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Seniors' narratives of asking (and not asking) for help after a fall: implications for identity
- Authors:
- MILLER Patricia A., et al
- Journal article citation:
- Ageing and Society, 36(2), 2016, pp.240-258.
- Publisher:
- Cambridge University Press
Falls among community-dwelling seniors constitute a major public health concern because of the potential morbidity and mortality associated with the fall. This study examined the informal care networks accessed by Canadian seniors who had visited the Emergency Department as a result of a fall, and considered the implications of the processes of asking for and receiving help on the senior's identity. Four themes were identified. The first was valuing independence. The remaining three themes concerned threats to the participants' identities linked to the need to ask for or receive help from family and friends. They were: becoming indebted, feeling devalued and becoming a burden to others. Seniors were noted to excuse family members from the expectation of helping because of work and family commitments, and illness. Participants described a mutually beneficial relationship with friends wherein both parties valued their independence and provided assistance to the other when needed. Their comments suggested that assistance was viewed as a good to be traded among peers. The findings indicate that seniors value their independence and may not seek help even when it appears to be available, if asking threatens valued identities. Health and social care practitioners and policy makers responsible for planning and delivery of services should take this into account in order to ensure the best possible care for injured community-dwelling seniors. (Edited publisher abstract)
Transitions in living arrangements of Canadian seniors: findings from the NPHS longitudinal data
- Authors:
- SARMA Sisira, HAWLEY Gordon, BASU Kisalaya
- Journal article citation:
- Social Science and Medicine, 68(6), March 2009, pp.1106-1113.
- Publisher:
- Elsevier
This paper examines transitions in living arrangement decisions of the seniors using the first six cycles of the Canadian longitudinal National Population Health Survey microdata. Transitions from independent to intergenerational and institutional living arrangements are uniquely analyzed using a discrete-time hazard rate multinomial logit modelling framework and accounted for unobserved individual heterogeneity in the data. Results show: a) provision of publicly-provided homecare reduces the likelihood of institutionalization, but it has no effect on intergenerational living arrangements; b) access to social support services reduces the probability of both institutional and intergenerational living arrangements; c) higher levels of functional health status, measured by Health Utility Index, reduce the probability of transitions from independent to intergenerational and institutional living arrangements; d) a decline in self-reported health status increases the probability of institutionalization, but its effect on intergenerational living arrangements is statistically insignificant; e) higher levels of household income tend to decrease the probability of institutionalization; and f) the likelihood of transitioning to both intergenerational and institutional living arrangements increases with the duration of survival. Our findings suggest that access to and availability of publicly-provided homecare, social support services and other programs designed to foster better functional health status would contribute positively towards independent or intergenerational living arrangements and reduce the probability of institutionalization.
The future Home Improvement Agency: supporting choice and maintaining independence: a report overview
- Author:
- FOUNDATIONS
- Publisher:
- Great Britain. Department for Communities and Local Government
- Publication year:
- 2008
- Pagination:
- 38p.
- Place of publication:
- London
This report gives an overview of the key findings of the Future HIA project carried out by Foundations on behalf of Communities and Local Government (CLG). Home Improvement Agencies (HIAs) help vulnerable people to maintain their independence. Their primary focus is the repair or adaptation of the client's home, and in support of this objective they may provide a range of services depending on local needs and circumstances. The Future HIA project aims to set out a broad agenda for the evolution of the sector to its next level. It highlights what is already being done well by HIAs and suggests models for wider application.
How to thrive past 55: what science tells us about ageing well
- Editors:
- WILSON Deanna, (ed.)
- Publisher:
- Help the Aged
- Publication year:
- 2008
- Pagination:
- 192p.
- Place of publication:
- London
We are all living longer lives – and we want to remain fit and active for as long as possible. How to Thrive Past 55 presents the facts, direct from the scientists, about how to achieve this – often by making simple changes to our lifestyle. And best of all, it tells us that it’s never too late. This book offers the sort of down-to-earth advice that anyone can benefit from.
Trust in older persons: a quantitative analysis of alignment in triads of older persons, informal carers and home care nurses
- Authors:
- DOEKHIE Kirti D., et al
- Journal article citation:
- Health and Social Care in the Community, 27(6), 2019, pp.1490-1506.
- Publisher:
- Wiley
Self‐management by older persons could be influenced by the level of trust found in triads of informal carers, formal care providers and care recipient, the older person. Little research has been done on care providers’ trust in older persons. This study aims to explore the level of trust that informal carers and home care nurses have in older persons, the extent of alignment in triads and the relationship between trust in older persons and self‐management. This study conducted a cross‐sectional survey study in the Netherlands, sampling 133 older persons, 64 informal carers and 72 nurses, which resulted in 39 triads. Alignment level was analysed through Intraclass Correlation Coefficient 1 scores and absolute and mean difference scores. Correlation analysis and one‐way analysis of variance measured the relationship between trust and self‐management. The results show that triads contain both alignment and misalignment. Misalignment occurs mostly when informal carers and nurses have little trust in the older person while this person views their own behaviour towards their caregivers positively. Care providers’ trust levels relate significantly to their perception of the person's ability to self‐manage, but not to the person's self‐rated ability. This could be explained by care providers not communicating their intrinsic trust in the older person to them. Trust building could be enhanced by organising discussions of mutual expectations of trust and both formal and informal care providers could benefit from compassionate assessment training, to learn how to openly express their trust in the older person. (Edited publisher abstract)
‘Independence’ among older people receiving support at home: the meaning of daily care practices
- Author:
- BARKEN Rachel
- Journal article citation:
- Ageing and Society, 39(3), 2019, pp.518-540.
- Publisher:
- Cambridge University Press
Later life care practices are closely entangled with the ideals of independence and dependence. Based on an interpretive analysis of qualitative interviews with 34 people aged 65–100 receiving home care in Ontario, Canada, this article explores older people's subjective interpretations of caring for themselves (i.e. independence) and receiving support from others (i.e. dependence). Findings suggest that individuals construct subjective meanings of independence in relation to their changing physical capacities, and in the context of their relationships with family members, friends and formal care providers. First, participants considered their care activities to be a way of maintaining independence when they undertook certain practices with the intention of staving off dependency and future decline. Second, when they accepted assistance, many engaged in care relations that allowed them to preserve an independent identity in the face of limits to physical self-sufficiency. Third, participants reached the limits of independence when they lacked adequate assistance, and were unable to care for themselves in desirable ways. Findings illustrate how objective circumstances related to social and financial resources as well as access to formal services shape subjective interpretations, allowing some older people to hold on to independent identities while exacerbating feelings of dependency among others. (Publisher abstract)
Improving life satisfaction for the elderly living independently in the community: care recipients' perspective of volunteers
- Author:
- WILSON Anne
- Journal article citation:
- Social Work in Health Care, 51(2), February 2012, pp.125-139.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Informal carers (in this case referring to unpaid volunteers not related to those in need) provide a range of services to help older people with health and social needs to remain living independently in their own homes and communities. This article reports on clients' perspectives of support received from a volunteer support programme in South Australia which aims to increase the independence of frail and older people isolated in their own homes. A qualitative study was undertaken, using face-to-face semi-structured interviews with 16 randomly selected clients to gather data. The article describes the results of analysis, including quotations from the transcribed interviews, which identified 3 main themes relating to improved life satisfaction: being helped with daily activities, positive human contact, and fear of a poorer quality of life. It concludes that the findings demonstrate that older people are able to remain independent if provided with appropriate community care services, and that addressing recipients' social, emotional, and mobility needs supported them to remain living at home.
Family care, independent living and ethnicity
- Authors:
- HARPER Sarah, LEVIN Sonya
- Journal article citation:
- Social Policy and Society, 4(2), April 2005, pp.157-169.
- Publisher:
- Cambridge University Press
The UK's national population structure, in line with most Western societies, is ageing rapidly. The combination of falling fertility and increasing longevity is having an impact on family structures and resultant relationships, with the emergence of long vertical multi-generational families replacing the former laterally extended family forms. This is occurring at a time when UK government policy is placing increasing reliance on families to provide health and social care and support for the growing number of frail older people. While there has been extensive research on family care within the majority white population, there is less understanding of the elder family care provision for the UK's growing older ethnic population. This paper discusses the changing demographics, new government policy on promoting independent living and its implications for family care provision, and reviews our current understanding of family care and support for older people within the UK’s varied ethnic minority families.
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.
Relative values
- Author:
- STILES Jenny
- Journal article citation:
- Community Care, 30.4.98, 1998, p.8.
- Publisher:
- Reed Business Information
Looks at ways to involve families of service users more in their care.