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We need to talk about caring: dealing with difficult conversations
- Author:
- INDEPENDENT AGE
- Publisher:
- Independent Age
- Publication year:
- 2016
- Pagination:
- 41
- Place of publication:
- London
Drawing on the findings from an online poll of 2,066 people and a series of focus groups and interviews, this report looks at how and why families avoid talking about challenges they may face in older age. The findings cover the types of conversations taking place, the family members that are hardest to talk to, the topics that are the most difficult to talk about, and the barriers to talking about ageing. Respondents identified future care and housing needs such as end of life care preferences, who will care for them when they were older, and where they would live if they could no longer live at home as the most difficult topics to talk about. The research found that over 60% of people aged 65 and over had never had a conversation with their family about these three issues. Key barriers to conversations identified included lack of knowledge and confidence to begin a conversation, avoiding facing undesirable possibilities, such as residential care, and lack of time for discussion. The report makes recommendations to help remove these barriers, including for agencies make their care information more accessible, for care homes need to increase their outreach to show more people what living in a care home is like; and for conversations about care in later life to become more natural, with health and care professionals encouraging families they work with to think about key conversations relating to ageing and care. (Edited publisher abstract)
Service providers' perceptions of working in residential aged care: a qualitative cross-sectional analysis
- Authors:
- BENNETT Michelle K., et al
- Journal article citation:
- Ageing and Society, 35(9), 2015, pp.1989-2010.
- Publisher:
- Cambridge University Press
A number of professional disciplines employed internally and externally provide services in Residential Aged Care Facilities (RACFs). Literature has long highlighted numerous workplace issues in RACFs, yet little progress has been made in addressing these. As such there has been a call for greater understanding of shared issues among service providers. The aim of the current study is to explore and compare the perceptions of a cross-section of service providers regarding the challenges and motivators to working in RACFs. In-depth semi-structured interviews were conducted with 61 participants including: care managers, nurses, assistants in nursing, care, domestic and support staff, and speech pathologists. Analysis revealed few issues unique to any one service discipline, with four key themes identified: (a) working in RACFs is both personally rewarding and personally challenging; (b) relationships and philosophies of care directly impact service provision, staff morale and resident quality of life; (c) a perceived lack of service-specific education and professional support impacts service provision; and (d) service provision in RACFs should be seen as a specialist area. These data confirm there are key personal and professional issues common across providers. Providers must work collaboratively to address these issues and advocate for greater recognition of RACFs as a specialist service area. Acknowledging, accepting and communicating shared perceptions will reduce ongoing issues and enhance multi-disciplinary care. (Publisher abstract)
Older people who use BSL: preferences for residential care provision in Wales
- Authors:
- HUNT Ros, ORAM Rosemary, YOUNG Alys
- Publisher:
- University of Manchester
- Publication year:
- 2010
- Pagination:
- 59p.
- Place of publication:
- Manchester
The Welsh Assembly Government has begun to consider whether there is a case for the establishment of a specialist, Sign Language medium, residential care provision for deaf people in Wales. Currently there is no care home provision in Wales where British Sign Language (BSL) is used as a matter of course. All deaf older people in Wales are placed in care environments where BSL is not routinely used by staff and where they are often the only deaf resident. The study comprised: 4 community consultations involving 32 deaf people throughout Wales; 6 stakeholder interviews with representatives of relevant specialist service providing organisations in Wales; and 7 individual interviews with older deaf people. The findings are discussed under the following headings: high levels of concern about the current situation; communication and language as pre-eminent issues; failure to meet cultural needs; the whole older people’s care spectrum; arguments for specialist residential care; and barriers to specialist residential care provision. The report concludes that there is a clear need to change current practice. Meeting deaf people’s linguistic and cultural needs should be the starting point in making decisions about future care provision, and in judging the efficacy and appropriateness of this care.
Making observations: the potential of observation methods for gerontology
- Editors:
- CLARK Andrew, (ed.)
- Publisher:
- Centre for Policy on Ageing
- Publication year:
- 2007
- Pagination:
- 79p.
- Place of publication:
- London
In describing how observational methods have been used in their research projects the authors draw out the pros and cons of employing observation to collect data. The studies cover structured observation to conduct a comparative study of two residential care homes; using video to research communication and interaction amongst older people with dementia - practical, ethical and epistemological issues; theory and practice of observational research in the outdoor setting; and comparing data derived through observation alone and arising out of observation accompanied by discourse, in studies located at cemeteries.
Who cares?: information and support for the carers of people with dementia
- Author:
- GREAT BRITAIN. Department of Health
- Publisher:
- Great Britain. Department of Health
- Publication year:
- 2007
- Pagination:
- 96p.
- Place of publication:
- London
- Edition:
- Rev. ed.
This booklet for carers gives information about dementia, caring for someone with dementia and the help available to carers. This edition has been developed with the valuable assistance of Help the Aged, Age Concern (England), the Alzheimer's Society, The Princess Royal Trust for Carers, Dementia Voice and the South London and Maudsley NHS Trust.
Stress and strain of moving
- Authors:
- WYLD Cynthia, et al
- Journal article citation:
- Community Care, 18.4.02, 2002, pp.36-37.
- Publisher:
- Reed Business Information
Reports on a study examining the reactions of residents, relatives and staff to changes caused by a temporary relocation when residential homes have been rebuilt or refurbished.
Managing emotional and psychological distress in older people
- Author:
- CHAPMAN Felicity
- Journal article citation:
- Working with Older People, 22(4), 2018, pp.234-242.
- Publisher:
- Emerald
Purpose: Much has been written about helping those with dementia. But what about those for whom distress is not primarily related to a neurological cause and there is no psychiatric history? The purpose of this paper is to offer a guide for allied health professionals and family carers to manage distress in older people who are able to engage in language based communication and who are experiencing significant change or loss. Design/methodology/approach: This practice informed paper draws on the authors’ extensive experience working as a mental health social worker who specializes in work with older people in the community and in care, with family carers and in educating allied health professionals on how to manage presentations of distress in older people. Findings: Three foundational management strategies are discussed: understand the reason for distress, implement the C.A.R.E. Plan and maximize comfort in exploration and referral. Research limitations/implications: This viewpoint piece has not been substantiated through research and does not reflect training in the field of clinical geropsychology. Originality/value: The ideas in this paper are original and are practical solutions to common problems that can be faced by workers or family in close contact with older people. The information can be applied immediately to whatever setting is relevant for the reader and is written in easy to understand language. Furthermore, its aim is not only to increase skill and confidence for the reader but also to promote the emotional and psychological wellbeing of older people. (Publisher abstract)
Daily crying prevalence and associated factors in older adult persons living in nursing homes: findings from a regional study
- Authors:
- PALESE Alvisa, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 33(1), 2018, p.e85–e93.
- Publisher:
- Wiley
Objectives: The study aims to evaluate the prevalence of nursing home (NH) resident crying and associated factors at the individual and NH levels. Design: A regional retrospective study design has been used. Participants and setting: A total of 8875 residents, living in 105 NHs, were included. Measurements: The occurrence of an episode of crying on at least a daily basis in the last month was the dependent variable; independent variables were set at individual and at the NH levels as reported in the Val.Graf regional database. Results: A total of 1,443 (16.3%) residents reported daily episodes of crying over the last month. Several individual variables were significantly associated with crying; female gender (odds ratio [OR] 2.535, 95% confidence interval [CI] 2.069–3.107); sad, pained or worried facial expressions (OR 1.885, 95% CI 1.785–2.021); negative thoughts (OR 1.650, 95% CI 1.508–1.804); unrealistic fears (OR 1.410, 95% CI 1.295–1.534); anger with self or others (OR 1.141, 95% CI 1.043–1.248); repetitive anxious complaints/concerns (OR 1.136, 95% CI 1.045–1.235); clinical instability (OR 1.186, 95% CI 1.018–1.381); pain (OR 1.183, 95% CI 1.058–1.323); night restlessness (OR 1.180, 95% CI 1.100–1.267); communication problems (OR 1.169, 95% CI 1.051–1.300); and cognitive impairment (OR 1.086, 95% CI 1.019–1.156); all increased the likelihood of crying. Conversely, sociability (OR 0.866, 95% CI 0.805–0.932) and being involved in social based activities (OR 0.882, 95% CI 0.811–0.960) were protective against crying. However, the previously mentioned variables have explained only 35.9% of variance in daily crying. Conclusions: Around one out of six residents living in NH cries on a daily basis, and the reasons are also at the individual level. Residents seem to cry for attachment and clinical needs and to express stress and unhappiness; more research is needed, aiming at discovering other factors associated with resident's daily crying. (Publisher abstract)
How nursing home residents with dementia respond to the interactive art installation ‘VENSTER’: a pilot study
- Authors:
- LUYTEN Tom, et al
- Journal article citation:
- Disability and Rehabilitation: Assistive Technology, 13(1), 2018, pp.87-94.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
The goal of this study was (1) to determine whether and how nursing home residents with dementia respond to the interactive art installation in general and (2) to identify whether responses change when the content type and, therefore, the nature of the interaction with the artwork changes. The interactive art installation ‘VENSTER’ evokes responses in nursing home residents with dementia, illustrating the potential of interactive artworks in the nursing home environment. Frequently observed responses were naming, recognising or asking questions about depicted content and how the installation worked, physically gesturing towards or tapping on the screen and tapping or singing along to the music. It seemed content matters a lot. When VENSTER is to be used in routine care, the choice of a type of content is critical to the intended experience/usage in practice. In this study, recognition seemed to trigger memory and (in most cases) a verbal reaction, while indistinctness led to asking for more information. When (initially) coached by a care provider, residents actively engaged physically with the screen. Responses differed between content types, which makes it important to further explore different types of content and content as an interface to provide meaningful experiences for nursing home residents. Implications for rehabilitation: 1) VENSTER can facilitate different types of responses ranging from verbal reactions to active physical engagement. The choice of a type of content is critical to the intended experience/usage in practice; 2) Activating content seems suitable for use as a meaningful experience during the spare time in between existing activities or therapy; 3) Sessions with interactive content are short (avg. 30 mins) and intense and can therefore potentially be used as an activating therapy, activity or exercise; 4) In order to actively engage residents with dementia, the role of the care provider seems very important. (Edited publisher abstract)
Knowledge of dementia: do family members understand dementia as a terminal condition?
- Authors:
- ANDREWS Sharon, et al
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 16(5), 2017, pp.556-575.
- Publisher:
- Sage
Current research identifies advanced dementia to be the terminal phase of this progressive and incurable condition. However, there has been relatively little investigation into how family members of people with advanced dementia understand their relative’s condition. In this article, the authors report on semi-structured interviews with 10 family members of people with advanced dementia, in a residential aged care facility. Using a qualitative, descriptive design, they explored family members’ understandings of dementia, whether they were aware that it was a terminal condition, and the ways they developed their understandings. Findings revealed that the majority of family members could not recognise the terminal nature of dementia. Relying on predominantly lay understandings, they had little access to formal information and most failed to conceptualise a connection between dementia and death. Moreover, family members engaged in limited dialogue with aged care staff about such issues, despite their relatives being in an advanced stage of the disease. Findings from our study suggest that how family members understand their relative’s condition requires greater attention. The development of staff/family partnerships that promote shared communication about dementia and dying may enhance family members’ understandings of the dementia trajectory and the types of decisions they may be faced with during the more advanced stages of the disease. (Edited publisher abstract)