 in the older person’s home and 9 in hospital. The meetings were transcribed and a qualitative content analysis was performed. The findings show that care-planning meetings at home appeared to enable older people's involvement in the discussions. Fewer people participated in the meetings at home and there was less parallel talking. Unrelated to the place of the care-planning meeting, the older people were able to influence concerns relating to the amount of care, and the choice of provider. However, they were not able to influence the way the help should be provided or organised. The article concludes that planning care at home enabled an increase in involvement on the part of the older people, but this did not appear to be enough to obtain any real influence.
Hybrid inclusion - the new consumerism of Danish welfare services
- Author:
- HOJLUND Holger
- Journal article citation:
- Journal of European Social Policy, 19(5), December 2009, pp.421-431.
- Publisher:
- Sage
This article focuses on the provision of care for older people in Denmark where recent fundamental changes to welfare structures has meant decision making has become more consumer orientated and both private enterprises and non-profit organisations have been invited to tender for the delivery of welfare services. This author uses a systems approach in which the three decision making systems of organisations, as autopoietic systems of decision making, persons, who individually wear roles in the realm of communication and the concepts of inclusion and exclusion, where persons are approached inside some communicative systems while at the same time being outside others are equally considered. Rather than a simple transition from traditional welfare models to markets models, the author sees the inclusion of citizens in decision making has resulted in hybridisation, with different rationalities brought together with purpose, rather than unhappily as a forced marriage. Network approaches to welfare in general and care of older people specifically, systems for needs assessments, home visits and choosing providers are discussed
Capturing the concealed: Interprofessional practice and older patients' participation in decision-making about discharge after acute hospitalization
- Authors:
- HUBY Guro, et al
- Journal article citation:
- Journal of Interprofessional Care, 21(1), January 2007, pp.55-67.
- Publisher:
- Taylor and Francis
The aim of this paper is to investigate ways in which the dynamics of interprofessional work shaped older patients' “participation” in decision-making about discharge from acute hospital care in a medical directorate of a District General Hospital in Scotland. Twenty-two purposively selected older patients and their key professional hospital carers in three different ward environments participated in the study. An ethnographic approach was adopted, involving semi-structured interviews with patients and staff combined with rigorous observation of the practical context for staff and patient interactions during the discharge planning process over a 5-month period. Patients' and staff's understanding of “decision-making” and their priorities for discharge were different, but patients' perspectives fragmented and became invisible. Care routines, which centred around assessments and the decisions that flowed from these tended to exclude both staff and patients from active decision-making. Research and practice on patient involvement in discharge decision-making needs to focus on the organizational context, which shapes patients', unpaid carers' and staff's interactions and the dynamics by which some views are privileged and others excluded. Procedurally driven care routines and their impact on patients', carers' and staff's opportunity to actively engage in decision-making should be re-considered from an empowerment perspective.