scholarly journals ‘They're just who they've always been’: the intersections of dementia, community and selfhood in Scottish care homes

2017 ◽  
Vol 38 (5) ◽  
pp. 1063-1082
Author(s):  
STEVE MULLAY ◽  
PAT SCHOFIELD ◽  
AMANDA CLARKE ◽  
WILLIAM PRIMROSE

ABSTRACTIssues stemming from differences and similarities in cultural identities affect residents and workforces in care homes in Scotland, as they do across the United Kingdom. Theoretical guidance and policy drivers emphasise the importance of considering cultural diversity when planning or enacting person-centred care processes, regardless of where health or social care takes place. Nevertheless, there is a recognised worldwide dearth of research concerning the intersections of culture, dementia and long-term care. This being so, a recent research study found that inadequate understandings of issues stemming from cultural diversity could be seen to constrain person-centred care in some Scottish care homes. In addition, the study uncovered little-recognised socio-cultural phenomena which were observed to positively enhance person-centre care. This article will focus on that, and will lay out findings from the study which lead to the following broad assertion: there is a broad lack of understanding of the power, and potential utility, of shared identity and community as a bulwark against the erosion of personhood which is often associated with dementia. This article describes these findings in some detail, thereby providing fresh insights into how shared cultural identity, and the sense of community it may bring, bears upon the interactions between workers and residents with dementia in Scottish care homes. It then suggests how the school of ‘person-centred care’ may be developed through further research into these phenomena.

2005 ◽  
Vol 25 (6) ◽  
pp. 319-338 ◽  
Author(s):  
ANN NETTEN ◽  
JACQUETTA WILLIAMS ◽  
ROBIN DARTON

In the United Kingdom, as in many other developed countries, there is an established market in the provision of long-term care-homes for older people. Implicit in the market mechanism is the assumption that homes will close, but it was not until 1999–2000 that closures of care-homes received widespread public attention. This paper draws on a multi-method study that investigated home closures in England from several perspectives. The rate of home closures rose substantially between 1998 and 2000 and, although sources give different estimates, it subsequently appears to have remained at about five per cent each year. The net result has been a reduction in capacity, particularly in smaller homes. While their emphases differed, both regulators and providers broadly pointed to the same factors behind the closures: the local authorities, the majority purchasers of care-home places, were under pressure to keep fees down, and national policies that raised costs were coming into force or were anticipated, notably the National Minimum Wage and the National Care Standards. Other factors, such as problems in recruiting suitable staff, particularly those with nursing qualifications, also played a role. The government's response, driven primarily by concerns about the effect on delayed discharges from acute hospital beds, was to retreat on the Standards and to increase funding to local authorities. While this has been a helpful step, more needs to be done to prevent good homes closing and to provide incentives that will retain and promote diverse provision.


2009 ◽  
Vol 19 (4) ◽  
pp. 309-316 ◽  
Author(s):  
Najma Siddiqi ◽  
Andrew Clegg ◽  
John Young

SummaryDelirium is a distressing but preventable condition associated with increased morbidity and mortality, and significant financial costs. Most research on delirium has focused on high-risk patients in hospitals. Another group also at high risk are residents in care homes for older people. This report reviews the literature on the occurrence, aetiology, outcomes, prevention and treatment of delirium in long-term care. Delirium appears to be common in this setting, with a median point prevalence estimate of 14.2% in studies comparable to the UK. However, there is a paucity of high-quality studies, likely to reflect the difficulty in conducting research in this population and the particular challenges of investigating delirium. Addressing delirium successfully in care homes presents an opportunity to improve care standards and to reduce inequalities in health and social care. Well-designed prospective cohort studies and robust evaluations of interventions to prevent and treat delirium are needed.


2016 ◽  
Vol 24 (6) ◽  
pp. 744-751 ◽  
Author(s):  
Jennifer Kane ◽  
Kay de Vries

Background: The concept of dignity is recognised as a fundamental right in many countries. It is embedded into law, human rights legislation and is often visible in organisations’ philosophy of care, particularly in aged care. Yet, many authors describe difficulties in defining dignity and how it can be preserved for people living in long term care. Objectives: In this article, Nordenfelt’s ‘four notions of dignity’ are considered, drawing on research literature addressing the different perspectives of those who receive, observe or deliver care in the context of the long-term care environment. Methods: A review of the literature was undertaken using the terms ‘nursing homes’, ‘residential care’ or ‘long-term care’. The terms were combined and the term ‘human dignity’ was added. A total of 29 articles met the inclusion criteria from the United Kingdom (14), United States (2), Australia (1), Sweden (3), Hong Kong (2), Norway (3), Nordic (1), Taiwan (1), Netherlands (1). Ethical Considerations: Every effort has been made to ensure an unbiased search of the literature with the intention of an accurate interpretation of findings. Discussion: The four notions of dignity outlined by Nordenfelt provide a comprehensive description of the concept of dignity which can be linked to the experiences of people living in long-term care today and provide a useful means of contextualising the experiences of older people, their families and significant others and also of staff in long-term care facilities. Of particular interest are the similarities of perspectives of dignity between these groups. The preservation of dignity implies that dignity is a quality inherent in us all. This links directly to the exploration and conclusions drawn from the literature review. Conversely, promoting dignity implies that dignity is something that can be influenced by others and external factors. Hence, there are a number of implications for practice. Conclusion: We suggest that two of Nordenfelt’s notions, ‘dignity of identity’ and ‘dignity of Menschenwüde’, are a common thread for residents, family members and staff when conceptualising dignity within long-term care environments.


2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Marilyn Macdonald ◽  
Ziwa Yu ◽  
Lori E. Weeks ◽  
Elaine Moody ◽  
Beth Wilson ◽  
...  

2012 ◽  
Vol 47 (2) ◽  
pp. 140-152 ◽  
Author(s):  
Muhammad Riaz ul Haq ◽  
Chris Metcalfe ◽  
Hongxia Li ◽  
Wayne Parker

The presence of pharmaceutically active compounds in the aquatic environment has become well established, and their presence is of potential concern because they are designed to produce biological response in the target receptor, may bear intrinsic toxicity (e.g. cytostatic agents, antibiotics) and they possess the potential to foster and maintain drug resistance. For both risk assessment and risk management purposes, it is important to identify the major sources of pharmaceuticals in the environment. Healthcare facilities may be major sources of the discharges of these compounds into municipal sewers. In this study, we investigated the contributions to the wastewater treatment plant (WWTP) influents from two hospitals and two long-term care homes of nine compounds. Twenty-four hour composite samples were collected over 5 consecutive days from the effluents of these facilities. The WWTPs receiving sewage from these facilities were also sampled on the same days to facilitate mass balance calculations. The results showed that the healthcare facilities contributed a greater proportion of the antibiotic compounds to the WWTPs than the other target compounds; with maximum contributions of ciprofloxacin by hospitals and long-term care homes of 26.7 and 37%, respectively.


2018 ◽  
Vol 53 (6) ◽  
pp. 4863-4885
Author(s):  
Caitlin McArthur ◽  
John Hirdes ◽  
Ashok Chaurasia ◽  
Katherine Berg ◽  
Lora Giangregorio

2021 ◽  
Author(s):  
Julia Brassolotto ◽  
Carly-Ann Haney ◽  
Sienna Caspar ◽  
Shannon Spenceley

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