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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.
Voluntary and involuntary driving cessation in later life
- Authors:
- CHOI Moon, MEZUK Briana, REBOK George W.
- Journal article citation:
- Journal of Gerontological Social Work, 55(4), May 2012, pp.367-376.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
There is limited quantitative information about the differences between voluntary and involuntary driving cessation or the factors associated with these transitions. This study explored the decision-making process of driving cessation in later life, with a focus on voluntary decisions. The sample included 83 former drivers from the Baltimore Epidemiologic Catchment Area Study (mean age 75.3 years and 73.5% females). A majority of participants (83%) reported stopping driving of their own volition. However, many voluntary driving retirees reported external factors such as financial difficulty, anxiety about driving, or lack of access to a car as main reasons for driving cessation. The authors conclude that the distinction between voluntary and involuntary driving cessation is in practice ambiguous and that factors beyond health status, including financial strain, play a role in the transition to non-driving.
'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.
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.
ATdementia: an information resource on assistive technologies that help support the independence of people with dementia
- Authors:
- BURROW Simon, BROOKS Deborah
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 11(4), July 2012, pp.553-557.
- Publisher:
- Sage
Assistive technology has been defined as ‘any device or system that allows an individual to perform a task that they would otherwise be unable to do’. These technologies have the capacity to be enabling or disabling for people who are living with dementia. Accessible information is required to equip people to make informed decisions about what technologies are available and how they may be utilised to support independence. This article describes the development of a web-based resource called ATdementia which was designed to provide independent information on assistive technologies for people who are living with dementia. It was designed to be accessed by people with dementia, families, supporters and professionals. The article describes the development and the early operation of ATdementia. Mention is also made of the ATguide, a self-assessment tool to support decision-making in relation to technologies. ATguide was launched in 2012.
The use of the Mental Capacity Act among hospital patients: findings from a case study of one Acute Hospital Trust in England
- Authors:
- PHAIR Lynne, MANTHORPE Jill
- Journal article citation:
- Journal of Adult Protection, 14(6), 2012, pp.259-270.
- Publisher:
- Emerald
This paper presents findings from a review of hospital policies and practices in one NHS Trust in England. The focus of the review was hospital staff policy and practice in safeguarding the rights of vulnerable patients. A sample of 42 staff members was surveyed to investigate their knowledge of the Mental Capacity Act 2005 in 2010. Analysis revealed limited confidence and knowledge about the Mental Capacity Act 2005 and uncertainties about its relevance to clinical practice. In relation to safeguarding, there was limited realisation of the potential of the Act to uphold the rights of patients lacking capacity and staff responsibilities. MCA training had not made a great impression; hospital policies were inconsistent and lacked coherence. The authors concluded that the findings of this case study may be applicable to other hospitals and to other providers of health and social care services. The relevance of the MCA could be highlighted and used on several induction and training programmes. The study identifies features of policy and practice that could be investigated in other organisations.
Improving practice in communication with older people and support networks living in housing with care schemes: aspirations and ambitions
- Authors:
- MANTHORPE Jill, SAMSI Kritika
- Journal article citation:
- British Journal of Social Work, 42(8), 2012, pp.1495-1512.
- Publisher:
- Oxford University Press
In the UK, the options relating to housing with care will likely increase, as they promote choice and independence. If housing with care services offer end-of-life care to their service users, their staff will need to engage with social workers and other professional networks and these professionals will need to understand the context and ethos of housing with care provision. In order to investigate whether existing literature will assist professional communication across sectors, a scoping literature review was conducted. Findings were grouped into themes, according to the project brief, focusing on: confidence and skills, making decisions and plans, and access to support and training. Several elements were identified as potentially supportive of staff confidence, such as obtaining biographical information, mutually respectful working relationships, managerial support and better understanding of specialist communication needs.
Improving decision-making in the care of older people: exploring the decision ecology: report
- Author:
- JOSEPH ROWNTREE FOUNDATION
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2012
- Pagination:
- 71p.
- Place of publication:
- York
The proportion of the population in retirement is estimated to rise significantly. This major demographic change makes it imperative to review the position of older people both as receivers and as givers of care and support. This report reviews the evidence relating to how to improve decisions made by and for older people about their care and support. It investigates how formal, semi-formal and informal relationships can work together to best effect, and the relationship between risk, trust, and good decision-making. The report: examines the nature of decision-making; explores the 'decision ecology' - the multi-factored contextual backdrop to decisions about risk and trust in an ageing society; discusses factors that influence, improve and impede caring decisions taken by a range of actors; considers the role of narratives in improving decisions for, by and about older people and their care; appraises risk management and trust development strategies; and investigates responsibility in decision-making. It argues that effective decision-making requires constructive partnerships between older people (carers and cared-for), and informal and formal carers that understand their value, potential shortcomings and strengths. However, risk elimination is not possible and the wellbeing of older people requires positive risk-taking.
Improving decision-making in the care and support of older people: summary
- Author:
- JOSEPH ROWNTREE FOUNDATION
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2012
- Pagination:
- 4p.
- Place of publication:
- York
The proportion of the population in retirement is estimated to rise significantly. This major demographic change makes it imperative to review the position of older people both as receivers and as givers of care and support. This report summary outlines the findings of a review of the evidence relating to how to improve decisions made by and for older people about their care and support. It investigates how formal, semi-formal and informal relationships can work together to best effect, and the relationship between risk, trust, and good decision-making. This summary lists the key points identified by the review and also briefly discusses the findings in relation to: how decisions are made; the decision-making ecology; influences on caring decisions; the role of narrative; risk and trust; and responsibility. It argues that effective decision-making requires constructive partnerships between older people (carers and cared-for), and informal and formal carers that understand their value, potential shortcomings and strengths. However, risk elimination is not possible and the wellbeing of older people requires positive risk-taking.