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Establishing empirically-informed practice with caregivers: findings from the CARES program
- Author:
- BLACK Kathy
- Journal article citation:
- Journal of Gerontological Social Work, 56(6-7), 2013, pp.585-601.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
There is increasing interest in delivering efficacious interventions to caregivers. This study reports on the processes and findings from a modified approach of the Wraparound System of Care. The practice model is implemented over 4 phases and is based on 3 theoretical constructs and 10 principles. The evaluation utilized treatment fidelity measures and employed a quasi-experimental pretest/posttest design to examine caregiver outcomes (N = 120). Findings suggest significant improvement among caregivers’ self-reported health, life satisfaction, well-being, and quality of life, as well as a reduction in caregiver risk and burden. Delineation of the processes used in the model are presented. (Publisher abstract)
Modeling causes of aggressive behavior in patients with dementia
- Authors:
- MORGAN Robert O., et al
- Journal article citation:
- Gerontologist, 53(5), 2013, pp.738-747.
- Publisher:
- Oxford University Press
Purpose of the Study: To examine factors predicting development of aggression in patients with dementia as a step toward developing preventive strategies and nonpharmacologic therapies. Design and Methods: Study participants were 171 nonaggressive, community-residing VA patients aged more than 60, newly diagnosed with dementia. Patients and caregivers were assessed at baseline and at months 5, 9, 13, 17, 21, and 25. Aggression was evaluated using the Cohen-Mansfield Agitation Inventory. Survival models incorporating direct and indirect effects were conducted to estimate associations between psychosocial factors (baseline and change measures of dementia severity, pain, depression, caregiver burden, patient–caregiver relationship, and nonaggressive physical agitation) and time to aggression onset. Results: Higher levels of baseline caregiver burden, worst pain, declining patient–caregiver relationship, and increasing nonaggressive physical agitation predicted increased risk of aggression. Baseline dementia severity and depression were indirectly related to onset of aggression. The association between increasing nonaggressive physical agitation and time to aggression onset was independent of the associations between our psychosocial measures and time to aggression onset. Implications: Potentially mutable factors were associated with development of aggression. The longitudinal design of this study and its sample of newly diagnosed, previously nonaggressive dementia patients strengthen prior findings in the literature. (Publisher abstract)
From Canada to Kircubbin: learning from North America on housing an ageing population – Part 1
- Author:
- THOMPSON Eileen
- Journal article citation:
- Housing Care and Support, 16(2), 2013, pp.58-63.
- Publisher:
- Emerald
Purpose – The purpose of this study was to learn lessons from North America on housing an ageing population, both in terms of supporting people to “age in place”, and available options for those who need/wish to move. Design/methodology/approach – The project, funded by the Winston Churchill Memorial Trust, comprised a six-week travel fellowship to the USA and Canada to meet with housing professionals from the public and private sectors and find out about best practice initiatives and efficient models for housing older people. Findings – This report is written in two parts. This, the first, considers models which are successfully facilitating individuals and communities to support each other to age in place, for example, the Beacon Hill Village model which has taken off in the USA in a big way. Technology can, and will, also play an important role in enhancing the lives of older people in the future, but housing is really about people and it will be people who will make the real difference on this issue. Originality/value – This was a unique opportunity to learn lessons from North America on how to effectively meet the needs of the older population, now and in the future. (Publisher abstract)
Living and dying with dignity in Chinese society: perspectives of older palliative care patients in Hong Kong
- Authors:
- HO Andy Hau Yan, et al
- Journal article citation:
- Age and Ageing, 42(4), 2013, pp.455-461.
- Publisher:
- Oxford University Press
Background: The empirical Dignity Model has profoundly influenced the provision of palliative care for older terminally ill patients in the West, as it provides practical guidance and intervention strategies for promoting dignity and reducing distress at the end-of-life. Objective: To examine the concept of ‘living and dying with dignity’ in the Chinese context, and explore the generalisability of the Dignity Model to older terminal patients in Hong Kong. Methods: using qualitative interviews, the concept of dignity was explored among 16 older Chinese palliative care patients with terminal cancer. Framework analysis with both deductive and inductive methods was employed. Results: The three major categories of themes of the Dignity Model were broadly supported. However, the subtheme of death anxiety was not supported, while two subthemes of generativity/legacy and resilience/fighting spirit manifested differently in the Chinese context. Furthermore, four new emergent themes have been identified. They include enduring pain, moral transcendence, spiritual surrender and transgenerational unity. Conclusion: These findings highlight both a cultural and a familial dimension in the construct of dignity, underline the paramount importance of cultural awareness and competence for working with ethnically diverse groups, and call for a culturally sensitive and family oriented approach to palliative care interventions with older Chinese terminal patients. (Publisher abstract)
The ethics of transnational market familism: inequalities and hierarchies in the Italian elderly care
- Author:
- NARE Lena
- Journal article citation:
- Ethics and Social Welfare, 7(2), 2013, pp.184-197.
- Publisher:
- Taylor and Francis
- Place of publication:
- Abingdon
This article examines the recent transformations of the Italian welfare state from a familist welfare model to what is described as transnational market familism. In this model, families buy in care labour, commonly provided by migrant workers. The article analyses the ethical implications of the migrant-in-the-family model, which transforms the care relationship between the caregiver and care receiver into a complex relationship between the family member organising care, the migrant caregiver and the dependent care receiver. The context of such welfare provision is transnational. Examining this care triangle, the author draws on care ethics and individualization perspective for an analysis of how social policies safeguard, or overlook, human interaction and care relationships in the context of global hierarchies. The article draws on ethnographic data gathered in Naples, Italy, during 2004–2005, including interviews with Neapolitan employers and elderly care-receivers, interviews with migrant workers, as well as participant observations. (Edited publisher abstract)
Long-term care funding in England: an analysis of the costs and distributional effects of potential reforms
- Authors:
- HANCOCK Ruth, et al
- Publisher:
- University of Kent. Personal Social Services Research Unit
- Publication year:
- 2013
- Pagination:
- 13
- Place of publication:
- Canterbury
This paper examines projected costs and distributional effects of Government plans to reform the systems that determine how much the state contributes to people's long-term care costs compared with the current system. It also contrasts these costs and distributional effects with the central recommendation of the Commission on the Funding of Care and Support (Dilnot Commission) which was set up by the Government and reported in 2011. Two variants on the Government’s plans which would give additional help to recipients of residential care with capital below the proposed higher capital threshold are also considered. (Edited publisher abstract)
Commissioning care and support for older people with high support needs
- Author:
- JOSEPH ROWNTREE FOUNDATION
- Publisher:
- Joseph Rowntree Foundation
- Publication year:
- 2013
- Pagination:
- 4
- Place of publication:
- York
This paper provides practical guidance for commissioners of older people’s services on the range of models and approaches available for supporting older people with high support needs. It describes the options that are available, what makes them successful and beneficial, and suggests five priorities for commissioners. (Original abstract)
The future for meals on wheels? Reviewing innovative approaches to meal provision for ageing populations
- Authors:
- WINTERTON Rachel, WARBUNTON Jeni, OPPENHEIMER Melanie
- Journal article citation:
- International Journal of Social Welfare, 22(2), 2013, pp.141-151.
- Publisher:
- Wiley
The global phenomenon of population ageing is impacting on how community care is delivered, and a key component of health and social care services for the frail elderly is Meals on Wheels (MOW), a service that has traditionally encompassed delivering meals to older people in their homes. However, aspects of this conceptualisation of MOW are being redefined in order to address challenges posed by tightening global financial contexts, a reliance on volunteers and increasing social isolation among ageing populations. Through a review of the literature and websites from selected countries (UK, USA, Canada, Australia), this article explores and critically evaluates models of MOW delivery addressing these challenges. Findings suggest that MOW services are utilising a marketised approach, moving outside of the home and incorporating diverse volunteer roles. These findings demonstrate how services such as MOW can develop sustainable approaches to service delivery in a contemporary context. (Publisher abstract)
Community services' involvement in the discharge of older adults from hospital into the community
- Authors:
- GUERIN Michelle, GRIMMER Karen, KUMAR Saravana
- Journal article citation:
- International Journal of Integrated Care, 13(3), 2013, Online only
- Publisher:
- International Foundation for Integrated Care
Aims: The primary aim of this systematic review was to identify and critically appraise the relevant literature detailing methods of community services' involvement in the discharge of older adults across the hospital-community interface. A secondary aim was to identify the most effective methods of community service involvement in the discharge process of older adults. Methods: Twenty-nine databases were searched from 1980 to 2012 (inclusive) for relevant primary published research, of any study design, as well as relevant unpublished work (e.g. clinical guidelines) which investigated community services' involvement in the discharge of older individuals from hospital into the community. Data analysis and quality appraisal (using McMaster critical appraisal tools) were undertaken predominately by the lead author. Data was synthesised qualitatively. Results: Twelve papers were eligible for inclusion (five randomised controlled trials, four before and after studies and three controlled trials), involving a total of 8440 older adults (>65 years). These papers reported on a range of interventions. During data synthesis, descriptors were assigned to four emergent discharge methods: Virtual Interface Model, In-reach Interface Model, Out-reach Interface Model and Independent Interface Model. In each model, the findings were mixed in terms of health care and patient and carer outcomes. Conclusions: It is plausible that each model identified in this systematic review has a role to play in successfully discharging different cohorts of older adults from hospital. Further research is required to identify appropriate population groups for various discharge models and to select suitable outcome measures to determine the effectiveness of these models, considering all stakeholders' involved. (Edited publisher abstract)
Mentors' experiences of using the Active Mentoring model to support older adults with intellectual disability to participate in community groups
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 38(4), 2013, pp.344-355.
- Publisher:
- Taylor and Francis
Background: Social inclusion is a widely acknowledged goal; who is best positioned to provide support and how support is delivered are key questions. Using Active Mentoring training, members of community groups mentored a person with intellectual disability and supported their inclusion in that group. Methods: Interviews with 14 mentors explored their experiences of supporting a previously unknown person with intellectual disability to participate in their community group. Findings: The core theme was No Different From Us. Mentors saw beyond the disability, they valued others, were community leaders, and had intrinsic qualities. With some basic orientation to the task, mentors were able to support the inclusion of their mentee in the group. Conclusion: Community members are willing to support people with intellectual disability to join their community groups. The Active Mentoring training is one way of harnessing the goodwill of community groups and their members to include people with intellectual disability to participate on an individual basis in community groups. (Publisher abstract)