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Aged care residents’ prioritization of care: a mixed‐methods study
- Authors:
- LUDLOW Kristiana, et al
- Journal article citation:
- Health Expectations, 24(2), 2021, pp.525-536. Online only
- Publisher:
- Wiley
Background: Eliciting residents’ priorities for their care is fundamental to delivering person‐centred care in residential aged care facilities (RACFs). Prioritization involves ordering different aspects of care in relation to one another by level of importance. By understanding residents’ priorities, care can be tailored to residents’ needs while considering practical limitations of RACFs. Objectives: To investigate aged care residents’ prioritization of care. Design: A mixed‐methods study comprising Q methodology and qualitative methods. Setting and participants Thirty‐eight residents living in one of five Australian RACFs. Method: Participants completed a card–sorting activity using Q methodology in which they ordered 34 aspects of care on a pre‐defined grid by level of importance. Data were analysed using inverted factor analysis to identify factors representing shared viewpoints. Participants also completed a think‐aloud task, demographic questionnaire, post‐sorting interview and semi‐structured interview. Inductive content analysis of qualitative data was conducted to interpret shared viewpoints and to identify influences on prioritization decision making. Results: Four viewpoints on care prioritization were identified through Q methodology: Maintaining a sense of spirituality and self in residential care; information sharing and family involvement; self‐reliance; and timely access to staff member support. Across the participant sample, residents prioritized being treated with respect, the management of medical conditions, and their independence. Inductive content analysis revealed four influences on prioritization decisions: level of dependency; dynamic needs; indifference; and availability of staff. Conclusions: Recommendations for providing care that align with residents’ priorities include establishing open communication channels with residents, supporting residents’ independence and enforcing safer staffing ratios. (Edited publisher abstract)
Adult protective services clients confirmed for self-neglect: characteristics and service use
- Authors:
- ERNST Joy Swanson, SMITH Charles A.
- Journal article citation:
- Journal of Elder Abuse and Neglect, 23(4), September 2011, pp.289-303.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Self-neglect is the unwillingness or inability of an older adult to meet their own basic needs due to physical or mental incapacities. Noting that the majority of cases reported to adult protective services agencies in the US involve self-neglect, this research aimed to describe the characteristics of self-neglect in older adults. The retrospective record-based study used administrative data from an adult protective services agency located in Maryland to provide a profile of self-neglect in 210 older adult clients, aged 65 years of age or older, in terms of health status, functional abilities, and service use. The clients were predominantly female and not married; over 90% received services of some kind. Common health problems included nutritional frailty, arthritis, incontinence and vision problems. The most common services recommended were ongoing adult protective services, medical care, counselling, in-home aid services, case management, and psychiatric care. The article discusses the results of the study and their implications.
Personal Social Services Adult Social Care Survey, England, 2020-21
- Author:
- NHS DIGITAL
- Publisher:
- NHS Digital
- Publication year:
- 2021
- Pagination:
- 21
- Place of publication:
- Leeds
This report contains findings from the Adult Social Care Survey 2020-21 (ASCS). The national survey takes place every year and is conducted by Councils with Adult Social Services Responsibilities (CASSRs). The survey seeks the opinions of service users aged 18 and over in receipt of long-term support services funded or managed by social services and is designed to help the adult social care sector understand more about how services are affecting lives to enable choice and for informing service development. Key findings include: 67.7 per cent of the service users were very or extremely satisfied with the care and support they received; 2.1 per cent of service users were very or extremely dissatisfied with the care and support they received; over 90 per cent of the service users that reported they feel clean and are able to present themselves in the way they want, also reported they have adequate or as much control over their daily life as they want; 9.5 per cent of these service users feel they have no control or some control but not enough. For the councils that took part in the survey, 34.4 per cent reported they had as much social contact as they wanted with people they like. In contrast, 13.2 per cent reported they had little social contact and felt socially isolated. For service users with Learning Disability Support PSR, a higher proportion rate their health in general to be good or very good. In contrast, service users with Physical Support PSR have the highest proportion who rate their health in general to be bad or very bad. (Edited publisher abstract)
Personal Social Services Adult Social Care Survey (ASCS): England, 2019-20
- Author:
- NHS DIGITAL
- Publisher:
- NHS Digital
- Publication year:
- 2020
- Pagination:
- 33
- Place of publication:
- Leeds
This report contains findings from the Adult Social Care Survey 2019-20 (ASCS). The national survey takes place every year and is conducted by Councils with Adult Social Services Responsibilities (CASSRs). The survey seeks the opinions of service users aged 18 and over in receipt of long-term support services funded or managed by social services and is designed to help the adult social care sector understand more about how services are affecting lives to enable choice and for informing service development. Key findings include: 64.2 per cent (389,130) of service users were very or extremely satisfied with the care and support they received; 2.1 per cent (12,430) of service users were very or extremely dissatisfied with the care and support they received; there was a significant increase in the percentage of service users that reported having no pain – 37.2 per cent of service users (225,650) reported they had no pain or discomfort on the day that they completed the survey compared to 36.6 per cent (229,540) in 2018-19; the percentage of service users aged over 85 has fallen over each of the last 5 years – the percentage decreased from to 27.3 per cent (172,580) in 2018-19 to 26.8 per cent (162,230) in 2019-20; the percentage of service users who answered that their family pays for some more care increased from 10.8 per cent (68,560) in 2018-19 to 11.6 per cent (70,050) in 2019-20; the proportion of service users that have practical help on a regular basis from either a partner, family member, friend or neighbour, who lived in their household, increased from 40.8 per cent (256,410) in 2018-19 to 42.3 per cent (256,220) in 2019-20. (Edited publisher abstract)
Some limits and political implications of participation within health and social care for older adults
- Author:
- CAREY Malcolm
- Journal article citation:
- Ageing and Society, 39(8), 2019, pp.1691-1708.
- Publisher:
- Cambridge University Press
This paper critically examines service user participation and involvement for older adults. It concentrates on research and community-led engagement for older people, and maintains that despite extensive support and expansion, participation offers a complex form of governance and ideological control, as well as a means by which local governments and some welfare professions seek to legitimise or extend their activities. Some of the paradoxes of participation are discussed, including tensions that persist between rhetorical claims of empowerment, active citizenship and democratic engagement, on one hand, despite tendencies towards risk-aversion, welfare retrenchment and participant ambivalence, on the other. The paper also highlights practical problems in relation to participative research and community involvement, and questions arguments that participation may challenge the authority of welfare professionals. Critical theory is drawn upon to contextualise the role of participative narratives within wider welfare, including its role in moving debate away from ownership or redistribution while masking and validating policy-related goals which can counter many older people's needs. Tension is also noted between participation projects represented as resources to support ageing identities as opposed to those representing technologies for social regulation and conformity. (Edited publisher abstract)
“They’re always in a hurry” - Older people´s perceptions of access and recognition in health and social care services
- Authors:
- TIILIKAINEN Elisa, et al
- Journal article citation:
- Health and Social Care in the Community, early cite 5 February 2019,
- Publisher:
- Wiley
The article examines older people's perceptions of quality of life from the perspective of access and use of health and social care services. The data include focus group discussions with older people living alone. The data were analysed using thematic analysis focusing on the older people's collective views on health and social care services as supportive or restrictive factors for their quality of life. Two central themes were present in all the focus group discussions: the importance of accessing services and information regarding the services, and need for recognition within the services/by the professionals. Both themes were connected to the older people's desire to maintain autonomy in their everyday life despite increasing functional disabilities, which was seen as an important factor of quality of life. The older people felt that accessing and finding information about the services was difficult, and dependent on the professional's good will and the older person's own financial resources. Within the services, older people experienced a lack of recognition of their own personhood and individual needs. The participants felt that they were easily bypassed and left out of negotiations regarding their own care. The article highlights the importance of developing health and social care services and practices towards a more holistic approach recognising older people's individual needs. (Edited publisher abstract)
‘Paying our own way’: application of the capability approach to explore older people’s experiences of self-funding social care
- Authors:
- TANNER Denise, WARD Lizzie, RAY Mo
- Journal article citation:
- Critical Social Policy, 38(2), 2018, pp.262-282.
- Publisher:
- Sage
Adult social care policy in England is premised on the concept of personalisation that purports to place individuals in control of the services they receive through market-based mechanisms of support, such as direct payments and personal budgets. However, the demographic context of an ageing population and the economic and political context of austerity have endorsed further rationing of resources. Increasing numbers of people now pay for their own social care because either they do not meet tight eligibility criteria for access to services and/or their financial means place them above the threshold for local authority-funded care. The majority of self-funders are older people. Older people with complex and changing needs are particularly likely to experience difficulties in fulfilling the role of informed, proactive and skilled navigators of the care market. Based on individual interviews with older people funding their own care, this article uses a relational-political interpretation (Deneulin, 2011) of the capability approach (CA) to analyse shortfalls between the policy rhetoric of choice and control and the lived experience of self-funding. Whilst CA, like personalisation, is seen as reflecting neo-liberal values, we argue that, in its relational-political form, it has the potential to expose the fallacious assumptions on which self-funding policies are founded and to offer a more nuanced understanding of older people’s experiences. (Edited publisher abstract)
Are services inclusive? A review of the experiences of older GSD women in accessing health, social and aged care services
- Authors:
- DUNE Tinashe, et al
- Journal article citation:
- International Journal of Environmental Research and Public Health, 17(11), 2020, Online only
- Publisher:
- Molecular Diversity Preservation International and Multidisciplinary Digital Publishing Institute
The review aimed to examine the views and experiences of ageing gender and sexually diverse (GSD) women - a triple minority in relation to their age, gender and sexual orientation - in accessing health, social and aged care services. Eighteen peer reviewed articles identified from seven electronic databases in health and social sciences were evaluated according to predefined criteria and a thematic review methodology drawing upon socio-ecological theory was used to analyse and interpret the findings. Four major themes were identified from the analysis: “The Dilemma of Disclosure”, “Belonging/Connection”, “Inclusiveness of Aged Care” and “Other Barriers to Access Care”. In the dilemma of disclosure, older GSD women consider factors such as previous experiences, relationship with the provider and anticipated duration of stay with the provider before disclosing their sexual identifies. The review also revealed that aged care services lack inclusiveness in their policies, advertising materials, aged care spaces and provider knowledge and attitude to provide sensitive and appropriate care to GSD women. Overall, older GSD women experience multiple and multilevel challenges when accessing health, aged and social services and interventions are needed at all levels of the socio-ecological arena to improve their access and quality of care. (Edited publisher abstract)
Forecasting the adult social care workforce: a summary report of workforce intelligence
- Author:
- CENTRE FOR WORKFORCE INTELLIGENCE
- Publisher:
- Centre for Workforce Intelligence
- Publication year:
- 2015
- Pagination:
- 45
- Place of publication:
- London
Report, commissioned by Department of Health, which aims to assess the future demand for and supply of the adult social care workforce in England over the next 15 years to 2030. The project uses the Centre for Workforce Intelligence robust workforce planning framework. Census data from the Office of National Statistics together with findings of the report 'Estimating the Need for Social Care Services for Adults with Disabilities in England 2012-2030 '(Emerson et al, 2012), were used to explore the demand for social care services. Key data from Skills for Care's National Minimum Data Set for Social Care (NMDS-SC) and their publication 'The size and structure of the adult social care sector and workforce in England, 2014' provided a basis for modelling data. The forecast suggests the adult social care workforce will need to grow from 1.2 million to almost 1.6 million (FTE) to meet a 33 per cent growth in adult social care demand by 2030. The research also suggests that people with learning difficulties are also living longer requiring social care services for longer for which the social care workforce will need to grow accordingly. It highlights a likely increase in demand for residential and nursing care in particular. An accompanying infographic has also been produced to highlight the key findings from the report, as well as a technical report, which provides an overview of the data used in the model, as well as details of how the calculations were made. (Edited publisher abstract)
Good practice in social care: the views of people with severe and complex needs and those who support them
- Authors:
- GRIDLE Kate, BROOKS Jenni
- Journal article citation:
- Health and Social Care in the Community, 22(6), 2014, pp.588-597.
- Publisher:
- Wiley
This paper reports findings drawn from a study of good practice in English social care for adults with disability and older people with severe and complex needs. People with severe and complex needs are a relatively small proportion of adult social care service users, but they are growing in numbers and have resource-intensive needs. The study involved qualitative research with adults with disability and older people with severe and complex needs, family carers and members of specialist organisations (n = 67), focusing on the features of social care services they considered to be good practice. Data were collected between August 2010 and June 2011. The approach to data collection was flexible, to accommodate participants' communication needs and preferences, including face-to-face and telephone interviews, Talking Mats© sessions and a focus group. Data were managed using Framework and analysed thematically. Features of good practice were considered at three levels: (i) everyday support; (ii) service organisation; and (iii) commissioning. Findings relating to the first two of these are presented here. Participants emphasised the importance of person-centred ways of working at all levels. Personalisation, as currently implemented in English social care, aims to shift power from professionals to service users through the allocation of personal budgets. This approach focuses very much on the role of the individual in directing his/her own support arrangements. However, participants in this study also stressed the importance of ongoing professional support, for example, from a specialist key worker or case manager to co-ordinate diverse services and ensure good practice at an organisational level. The paper argues that, despite the recent move to shift power from professionals to service users, people with the most complex needs still value support from professionals and appropriate organisational support. Without these, they risk being excluded from the benefits that personalisation, properly supported, could yield. (Publisher abstract)