The factors influencing access to health and social care in the farming communities of County Down, Northern Ireland

2006 ◽  
Vol 26 (3) ◽  
pp. 373-391 ◽  
Author(s):  
DEIRDRE HEENAN
Keyword(s):  
Health Care ◽  
Northern Ireland ◽  
Older People ◽  
Social Care ◽  
Service Providers ◽  
Farming Communities ◽  
Access To Health ◽  
Health And Social Care ◽  
County Down ◽  
Farming Families

Against a background of limited previous research, this paper examines the access to health and social care among older people in the farming communities of County Down, Northern Ireland. In-depth interviews were conducted with 45 people aged 60 or more years living on family farms to collect information about health care needs and service use and adequacy. In addition, interviews with service providers provided information on their perceptions of the farming communities' needs. The findings indicate that there are specific rural dimensions of access to services and that among the respondents there was substantial unmet need. For many farming families, using services is determined by much more than being able to reach them physically. The lack of reliable information, the culture of stoicism and the absence of appropriate services impeded obtaining effective support. Recent health care policies and strategies have stressed the importance of developing local services that are responsive to need in consultation with service users, but there is worryingly little evidence that this has occurred. It is concluded that if effective outcomes are to be achieved, policies must recognise the specific characteristics of rural populations and be sensitive to the needs, attitudes and expectations of farming families. The current lack of understanding about the distinct needs of these communities at present exacerbates the isolation and marginalisation of already vulnerable older people.

scholarly journals 532 CARING FOR AND CARING ABOUT OLDER PEOPLE LIVING WITH SEVERE FRAILTY DURING COVID-19

2021 ◽  
Vol 50 (Supplement_2) ◽  
pp. ii8-ii13
Author(s):  
R Green ◽  
H King ◽  
C Nicholson
Keyword(s):  
Health Care ◽  
Older People ◽  
Health Care Services ◽  
Social Care ◽  
Social Contact ◽  
Care Services ◽  
Poor Access ◽  
Health And Social Care ◽  
Video And Audio ◽  
The Impact

Abstract Introduction An ongoing study collected survey and interview data from older people with frailty living in the community near end-of-life during the Covid-19 pandemic. Methods Unstructured interviews with older people with frailty living in the community (N = 10), which included accounts from unpaid carers (N = 5), were video and audio recorded between October–November 2021. Six of these older people have died since fieldwork completion. A face-to-face survey collected data from a further 10 older people. Participants ages ranged from 70–99, 11, men, and 9 women, living in owned, rented, or sheltered accommodation, with Clinical Frailty Scores of 6 (N = 8), 7 (N = 9), and 8 (N = 3). Results Topics raised in relation to the pandemic included loss of social contact and increased loneliness, concern about not physically getting out, and losing physical function. Older people struggled to gain access to health and social care for support and previously received services were withdrawn. Most participants did not have access to internet and relied heavily on families to facilitate virtual contact with health professionals. Families and friends were the main anchor in facilitating social and health care including chasing up medications, liaising with social care to ensure quality and consistency of care provided, and monitoring older people’s health. Where older people’s conditions worsened family provided intense support, though family carers described the strain and unsustainability of this provision. Older people and their families felt they had been forgotten. Conclusions These are insights from hard-to-reach population that are frequently invisible. Greater examination of the impact of using communication technologies in care provision on those with poor access to and capabilities with using these technologies is required. Unpaid carers need more information and resources to support the care they provide and to facilitate access to appropriate social and health care services for those they care for.

scholarly journals Lack of Coordination between Health Care and Social Care in Multi-Professional Teamwork - the Obstacle for Coherent Care of Older People Suffering from Multi-Morbidity

2020 ◽  
Author(s):  
Ulla Melin Emilsson ◽  
Anna-Lena Strid ◽  
Maria Söderberg
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Older People ◽  
Focus Groups ◽  
Social Care ◽  
The Elderly ◽  
Frail Older People ◽  
Care Needs ◽  
Health And Social Care ◽  
Coordination And Collaboration

Abstract The lack of a cohesive health and social care is a well-known problem of significance for ageing people in general and frail older people in particular. Responsibility for organising and conducting social care and healthcare for the elderly rests on different principals in different countries but difficulties with organisational coordination and collaboration between professions and authorities in social care and healthcare is an extensive concern worldwide. Regardless of the distribution of responsibilities, collaboration and coordination structures are complex and often lead to problems. However, the gap in the coordination between different organisations and the collaboration between professions, implying that frail older people with major care needs still living in their own homes are pinched, has received hardly any recognition. By closely following an implementation project focused on teamwork in order to improve collaboration and coordination between social care and healthcare, the purpose of this article is to fill this gap with the help of an example from Sweden. Data consisted of event diaries, observations, focus groups, structured questionnaires and interviews. Findings showed that multi-professional teams certainly were established, but did not work or last. Among the obstacles found the most prominent features were the various professions’ own organisations, territorial thinking and rivalries. The whole idea of the initiative to achieve a cohesive healthcare and social care for ageing frail older people fell through. By letting this happen, not only did the project hinder the development of better practice in serving older adults, but also cemented the problematic structures it was intended to dissolve.

Do digital technologies enhance older people’s access to health and social care: a rapid review of reviews. (Preprint)

2020 ◽  
Author(s):  
Tafadzwa Patience Kunonga ◽  
Gemma Frances Spiers ◽  
Fiona Beyer ◽  
Elisabeth Boulton ◽  
Alex Hall ◽  
...  
Keyword(s):  
Older People ◽  
Systematic Reviews ◽  
Social Care ◽  
Digital Technologies ◽  
Rapid Review ◽  
Care Services ◽  
Access To Health ◽  
Health And Social Care ◽  
First Contact ◽  
The Impact

BACKGROUND The 2020 COVID-19 pandemic prompted rapid implementation of new and existing digital technologies to facilitate access to health and care services during physical distancing. Older people may be disadvantaged, if they are unable to use smartphones, tablets, computers or other technologies. OBJECTIVE In this study, we synthesise evidence on the impact of digital technologies on older adults’ access to health and social services. METHODS We conducted a rapid review of systematic reviews, identified using comprehensive searches of six databases (January 2000 to October 2019). We looked for reviews in a population of adults aged ≥ 65 years in any setting, reporting outcomes related to the impact of technologies on access to health and social care services. RESULTS Seven systematic reviews met the inclusion criteria, providing data from 77 randomised controlled trials and 50 observational studies. All synthesised findings from low-quality primary studies, two using robust review methods. A majority of reviews focussed on digital technologies to facilitate remote delivery of care, including consultations and therapy. No studies examined technologies used for first contact access to care, such as online appointment scheduling. Overall, we found no reviews of technology to facilitate first contact access to health and social care such as online appointment booking systems for older populations. CONCLUSIONS The impact of digital technologies on equitable access to services for older people is unclear. Research is urgently needed into the positive and negative consequences, with identification of the groups most vulnerable to exclusion.

Does diagnosis determine delivery? The Islington study of older people's needs and health care costs

2004 ◽  
Vol 34 (1) ◽  
pp. 147-155 ◽  
Author(s):  
T. NELSON ◽  
J.-L. FERNANDEZ ◽  
G. LIVINGSTON ◽  
M. KNAPP ◽  
C. KATONA
Keyword(s):  
Health Care ◽  
Older People ◽  
Health Care Costs ◽  
Social Care ◽  
Living Alone ◽  
Service Usage ◽  
Factors Associated ◽  
People With Dementia ◽  
Health And Social Care ◽  
Care Costs

Background. Little is known about the factors associated with the receipt of care by older people. This study investigates the use, costs and factors associated with service usage among people aged 65 or older living in inner London.Method. A community-based survey, using questionnaires, examined psychiatric and physical morbidity, formal and informal care. The relationships between demographic, pathological features and the costs of health and social care were explored using multivariate regression.Results. A total of 1085 people were interviewed at home of these 18% did not receive any service at all. The total cost of services per week for people with dementia was £109, with activity limitation £14 and with depression £12. The greatest effect of physical limitation was on the receipt of social care. Dementia had the strongest effect on receipt of social care services. Depression increased health care costs to a much greater degree than social care costs. Despite presenting to services, black elders received significantly less health care than other people with the same needs. Older people living alone were more likely to receive social care support and appeared less likely to use health services.Conclusions. Physical dependency significantly affects both health and social care costs. Increasing cognitive impairment mainly leads to increasing social care costs. Overall costs are increased by physical dependency, dementia, depression, subjective health problems, living alone and are negatively affected by being black.

Trans Women’s Perceptions of Residential Aged Care in Australia

2019 ◽  
Vol 50 (5) ◽  
pp. 1304-1323 ◽  
Author(s):  
Andrea Waling ◽  
Anthony Lyons ◽  
Beatrice Alba ◽  
Victor Minichiello ◽  
Catherine Barrett ◽  
...  
Keyword(s):  
Older People ◽  
Social Care ◽  
Service Providers ◽  
Aged Care ◽  
Residential Aged Care ◽  
Gender Diverse ◽  
Health And Social Care ◽  
Women’S Perceptions ◽  
Trans Women ◽  
And Gender

Abstract Many older people in trans communities in Australia and elsewhere have experienced long histories of violence and discrimination in the health and social care sectors, making some of them fearful of interacting with contemporary health and social care providers. This study explored older trans women’s perceptions of these services. It involved a qualitative, thematic analysis of semi-structured, one-on-one audio-recorded interviews with ten trans women aged sixty years and older in Australia. Participants expressed a number of concerns about using residential facilities for older people in Australia, including potential for abuse and discrimination as a result of being trans, and not having access to appropriate treatments. Participants indicated a range of alternatives in using services, such as renovating the home, relocating to areas with greater access to trans-inclusive services and potential euthanasia. Participants perceived that service providers were not adequately trained for trans and gender diverse needs, and highlighted a number of ways aged care services could better support the trans and gender diverse community. The findings provide important information to assist health and social care professionals, including social workers, as well as residential care service providers, in supporting the health and well-being of older trans women.

scholarly journals A narrative review of literature on the use of health and social care by older trans adults: what can United Kingdom services learn?

2021 ◽  
pp. 1-22
Author(s):  
Susan Mary Benbow ◽  
Charlotte Eost-Telling ◽  
Paul Kingston
Keyword(s):  
Health Care ◽  
Social Care ◽  
The United States ◽  
Narrative Review ◽  
Cultural Humility ◽  
Service Improvement ◽  
Service Users ◽  
Strong Argument ◽  
Health And Social Care ◽  
Economic Inequalities

Abstract We carried out a narrative review and thematic analysis of literature on the physical health care, mental health care and social care of trans older adults to ascertain what is known about older trans adults’ contacts with and use of health and social care. Thirty papers were found: a majority originated in the United States of America. Five themes were identified: experience of discrimination/prejudice and disrespect; health inequalities; socio-economic inequalities; positive practice; and staff training and education. The first three themes present challenges for providers and service users. Experiences of discrimination/prejudice and disrespect over the course of their lives powerfully influence how older trans adults engage with care services and practitioners. Health and socio-economic inequalities suggest that older trans adults are likely to have greater need of services and care. The remaining two themes offer opportunities for service improvement. We conclude that more research is needed, that there is a strong argument for taking a lifecourse perspective in a spirit of cultural humility, and that contextual societal factors influence service users and providers. We identify positive trans-inclusive practices which we commend to services. More needs to be done now to make older adult services appropriate and welcoming for trans service users.

scholarly journals The importance of a room with a view for older people with limited mobility

2018 ◽  
Vol 19 (4) ◽  
pp. 273-285 ◽  
Author(s):  
Charles Musselwhite
Keyword(s):  
Older People ◽  
Design Methodology ◽  
Social Care ◽  
Structured Interviews ◽  
Content Type ◽  
Limited Mobility ◽  
Human Element ◽  
Health And Social Care ◽  
Vantage Points ◽  
Practical Implications

Purpose The purpose of this paper is to examine how older people who are almost entirely housebound use a view from their window to make sense of the world and stay connected to the outside space that they cannot physically inhabit. Design/methodology/approach Semi-structured interviews with 42 individuals were carried out who were living at home, were relatively immobile and had an interesting view outside they liked from one or more of their windows. Findings The findings suggest that immobile older people enjoy watching a motion-full, changing, world going on outside of their own mobility and interact and create meaning and sense, relating themselves to the outside world. Practical implications Findings suggest that those working in health and social care must realise the importance of older people observing the outdoors and create situations where that is enabled and maintained through improving vantage points and potentially using technology. Originality/value This study builds and updates work by Rowles (1981) showing that preference for views from the window involves the immediate surveillance zone but also further afield. The view can be rural or urban but should include a human element from which older people can interact through storytelling. The view often contains different flows, between mundane and mystery and intrigue, and between expected and random.

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