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Bodywork in dementia care: recognising the commonalities of selfhood to facilitate respectful care in institutional settings
- Author:
- KELLY Fiona
- Journal article citation:
- Ageing and Society, 34(6), 2014, pp.1073-1090.
- Publisher:
- Cambridge University Press
This paper draws on two data sources (Kelly's ethnographic study and a British Broadcasting Corporation television programme) to explore the practice of bodywork in the care of frail people with dementia in institutional settings. It explores the complexity of engaging in bodywork, particularly work that is distasteful to the care-worker, and shows how non-recognition of the selfhood of the person with dementia can result in practices that are demeaning and potentially abusive to those in receipt of such work. In contrast to a person-centred approach that urges practitioners to acknowledge people with dementia as unique individuals, with unique needs, wishes, abilities and desires, this paper argues for the use of Sabat's Selfs 1–3 construct to look for commonalities of selfhood, enabling care workers to recognise aspects of themselves in their patients as they carry out care, thereby facilitating care that empathically respects their patients' dignity and potential for vulnerability. Thus, it aims to advance theory and improve practice by arguing for the necessity of putting selfhood at the forefront of bodywork in order to facilitate respectful care that dignifies rather than objectifies the person. (Publisher abstract)
The dark side of Norwegian nursing homes: factors influencing inadequate care
- Authors:
- MALMEDAL Wenche, HAMMERVOLD Randi, SAVERMAN Britt-Inger
- Journal article citation:
- Journal of Adult Protection, 16(3), 2014, pp.133-151.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to investigate factors that influence the probability that staff will commit acts of inadequate care, abuse, and neglect. Design/methodology/approach: A cross-sectional survey study was carried out in one county in the middle of Norway (Sør-Trøndelag). Random sampling, stratified by size of nursing homes, and location (rural or urban areas), was used to select a variety of nursing homes from a total population of 55 nursing homes. All staff working in 16 nursing homes working were asked to participate in the study. A response rate of 79 per cent was achieved (n=616). Findings: Findings reveal that location and size of the nursing home, age of the staff, education level, job satisfaction, resident aggression, and conflicts between residents and staff predict inadequate care, abuse, and neglect. The most consistent findings are that resident aggression increases the risk for all three types of inadequate care, and that conflicts predict different types of inadequate care depending on whether the conflicts are related to direct care-giving activities or not. Practical implications: Nursing home care is an important part of care for the elderly, and should be characterized by good-quality services. The relation between inadequate care and resident aggression, conflicts, and other factors shown in this study points to the relevance of further improvements in nursing home practices to minimize the occurrence of episodes of inadequate care, abuse, and neglect. Originality/value: This study investigated the relationships between 11 specific factors and different types of inadequate care in a nursing home context. (Publisher abstract)
The training needs of staff supporting individuals ageing with intellectual disability
- Authors:
- WARK Stuart, HUSSAIN Rafat, EDWARDS Helen
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 27(3), 2014, pp.273-288.
- Publisher:
- Wiley
Background: The issue of ageing within the cohort of people with intellectual disabilities has been an increasing focus for research. However, the training needs of the staff who support them has not been subject of extensive examination. Materials and Methods: A multiround Delphi project was conducted focusing upon the impact ageing issues have on the support provided by disability workers, and what training is required to address the identified areas. Results: Three rounds of the Delphi identified twenty-six separate important issues. A thematic analysis identified five main themes including Generic Training Issues; Medical Issues; Emerging Ageing Issues Requiring Changing Support; Mental Health Issues; and Quality of Life. Conclusions: The study identified a series of training priorities for staff assisting people ageing with an intellectual disability. It would appear possible for many training programmes to be developed and delivered with minimal cost impacts even within rural localities. (Original abstract)
Your push to improve older people's care
- Author:
- MOORE Alison
- Journal article citation:
- Health Service Journal, 124(6393), 4 April 2014, pp.20-23.
- Publisher:
- Emap Healthcare
This article presents some readers suggestions for improving the care of frail older people. Areas covered include service structure and funding, workforce and staffing, ensuring the dignity of older people. (Original abstract)
The state of shared lives in England
- Author:
- SHARED LIVES PLUS
- Publisher:
- Shared Lives Plus
- Publication year:
- 2014
- Pagination:
- 15
- Place of publication:
- Liverpool
This report draws on a survey of Shared Lives Plus members to provide the first nationwide analysis of the Shared Lives services in England, covering the period April 2012 - March 2013. It provides a baseline to measure growth and development of the sector. The report includes figures on numbers of people using shared lives services, the number of carers, staff turnover and motivation, and numbers of users by region. The results demonstrate that Shared Lives is already a significant and highly effective part of the social care system, but has potential for growth. The report shows that whilst some regions are making much more use of Shared Lives than others, there are groups of people in every region who are not yet being routinely offered Shared Lives as a distinct choice. (Edited publisher abstract)
Micro-skills of group formulations in care settings
- Authors:
- JACKMAN Louisa J., WOOD-MITCHELL Amy, JAMES Ian A.
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 13(1), 2014, pp.23-32.
- Publisher:
- Sage
This study examines some of the micro-skills associated with the moment-to-moment decisions and actions involved in delivering group formulation sessions in dementia care settings. The authors discuss the therapeutic framework used by therapists from a number of Challenging Behaviour Services in the UK (Newcastle, Northumberland, South Tyneside, Teesside, Sutton and Merton, Northern Ireland) which is frequently referred to as the Newcastle or Colombo approach. Through a theoretical review and practice illustration, the study pays particular attention to the role of therapists’ questions and questioning styles in group formulation sessions, providing a framework which aims to facilitate care staffs’ understanding, reflection and empathy regarding their residents who are displaying ‘challenging behaviours’. The study also provides a potential guide to the training of therapists working in this area and thereby attempts to benefit clinical practices in an area where pharmacological approaches are usually the treatment of choice.
Still working for love? Recognising skills and responsibilities of home-based care workers
- Authors:
- BRIAR Celia, LIDDELL Elizabeth, TOLICH Martin
- Journal article citation:
- Quality in Ageing and Older Adults, 15(3), 2014, pp.123-135.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to focus on care workers employed in clients’ own homes recognising the skills and responsibilities of home-based care workers. Design/methodology/approach: Interviews and focus groups with domiciliary care workers in New Zealand centred on what these employees actually do during their working day. Findings: Home-based care workers require the same skills as residential care workers, but they also have greater responsibilities and receive less supervision and support, as they work largely in isolation. In addition, they must spend a large part of their working day travelling between clients: this time is unpaid, and brings their average hourly pay below the minimum wage. Practical implications: Although the home-based care workers who took part in this project love and are committed to making a positive difference to their clients, they also want the government, employers and the public to recognise their skills, efforts and their challenging working conditions. Originality/value: In earlier days of deinstitutionalisation, Graham described caring work as a “labour of love”. More than three decades years later, a New Zealand government minister described paid care workers as working partly “for love”. Care work is also currently perceived as unskilled. Both these perceptions depress the pay and working conditions of care staff, and in future may undermine the quality of care delivered to vulnerable clients. (Publisher abstract)
“Sliding Doors”: innovative approaches to supporting culture change
- Authors:
- WALKER Gill, GILLIES Laura
- Journal article citation:
- Journal of Integrated Care, 22(4), 2014, pp.154-164.
- Publisher:
- Emerald
Purpose: Reshaping Care for Older People (RCOP) and Integration of Health and Social Care are central to providing a care system in Scotland that meets older people's current and future needs. Their implementation requires a workforce with the appropriate knowledge, skills and values to engage with older people across health and social care sectors, which requires a change in professionals’ thinking about services. The paper aims to discuss these issues. Design/methodology/approach: NHS Education for Scotland, the Scottish Social Services Council and a learning and development consultancy designed and delivered innovative education resources to support health and social care staff across Scotland to understand the new agenda and recognise its meaning for practice. Findings: Two related resources were developed: workshop using actors to depict scenarios from older people's lives to support participants to reflect on the new policy direction and outcomes-focused approaches; and an online resource using the same characters that can be delivered locally for groups and individuals. Participants were enabled to identify what they need to do differently and how they can support one another to make necessary changes. A formal evaluation has been commissioned. Originality/value: The resource characters represent the people the new policy is designed to affect. By following their lives through an educational drama approach, health and social care staff can understand the difference RCOP and the integration agenda can make and recognise their part in effecting change. (Publisher abstract)
‘We need to know what’s going on’: Views of family members toward the sexual expression of people with dementia in residential aged care
- Authors:
- BAUER Michael, et al
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 13(5), 2014, pp.571-585.
- Publisher:
- Sage
This paper reports on a study which explored the views and attitudes of family members towards the sexual expression of residents with dementia in residential aged care facilities in two states in Australia. Recruitment was challenging and only seven family members agreed to an interview on this topic. Data were analysed using a constant comparative method. Family were generally supportive of residents’ rights to sexual expression, but only some types of behaviours were approved of. There was an acknowledgement that responding to residents’ sexuality was difficult for staff and many families believed that they should be kept informed of their relative’s sexual behaviours and moreover be involved in decision making about it. Findings suggest the need for family education and a larger study to better understand the views and motivations of family carers and how these might impact on the sexual expression of the older person with dementia living in residential aged care. (Publisher abstract)
Attachment and coping of dementia care staff: The role of staff attachment style, geriatric nursing self-efficacy, and approaches to dementia in burnout
- Authors:
- KOKKONEN Taru-Maija, et al
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 13(4), 2014, pp.544-568.
- Publisher:
- Sage
Past research suggests that dementia care staff are vulnerable to the development of burnout, which has implications for staff well-being and hence the quality of care for people with dementia. Studying personal vulnerability factors in burnout is important as it can guide staff training and support. Attachment theory suggests that adult attachment styles affect caregiving relationships and individuals’ responses to stress, providing a framework for understanding caregivers’ styles of coping. This cross-sectional survey study examined relationships between staff attachment styles, geriatric nursing self-efficacy, and approaches to dementia in burnout. Seventy-seven members of dementia care staff working on inpatient wards for older people completed self-report questionnaires. Insecure attachment, lower levels of self-efficacy, and more optimistic attitudes in staff were related to higher levels of burnout. Staff training on the role of attachment in dementia care is recommended. Further research is required to explore mediating factors between adult attachment styles and burnout. (Publisher abstract)