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Supporting older co-resident carers of older people – the impact of Care Act implementation in four Local Authorities in England
- Authors:
- O'ROURKE Gareth, et al
- Journal article citation:
- Social Policy and Society, 20(3), 2021, pp.371-384.
- Publisher:
- Cambridge University Press
The Care Act 2014 provides for ‘parity of esteem’ between people with social care needs and carers. This is achieved by extending the principles of prevention and wellbeing to carers; reinforcing carers’ right to an assessment; and setting national eligibility criteria for access to carer support services. This article reports on research that examined the impact of these changes on older co-resident carers of older people in four English local authorities. Findings are described in relation to four key themes: organisational arrangements and rationale; the aims of carer support and preventative services; design and delivery of carer assessment; and barriers to assessment and support. The findings of the research suggest that, despite the new statutory requirements, underlying contradictions and tensions in local authorities’ relationship with carers, and efforts to support them, remain unresolved. (Edited publisher abstract)
Improving healthcare access for older adults with intellectual disability: what are the needs?
- Authors:
- NAVAS Patricia, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 32(6), 2019, pp.1453-1464.
- Publisher:
- Wiley
This qualitative study was carried out in Spain with the aim of identifying the changes that the health system should make to improve healthcare access for older adults with intellectual disability. Three hundred and sixty‐nine family members and professionals expressed their opinion on how healthcare access could be improved. Participants responded to two open‐ended questions included in a general survey about the health status of older individuals with intellectual disability. Most informants were women and professionals who had known the person with intellectual disability for more than 12 months. A system of categories, which showed good inter‐rater agreement, was developed to analyse participants’ written responses. Both family members and professionals emphasized the need to improve disability training for healthcare practitioners and highlighted the urgent need for flexibility in the structure of a healthcare system that currently overlooks the specific needs of this vulnerable population. (Publisher abstract)
Safe later lives: older people and domestic abuse
- Author:
- SAFELIVES
- Publisher:
- SafeLives
- Publication year:
- 2016
- Pagination:
- 31
- Place of publication:
- London
This report focuses on older victims of domestic abuse, a group often overlooked in the literature that tends to focus on younger victims and perpetrators. It estimates that in the last year approximately 120,000 individuals aged 65+ have experienced at least one form of abuse (psychological, physical, sexual or financial). The report outlines the following six key findings: systematic invisibility of older people who are not represented in domestic abuse services and lack of recognition amongst some professionals of the phenomenon; long term abuse and dependency issues, which may add additional pressures to stay with an abusive partner; generational attitudes about abuse may make it hard to identify; increased risk of adult family abuse; services are not effectively targeted at older victims, and do not always meet their needs; and need for more coordination between services. The report argues that social care services need training to understand the dynamics of abuse in a caring relationship; they should target older people with messages that empower them to recognise their situation as abuse, and raise awareness of support available; and that services working with adults and their older parents must be trained to recognise abuse, and have clear referral pathways. (Edited publisher abstract)
Comparison of access, outcomes and experiences of older adults and working age adults in psychological therapy
- Authors:
- CHAPLIN Robert, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 30(2), 2015, pp.178-184.
- Publisher:
- Wiley
Objective: This study aimed to evaluate the access, experiences and outcomes of older adults receiving psychological therapies in comparison with adults of working age Methods: Primary and secondary care providers of psychological therapy services participated in the National Audit of Psychological Therapies. The main standards of access, experience and outcomes were measured by retrospective case records audits of people who completed therapy and a service user questionnaire. Outcomes were measured pre-treatment and post-treatment on the PHQ-9 and GAD-7. Results: A total of 220 services across 97 organisations took part, 137 (62%) in primary care. Service user questionnaires were received from 14,425 (20%) respondents. A total of 122,740 records were audited, of whom 7794 (6.4%) were older adults. They were under represented as 13% of the sample would have been expected to be over 65 years according to age adjusted psychiatric morbidity figures. People over 75 years had the third expected referral rate. Significantly, more older adults than working age adults completed therapy (59.6% vs 48.6%) and were assessed as having 'recovered' post-treatment (58.5% vs 45.5%). Older adults were more satisfied with waiting times and numbers of sessions, but there were no differences in self-reported experience of therapy. Conclusion: Although older adults are less likely to gain access to psychological therapies, they appear to have better outcomes than working age adults. Further work is needed to improve access for older people. (Publisher abstract)
A survey of community exercise programmes for stroke survivors in Scotland
- Authors:
- BEST C., et al
- Journal article citation:
- Health and Social Care in the Community, 20(4), July 2012, pp.400-411.
- Publisher:
- Wiley
Physical fitness is often reduced after stroke, but training can improve fitness and function. Clinical guidelines recommend long-term exercise participation for stroke survivors, yet there has been no previous research into what services are available to support this. This study sought information on session content, referral and assessment processes, and the qualifications of exercise instructors for 14 Exercise after Stroke services in Scotland. The majority of services were run by charity collaborations, followed by leisure centre services and health services. This information was cross-referenced with current clinical and exercise guidelines to determine whether existing resources were sufficient to meet stroke survivors’ needs for safe, effective and sustainable access to exercise. Findings suggested a shortage of stroke-specific community exercise programmes. The authors concluded that further service development was required to ensure appropriate instructor training and referral pathways are in place to enable stroke survivors to access exercise services in accordance with guidelines.
Transport and getting around in later life
- Authors:
- SUTTON Liz, HILL Katherine
- Publisher:
- Loughborough University. Centre for Research in Social Policy
- Publication year:
- 2010
- Pagination:
- 14p., bibliog.
- Place of publication:
- Loughborough
Getting out and about is important to older people’s independence, access to services and social networks. Transport is a key factor in preventing social exclusion and enabling older people to play a role in their communities. This project involved in-depth interviews with people (aged 65-84 at the first interview) 2 years apart to explore their changing needs and resources as they moved through later life. The research took a holistic approach to demonstrate the range of different structural, social and individual resources that people drew on to help manage. The purpose of this paper is to focus on the findings that relate to older people’s access to a range of transport and the impact that being able to use transport (or not) can have on their wider well-being. The findings contribute to policies concerning the independence and participation of older people in society. The paper examines changes in various aspects of older people’s transport use including: public transport use; car driving; and mobility scooter use.
Access to public mental health services among older adults with severe mental illness
- Authors:
- GILMER Todd P., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 24(3), March 2009, pp.313-318.
- Publisher:
- Wiley
Data from San Diego County, 2002-2006, were used to examine how older adults initially accessed the public mental health system, and their utilization over the subsequent 90 days. Multivariate regression models were used to control for demographic and clinical characteristics. Older adults (age 60 +) were more likely to access the public mental health system through the Psychiatric Emergency Response Team (PERT), a combined law-enforcement and psychiatric service that responds to psychiatric related 911 calls. Older adults were also less likely to receive follow-up care. This lower rate of follow-up was due to both the initial site of service - and an associated lower rate of follow-up among PERT clients - as well as a lower rate of follow-up among older adult clients initiating services in other sectors. This paper suggests two areas for intervention that would improve access to care for older adults: improving linkages and referrals between PERT and outpatient providers; and additional efforts to retain older adults at outpatient programs.
Access to information and services for older people: the joined-up approach
- Authors:
- RITTERS Katrina, DAVIS Howard
- Publisher:
- Great Britain. Department for Work and Pensions
- Publication year:
- 2008
- Pagination:
- 57p., bibliog.
- Place of publication:
- London
This report is based on interim findings from the evaluation of the LinkAge Plus pilots. It describes the innovative approaches to improving information and access to services for older people in the eight pilot areas. The pilot responses have included electronic information systems joining up information from partners; leaflet-based self-check lists; a council-wide IT system offering older callers additional services such as a home security check; an operational partnership whereby a range of service providers complete a simple checklist on each other's behalf when they visit a client and then refer for further services; network or neighbourhood centres extending the type of services they offer; and outreach in both urban and rural areas to reach the most isolated.
Primary concerns: older people's access to primary care
- Author:
- AGE CONCERN ENGLAND
- Publisher:
- Age Concern England
- Publication year:
- 2008
- Pagination:
- 19p.
- Place of publication:
- London
The report ‘Primary Concerns’ highlights the fact that older people use GP practice services more than younger adults; however nearly one in five 65-74 year olds are still experiencing difficulties in getting an appointment to see their GP or practice nurse. Research from the charity also shows that almost half of older people are not registered with an NHS dentist, despite a pledge from the Government almost ten years ago promising that everyone would have easy access to an NHS dentist within two years. With a shortage in NHS dentists, pensioners on low fixed incomes are often forced to either pay privately for dental treatment or just go without. Good oral health is essential to the overall health and well-being of older people and enables people to eat comfortably, enjoy a healthy diet, and speak and socialise without embarrassment.
Health and care services for older people: overview report on research to support the national service framework for older people
- Author:
- ASKHAM Janet
- Publisher:
- Great Britain. Department of Health
- Publication year:
- 2008
- Pagination:
- 84p., bibliog.
- Place of publication:
- London
This report summarises the key findings from a group of 16 studies commissioned by the Policy Research Programme under the ‘Older People’s use of services’ Research Initiative. The aim of the initiative was to inform and assess the implementation of the National Service Framework for Older People (2001)