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Empowered or overpowered? Service use, needs, wants and demands in elderly patients with cognitive impairments
- Authors:
- WOLFS Claire A. G., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 25(10), October 2010, pp.1006-1012.
- Publisher:
- Wiley
Current treatment options are often not sufficiently used by patients suffering from dementia or mild cognitive impairment. This study investigated to what extent and in what way these patients use the available treatment options, and identified factors and reasons that play a role in the non-utilisation of these options. Results revealed that counselling, medication, activities and home care were the options that were most frequently used by the 252 patients and caregivers who were included in the study. Group guidance and admissions were the main treatment categories that had not been used. The most important reasons given were refusal by the patient and the fact that help was not necessary yet according to the caregiver. Burden of care and cognition were the most important factors in predicting which of the treatment options were not utilised. Many patients and caregivers were not aware of the treatment options available to them. Awareness of these options is necessary to avoid situations in which the need for care support has become an acute necessity.
Evaluating the effectiveness of home-start support in Dutch families
- Authors:
- METZE Rosaline N., ABMA Tineke A., KWEKKEBOOM M.H.
- Journal article citation:
- Journal of Social Work, 19(3), 2019, pp.327-350.
- Publisher:
- Sage
Summary: Family Group Conferencing as deployed in child care might be useful in elderly care to strengthen older adults’ social networks and self-mastery. When Family Group Conferencing was implemented for older adults in the Netherlands, social workers were reluctant to refer. To discover reasons for this reluctance, this study examined social workers’ views and attitudes concerning Family Group Conferencing for their clients. Findings: In an initial exploratory study, a survey was distributed among social workers who worked with older adults and were informed about Family Group Conferencing, followed by three focus groups of social workers with and without Family Group Conferencing experience. Semi-structured individual interviews were also held with social workers and an employee of the Dutch Family Group Conferencing foundation. The respondents were positive about Family Group Conferencing, but hesitant about referring their older clients. Reasons were: they were already working with their clients’ social networks; they feared losing control over the care process; and they wondered how they could motivate their clients. They also reported that their clients themselves were reluctant, because they seemed to fear that Family Group Conferencing would lose them self-mastery, and they did not want to burden their social networks. Applications: The findings indicate that implementing Family Group Conferencing in elderly care is a complicated and slow process, partly because social workers have little experience with Family Group Conferencing. To facilitate social workers it might be necessary to offer them more guidance, in a joint process with the Family Group Conferencing foundation. One might also experiment with alterations to the Family Group Conferencing model, for example, by focusing less on family networks and more on reciprocity. (Edited publisher abstract)
Paradoxes in the care of older people in the community: walking a tightrope
- Authors:
- JANSSEN Bienke, ABMA Tineke A., van REGENMORTEL Tine
- Journal article citation:
- Ethics and Social Welfare, 8(1), 2014, pp.39-56.
- Publisher:
- Taylor and Francis
- Place of publication:
- Abingdon
The expansion of the older population suggests that there will be significant numbers in need of care and support in their own home environment. Yet, little is known about the kind of situations professionals are faced with and how they intervene in the living environment of older people. Qualitative data were collected over a period of 1.5 years from a multi-disciplinary community-based geriatric team in the Netherlands, and participant observations carried out. Forty-two cases discussed within the team meetings were analysed. Results demonstrate that providing care to older people is a dynamic process and revolves around various paradoxes as experienced by professionals. This is illustrated by presenting three paradoxes that emerged within the data: respecting autonomy versus preserving safety; the care needs of the care recipients versus the capacity of their informal carers to cope; and holding a formal orientation versus a tailored orientation on tasks. Providing care in the home environment of older people requires from professionals a continuous anticipation of (un)expected evolutions in situations of their care recipients. In order to optimally support older people professionals need ‘professional discretion’. They must be supported to systematically reflect on and legitimize their intervention strategies. (Publisher abstract)
Dealing with distrust and power dynamics: asymmetric relations among stakeholders in responsive evaluation
- Authors:
- BAUR Vivianne E., et al
- Journal article citation:
- Evaluation, 16(3), July 2010, pp.233-248.
- Publisher:
- Sage
Asymmetric relations among stakeholders create challenges in participatory evaluation processes. The aim of responsive evaluation is to include the issues of as many stakeholder groups as possible in the evaluation by engaging them in evaluative interaction. However, power and conflict may hinder equal and genuine communication about the value of the practices evaluated. This article discusses the use of a specific interpretation of responsive evaluation as an approach to foster dialogues among stakeholders in politically laden contexts. It aims to illustrate how asymmetric relations can be dealt with constructively, focusing on inclusion of marginalised groups, mutual learning and good dialogue. The article uses two reflective case narratives, conducted in a residential elderly care setting and in a psychiatric hospital, as examples of responsive evaluation projects in settings with marginalised groups. These case studies illustrate the changing, active roles of responsive evaluators. Both evaluation settings shed light on how to go about making social relations among stakeholders and the evaluator ‘the point’ in evaluation, and how to exploit these relations constructively in order to establish practice improvements.
Whose empowerment and independence?: a cross-national perspective on ‘cash for care’ schemes
- Author:
- UNGERSON Clare
- Journal article citation:
- Ageing and Society, 24(2), March 2004, pp.189-212.
- Publisher:
- Cambridge University Press
Uses qualitative data from a cross-national study of ‘cash for care’ schemes in five European countries (Austria, France, Italy, the Netherlands and the United Kingdom) to consider the concepts of empowerment and independence in relation to both care-users and care-givers. Locates the schemes along two axes, one of regulation/non-regulation, the other whether relatives can be paid or not. Each of the schemes has a different impact both on the care relationship and on the labour market for care. In the Netherlands where relatives can be paid, for example, a fully commodified form of informal care emerges; but in Austria and Italy with low regulation, a mix of informal and formal care-givers/workers has emerged with many international migrant workers. In the UK, direct payments allow care-users to employ local care-workers who deliver care for various lengths of time; while in France a credentialised system means that care-work is delivered by qualified workers but for very short intervals. Concludes that none of these schemes have a simple outcome or advantage, and that the contexts in which they occur and the nature of their regulation has to be understood before drawing conclusions about their impact on empowerment and independence on both sides of the care relationship.
Combating loneliness: a friendship enrichment programme for older women
- Author:
- STEVENS Nan
- Journal article citation:
- Ageing and Society, 21(2), March 2001, pp.183-202.
- Publisher:
- Cambridge University Press
In order to promote wellbeing and reduce loneliness, an educational programme on friendship enrichment for older women has been developed and implemented in the Netherlands. The friendship programme's main goal is empowerment; it aims to help women clarify their needs in friendship, analyse their current social network, set goals in friendship and develop strategies to achieve goals. Reduction of loneliness, when present, is also an important goal of the programme. A study that followed participants during the year after the programme found that a majority succeeded in developing new, or improving existing, friendships and in significantly reducing their loneliness. They also reported changes related to the self and social behaviour.
The measure and discuss intervention: a procedure for client empowerment and quality control in residential care homes
- Author:
- GREEN Van V.M.C.
- Journal article citation:
- Gerontologist, 37(6), December 1997, pp.817-822.
- Publisher:
- Oxford University Press
This article presents an intervention that is used to empower clients in residential care homes in the Netherlands. The intervention comprises a standardised survey-feedback procedure in which residents' opinions on life and care in their particular home are gauged, discussed, and reported. The procedure is designed to influence individuals and processes in the institution. It results in a report containing residents' collective opinion and recommendations and a plan for action. This provides residents' committees and managers with a basis for policy making and quality control.
Payments for care: a comparative overview
- Editors:
- EVERS Adalbert, PIJL Marja, UNGERSON Clare
- Publisher:
- Avebury
- Publication year:
- 1994
- Pagination:
- 358p.,tables,bibliogs.
- Place of publication:
- Aldershot
Presents a collection of papers looking at how payments for care schemes are developing across Western and Central Europe, the United States and Canada. Includes discussions of payments to 'volunteers', and consideration of the way in which social security and tax systems work to increase the incomes of care recipients and their carers. Also includes introductory chapters discussing general and theoretical issues involved in the development of systems of payments for care including the labour market, empowerment and the relationship between carers and care recipients.
Elderly care: a world perspective
- Editor:
- TOUT Ken
- Publisher:
- Chapman and Hall
- Publication year:
- 1993
- Pagination:
- 240p.,bibliog.
- Place of publication:
- London
Contains examples of successful service provision for older people from 40 countries. The case studies are organised into the following sections: care at home; community support; empowerment; participation; fitness and well-being; income generation; environment; integrated services; mental health; training for elder care; organisation of services; and older women.