Some social consequences of remodelling English sheltered housing and care homes to ‘extra care’

2008 ◽  
Vol 29 (1) ◽  
pp. 135-153 ◽  
Author(s):  
FAY WRIGHT ◽  
ANTHEA TINKER ◽  
JULIENNE HANSON ◽  
HEDIEH WOJGANI ◽  
RUTH MAYAGOITIA
Keyword(s):  
Older People ◽  
Residential Care ◽  
Social Consequences ◽  
Sheltered Housing ◽  
Older Person ◽  
Care Needs ◽  
Significant Development ◽  
The United Kingdom ◽  
Multi Disciplinary Team

ABSTRACTAcross the United Kingdom, new build and remodelled ‘extra care’ schemes are being developed in many areas on the assumption that they offer older people with care needs an alternative to residential care. This paper reports an evaluation by a multi-disciplinary team of 10 extra-care schemes remodelled from sheltered housing or residential care units. The evaluation audited buildings and identified social and architectural problems. No two schemes in the sample were alike; some aimed for a dependency balance and others set a dependency threshold for admission. The three criteria used for assessing eligibility were the number of paid care hours the older person had at home, their property status and the type of disability. This article focuses on the wide variation in assessing eligibility for an extra-care place and on some social consequences of remodelling. A number of tenants remained in situ during the remodelling process in six of the schemes. Building professionals were unanimous that retaining some tenants on site caused significant development delays and increased the remodelling costs. There was also a social price to pay. ‘Old’ tenants resented their scheme changing into extra care and were hostile towards ‘new’ tenants who had obvious needs for support. In some extra-care schemes, ‘old’ tenants were refusing to participate in meals and all social activities.

Residential care for social reasons

2012 ◽  
pp. 1799-1802
Author(s):  
Leslie Hicks ◽  
Ian Sinclair
Keyword(s):  
Great Britain ◽  
Young People ◽  
Residential Care ◽  
Clear Definition ◽  
Victorian England ◽  
Care Needs ◽  
The United Kingdom ◽  
Current Characteristics ◽  
Object Of Study ◽  
Developed World

Residential care for the young is an elusive object of study. Provided in the past by establishments as diverse as workhouses, orphanages, and reformatories, it has no clear definition marking its boundaries with foster care or boarding education; at the same time it variously aims to shelter, classify, control, and reform and it has no agreed theory or body of values. The need for residential care, and the difficulties of providing it, vary with time and place; the issues it raises are quite different in Romania than they are in California, or were in Victorian England. Given this diversity, any discussion of residential care needs to outline the context within which it was written. In the case of this chapter the context is provided by current British social policy. Although the focus is on residential care provided to young people by Children's Services in England for social reasons, the conclusions drawn are applicable to the rest of the United Kingdom. The issues raised by this provision have similarities in other parts of the developed world, in virtually all of which the use of residential care is declining. This chapter is written against the background of this decline. Its aims are as follows: ♦ to describe the current characteristics of residential child care in England, and by extension in Great Britain ♦ to outline the problems that have led to its numerical decline ♦ to identify practices that should overcome or reduce these problems ♦ to discuss the role that residential care might play in future.

Social and democratic participation in residential settings for older people: realities and aspirations

2000 ◽  
Vol 20 (3) ◽  
pp. 327-340 ◽  
Author(s):  
STEPHEN ABBOTT ◽  
MALCOLM FISK ◽  
LOUISE FORWARD
Keyword(s):  
Older People ◽  
Residential Care ◽  
Social Participation ◽  
Social Contact ◽  
Sheltered Housing ◽  
Democratic Participation ◽  
England And Wales ◽  
Residential Settings

This paper explores some of the experiences of older people living in residential settings (sheltered, very sheltered housing and residential care), in the context of theories of participation, consumerism and citizenship. It draws on material from personal interviews undertaken with over 100 older people in England and Wales, and also from discussions with staff. Two-thirds of respondents were aged over 85. A significant minority of residents expressed some concerns about the routines of life, such as meals and social contact. Staff expectations of social participation were often unrealistic: for many residents, social contact was more a matter of adjustment than of friendship. Residents did not participate in deciding how the residential settings where they lived should be organised and managed, except for helping with simple domestic tasks. There is a need to change both attitudes and practice to enable older people to participate more fully in these settings.

scholarly journals Older people’s perceived autonomy in residential care: An integrative review

2020 ◽  
pp. 096973302094811
Author(s):  
Tanja Moilanen ◽  
Mari Kangasniemi ◽  
Oili Papinaho ◽  
Mari Mynttinen ◽  
Helena Siipi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older People ◽  
Residential Care ◽  
Personal Characteristics ◽  
Comparison Method ◽  
Integrative Review ◽  
Care Needs ◽  
Mental Competence ◽  
Ethical Approval

Autonomy has been recognised as a key principle in healthcare, but we still need to develop a consistent understanding of older people’s perceived autonomy in residential care. This study aimed to identify, describe and synthesise previous studies on the perceived autonomy of older people in residential care. Ethical approval was not required, as this was a review of published literature. We carried out an integrative review to synthesise previous knowledge published in peer-review journals in English up to September 2019. Electronic and manual searches were conducted using the CINAHL, Philosopher’s Index, PubMed, SocINDEX, Scopus and Web of Science databases. The data were analysed using the constant comparison method. The review identified 46 studies. Perceived autonomy referred to the opportunities that older people had to make their own choices about their daily life in residential care, and achieving autonomy promoted both health and quality of life. Autonomy was linked to older people’s individual capacities, including their level of independence, physical and mental competence, personal characteristics, and whether relatives shared and supported their perceived autonomy. Professionals could facilitate or hinder older peoples’ autonomy in a number of ways, including providing opportunities for autonomy, how daily care needs and activities were managed, and controlling older people’s choices. Professionals’ characteristics, such as education and attitudes, and the older people’s living environments were also associated with their perceived autonomy and included organisational characteristics and physical and social care facilitators. Older people’s perceived autonomy promoted health and quality of life in residential care. However, their autonomy was associated with a number of protective and restrictive individual and environmental factors, which influenced whether autonomy was achieved.

Supporting the Long-Term Residential Care Needs of Older Homeless People With Severe Alcohol-Related Brain Injury in Australia: The Wicking Project

2007 ◽  
Vol 8 (3) ◽  
pp. 141-148 ◽  
Author(s):  
Alice Rota-Bartelink ◽  
Bryan Lipmann
Keyword(s):  
Brain Injury ◽  
Older People ◽  
Residential Care ◽  
Service Providers ◽  
Challenging Behaviors ◽  
Homeless People ◽  
Homeless Population ◽  
Care Needs ◽  
Supported Accommodation

For years, community service providers have been frustrated with the lack in availability of long-term, specialized supported accommodation for older people, particularly older homeless people, with severe acquired brain injury (ABI) and challenging behaviors. Although the incidence of ABI (particularly alcohol-related brain injury) is far wider than being confined to the homeless population, it is frequently misdiagnosed and very often misunderstood. Wintringham is an independent welfare company in Melbourne, Australia, that provides secure, affordable, long-term accommodation and high quality services to older homeless people. The high incidence of alcohol abuse among the resident population has led us to adapt our model of care to accommodate a complexity of need. However, there are some individuals with severely affected behaviors that continue to challenge Wintringham’s capacity to provide adequate support. The deficiency in highly specialized, long-term supported accommodation for older people with severe alcohol-related brain injury (ARBI) is the driving force behind this project. We aim to further develop and improve the current Wintringham model of residential care to better support people with these complex care needs. We will report on the synthesis of this project, which aims to test a specialized model that can be reproduced or adapted by other service providers to improve the life circumstances of these frequently forgotten people.

scholarly journals When Frail Older People Relocate in Very Old Age, Who Makes the Decision?

2019 ◽  
Vol 3 (4) ◽  
Author(s):  
Fiona Scheibl ◽  
Morag Farquhar ◽  
Jackie Buck ◽  
Stephen Barclay ◽  
Carol Brayne ◽  
...  
Keyword(s):  
Decision Making ◽  
Older People ◽  
Old Age ◽  
Residential Care ◽  
Care Home ◽  
Later Life ◽  
Old People ◽  
Care Needs ◽  
Health Crisis ◽  
Age In Place

Abstract Background and Objectives Older people are likely to transition to a new home closer to family who can provide assistance or to long-term residential care as their health declines and their care needs increase. A minority choose to move to “age-friendly” housing before the onset of disability, but the majority prefer to “age in place” and defer moving until health crises compel a transition. Older people living with dementia are likely to move into residential care, but not much is known about the role they play in decision making around these moves. This qualitative study addresses this gap in knowledge by examining how a rare cohort of “older old” people, most with some level of cognitive impairment, were involved in decisions surrounding assistance seeking and moving to a care home. Research Design and Methods Thematic analysis of qualitative interview data from Cambridge City over-75s Cohort (CC75C) study participants aged 95 years and older, who had moved in later life, and their proxy informants (n = 26). Results Moves at such an old age were made due to a complexity of push and pull factors which had layered dynamics of decision making. In most cases (n = 22), decision making involved other people with varying degrees of decision ownership. Only four older people, who moved voluntarily, had full ownership of the decision to move. Many relatives reported being traumatized by events leading up to the move. Discussion and Implications “Older old” people are sometimes unable to make their own decisions about moving due to the urgency of health crisis and cognitive decline. There is a need to support relatives to discuss moving and housing options at timely junctures before health crises intervene in an effort to optimize older people’s participation in decision making.

scholarly journals Ageing in extra-care housing: preparation, persistence and self-management at the boundary between the third and fourth age

2019 ◽  
Vol 40 (12) ◽  
pp. 2711-2731 ◽  
Author(s):  
Eleanor K. Johnson ◽  
Ailsa Cameron ◽  
Liz Lloyd ◽  
Simon Evans ◽  
Robin Darton ◽  
...  
Keyword(s):  
Older People ◽  
Longitudinal Research ◽  
Self Management ◽  
Care Needs ◽  
The Third ◽  
The United Kingdom ◽  
Care And Support ◽  
Care Workers ◽  
Operational Practices ◽  
Extra Care Housing

AbstractExtra-care housing (ECH) has been hailed as a potential solution to some of the problems associated with traditional forms of social care, since it allows older people to live independently, while also having access to care and support if required. However, little longitudinal research has focused on the experiences of residents living in ECH, particularly in recent years. This paper reports on a longitudinal study of four ECH schemes in the United Kingdom. Older residents living in ECH were interviewed four times over a two-year period to examine how changes in their care needs were encountered and negotiated by care workers, managers and residents themselves. This paper focuses on how residents managed their own changing care needs within the context of ECH. Drawing upon theories of the third and fourth age, the paper makes two arguments. First, that transitions across the boundary between the third and fourth age are not always straightforward or irreversible and, moreover, can sometimes be resisted, planned-for and managed by older people. Second, that operational practices within ECH schemes can function to facilitate or impede residents’ attempts to manage this boundary.

scholarly journals Living Independently: Exploring the Experiences of Visually Impaired People Living in Age-Related and Lifetime Housing Through Qualitative Synthesis

2017 ◽  
Vol 11 (2) ◽  
pp. 56-71
Author(s):  
Clíona Rooney ◽  
Karim Hadjri ◽  
Verity Faith ◽  
Máirin Rooney ◽  
Keith McAllister ◽  
...  
Keyword(s):  
Older People ◽  
Visual Impairment ◽  
Interpretative Phenomenological Analysis ◽  
Visually Impaired ◽  
Aging In Place ◽  
Sheltered Housing ◽  
Qualitative Synthesis ◽  
The United Kingdom ◽  
Visually Impaired People ◽  
Age Related

Objectives: The aim of this study is to gain a deeper understanding of the experiences of visually impaired older people living independently at home. Background: As populations are aging globally, there is now an increase in the prevalence of visual impairment. That means for ongoing and future aging-in-place strategies that seek to enable older people to remain independent for longer, more attention needs to be given to the needs of those with visual impairment. As people develop visual impairment, they use adaptive strategies including modifying long-term homes or relocating to more suitable accommodation. In the United Kingdom, aging-in-place strategies include employing statutory lifetime home standards (LTHS) in the home or relocating to sheltered housing to live independently with support available if required. Methods: To get a better understanding of the needs of the visually impaired in the home, 12 interviews with six visually impaired occupants of LTHS homes and six from sheltered accommodation were analyzed separately using interpretative phenomenological analysis. Secondly, qualitative synthesis was used to further analyze themes generated from both samples before interview results were conceptualized in two superordinate concepts, namely, “negotiating priorities” and “understanding visual impairment.” Results: Participants from both groups had similar needs and were willing to compromise by living with some negative features. Those who coped well with moving utilized various resources. Conclusions: These findings will shed more understanding on providing good quality housing for those with visual impairment wanting to live either independently or within healthcare home environments.

scholarly journals Home Alone or Not? A Mixed Methods Study of Different Perceptions of Social Isolation between Care Managers and Older Housebound Adults

2016 ◽  
Vol 1 (1) ◽  
Keyword(s):  
Mixed Methods ◽  
Older People ◽  
Social Isolation ◽  
Well Being ◽  
Mixed Methods Study ◽  
Assessment Process ◽  
Older Person ◽  
Care Needs ◽  
Care Manager ◽  
Care Managers

Purpose: This paper aims to discuss whether the level of social isolation and loneliness as assessed by care managers corresponds to the level of social isolation and loneliness as perceived by the older persons whose care needs are being assessed. Design/methodology/approach: This mixed methods study followed up the assessment of 40 older people by 20 care managers with a focus on the accuracy of the care manager’s assessment on the level of social isolation experienced by the service user. In order for this to be achieved structured interviews were conducted with both the older person and the care manager assessing their needs, with a specific focus on the assessment of loneliness and social isolation. Following these initial interviews two focus groups were then undertaken with the care manager to discuss the findings and unpack the assessment process. Findings: The key issues were that the true level of social isolation and loneliness was under assessed by the care manager completing the assessment. That the care manager’s assessment was predominantly focused on the physical well-being of the older person and heavily influenced by the assessment paperwork. Originality/value: This provides lessons for professionals about the lack of effectiveness of their assessment of social isolation and loneliness in older people, and the potential impact this has on the older person’s quality of life.

Making God wait: An alternative to residential care

1998 ◽  
Vol 1 (2) ◽  
pp. 21-24 ◽  
Author(s):  
Anne Bailey
Keyword(s):  
Older People ◽  
Residential Care ◽  
Community Care ◽  
Sheltered Housing ◽  
Frail Older People ◽  
Care Services

Frail older people have often had to choose between residential care and staying in their own homes with community care services. Both have disadvantages. The development of very sheltered housing in Wolverhampton has shown that there is a better way to meet the needs of frail and disabled older people.

scholarly journals Multi-Morbidity and Polypharmacy in Older People: Challenges and Opportunities for Clinical Practice

Geriatrics ◽  
2020 ◽  
Vol 5 (4) ◽  
pp. 85
Author(s):  
Pritti Aggarwal ◽  
Stephen J. Woolford ◽  
Harnish P. Patel
Keyword(s):  
Older People ◽  
Social Care ◽  
Older Person ◽  
Care Plans ◽  
Health And Social Care ◽  
Challenges And Opportunities ◽  
Care Systems ◽  
The Individual ◽  
Global Population ◽  
Multi Disciplinary Team

Multi-morbidity and polypharmacy are common in older people and pose a challenge for health and social care systems, especially in the context of global population ageing. They are complex and interrelated concepts in the care of older people that require early detection and patient-centred shared decision making underpinned by multi-disciplinary team-led comprehensive geriatric assessment (CGA) across all health and social care settings. Personalised care plans need to remain responsive and adaptable to the needs and wishes of the patient, enabling the individual to maintain their independence. In this review, we aim to give an up-to-date account of the recognition and management of multi-morbidity and polypharmacy in the older person.

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