scholarly journals Migrants’ pathways to aged care: the role of local relationships of care in facilitating access for super-diverse older populations

2021 ◽  
pp. 1-28
Author(s):  
Hanna Carlsson
Keyword(s):  
Access To Care ◽  
Care Home ◽  
Aged Care ◽  
Care Providers ◽  
Structured Interviews ◽  
Policy Makers ◽  
Older Migrants ◽  
Health And Social Care ◽  
First Generation Migrants ◽  
Past Experiences

Abstract The literature on older migrants often focuses on identifying the characteristics of ethnic groups that constitute ‘barriers’ for members of these populations to access care. This paper offers an alternative conceptualisation of access to care, by combining relational approaches to place and the notion of super-diversity. From this perspective, ‘access to care’ is perceived as an outcome of an individual's embeddedness in relationships of care in urban places. The objective of the study is to identify relationships of care that facilitate access to aged care for older first-generation migrants. Thirty-two semi-structured interviews were conducted with older migrants who were residents of Nijmegen or The Hague, The Netherlands. All interviewees had accessed home care, home aid and/or day care. Both relationships with minority-specific services and informal relationships of care, particularly those within local minority communities, were found to facilitate access to aged care. Past experiences with health and social care were also found to influence current relationships with formal care providers. This study, therefore, suggests that policy makers and care organisations should build long-term positive relationships with new and incoming migrant groups. In addition, it argues that policy makers and care providers should identify locally relevant shared migration-related (rather than ethnic) identities around which communities can be mobilised and targeted with appropriate services.

Constructing a career identity in the aged care sector: overcoming the “taint” of dirty work

2019 ◽  
Vol 48 (1) ◽  
pp. 76-97 ◽  
Author(s):  
Marilyn Clarke ◽  
Katherine Ravenswood
Keyword(s):  
Aged Care ◽  
Future Research ◽  
Professional Status ◽  
Care Providers ◽  
Structured Interviews ◽  
Dirty Work ◽  
Content Type ◽  
Career Identity ◽  
New Graduates ◽  
The Impact

PurposeThe purpose of this paper is to explore career identity within the aged care sector.Design/methodology/approachThe research employs a descriptive interpretive methodology using 32 in-depth, semi-structured interviews.FindingsThis paper shows that social processes and occupational and professional status issues shape career identity in an aged care context. Individuals seek positive career identities through emphasising job fit in relation to their personal experience and values in order to counteract the impact of “taint”.Research limitations/implicationsThis study was based in one organisation. Future research could explore its findings in the context of multiple organisations, and include the concept of career identity in other low status, “tainted” occupations, such as childcare, in order to develop a more complete understanding of identity construction processes.Practical implicationsThe findings suggest that aged care providers could employ a values-driven approach to recruitment, complementary to pay and career development, to enhance recruitment and retention of aged care employees. Universities and professional bodies could consider more active use of aged care student placements to highlight the opportunities that aged care offer to new graduates in allied health professions.Originality/valueThis paper extends our understanding of career identity in relation to “taint” and “dirty work” in the context of two occupational groups in the understudied sector of aged care.

Aged Care Residents’ Perspectives on Quality of Care in Care Homes: A Systematic Review of Qualitative Evidence

2021 ◽  
pp. 016402752198907
Author(s):  
Andrew S. Gilbert ◽  
Stephanie M. Garratt ◽  
Leona Kosowicz ◽  
Joan Ostaszkiewicz ◽  
Briony Dow
Keyword(s):  
Systematic Review ◽  
Quality Of Care ◽  
Quality Care ◽  
Care Home ◽  
Aged Care ◽  
Care Homes ◽  
Care Providers ◽  
Eligibility Criteria ◽  
Qualitative Evidence

There is increasing interest in harnessing aged care residents’ perspectives to drive quality improvement in aged care homes. We conducted a systematic review of qualitative evidence including literature examining residents’ descriptions of “quality of care” in aged care homes, using database searches and screening records according to eligibility criteria. Three independent reviewers conducted quality assessment of forty-six eligible articles and performed thematic synthesis of articles’ findings. We distinguish nine key themes describing factors influencing quality care: staffing levels, staff attitude, continuity, routine, environment, decision-making and choice, dignity of risk, activities, and culture and spirituality. While many themes were consistent across studies, residents’ prioritization of them varied. Aged care home residents have differing conceptions of quality care as well as heterogeneous and dynamic needs and preferences. Care providers are best able to facilitate quality care when intentional efforts are made to recognize this and tailor delivery of services the individual residents.

Dementia families: Relinquishing home care to aged care services: Guilt, traumatic loss and growth

Dementia ◽  
2020 ◽  
pp. 147130122097078
Author(s):  
Bruce D Walmsley ◽  
Lynne McCormack
Keyword(s):  
Home Care ◽  
Family Member ◽  
Interpretative Phenomenological Analysis ◽  
Phenomenological Study ◽  
Care Home ◽  
Family Members ◽  
Well Being ◽  
Aged Care ◽  
Structured Interviews ◽  
The Impact

Background and Objectives Few studies explore both negative and positive perspectives of family members who relinquish home care of a family member with dementia for systemic aged care. Research Design and Methods This phenomenological study sought the ‘lived’ experience of relinquishing the role of home carer for a family member with mild to severe dementia to others within care home settings, by seeking to understand the impact of aged care on family members’ psychological well-being. Using semi-structured interviews, positive and negative subjective interpretations from 17 families (27 individuals) provided data for analysis, following the protocols of interpretative phenomenological analysis. Results One superordinate theme, mistrust/integrity, overarched oscillation between mistrust of the aged care system and a struggle for personal integrity in caring for these participants. Two sub-themes emerged: intrinsic trauma and extrinsic trauma. Intrinsic trauma explained feelings of helplessness and guilt, and internally directed responses that triggered a retreat into submission ultimately reducing the participant’s role in advocacy. Extrinsic trauma represented externally directed responses such as anger and frustration, where family members became more engaged and watchful and recognised a need for vigilance and advocacy. Paradoxically oscillating between these personal struggles, participants exhibited growth, a third theme that defined assertive/advocacy utilised to nurture hope, gratitude, courage and change. Discussion and Implications Family members experienced complex distress as they relinquished home care to others within systemic aged care for a member with dementia. By developing adaptive responses as appropriate, for example, advocating for their family member or accepting compliance with treatment, collaborative care between family and staff created better outcomes for the family member with dementia.

scholarly journals Quality improvement in the voluntary sector: knowledge, capacity and education

2021 ◽  
Author(s):  
Samuel Quinn ◽  
Rhoda Macrae ◽  
Elaine Gifford ◽  
Helen Rainey ◽  
Mandy Andrew ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Capacity Building ◽  
Social Care ◽  
Gap Analysis ◽  
Care Delivery ◽  
Voluntary Sector ◽  
Structured Interviews ◽  
Policy Makers ◽  
Health And Social Care ◽  
National Governments

Quality improvement has been proposed as a means of enhancing health and social care on an international scale. Despite being a key stakeholder in health and social care delivery, there is a lack of evidence regarding the adoption of quality improvement in the voluntary sector. For this study, 21 semi-structured interviews and five focus groups were conducted with Scottish voluntary sector staff. A gap analysis was undertaken, and findings were used to co-create educational sessions that may aid capacity building. Our findings suggest that knowledge, adoption and practice of quality improvement are currently variable in the Scottish voluntary sector. Capacity building for improvement is most successful when supported with sector-specific examples and networking opportunities. We conclude that the current policy landscape provides an opportunity for national governments to involve the voluntary sector as an equal partner in the adoption of quality improvement. We make recommendations for researchers and policy makers on how this may be achieved.

“Something to get out of bed for”: creative arts for a happily ageing population

2016 ◽  
Vol 20 (4) ◽  
pp. 190-194 ◽  
Author(s):  
Paul Cann
Keyword(s):  
Older People ◽  
Social Care ◽  
Well Being ◽  
Creative Arts ◽  
Care Providers ◽  
Policy Makers ◽  
Content Type ◽  
The Arts ◽  
Health And Social Care ◽  
The Impact

Purpose The purpose of this paper is to relate the growing body of evidence about the impact of creative arts on the health and well-being of older people to the debate about active ageing, prevention and demographic change. Design/methodology/approach It draws on a range of researched examples in order to illustrate the impact of three different art forms – singing, dance and visual arts – on health and well-being. Findings The evidence exists in increasing volume and diversity that creative arts not only improve personal feelings of well-being but also key physiological measures. The arts are increasingly recognised as playing a major potential role in the delivery of health and social care interventions. Greater recognition and action are needed from policy makers, commissioners and care providers in health and social care that the arts are not a marginal and elitist avenue but a mainstream tool supporting older people to remain active, healthy and independent. Importantly, they represent a powerful source of motivation, agency and confidence. Social implications It argues that creative arts should become an integral and more prominent part of ageing policy. The evidence exists in increasing volume and diversity that creative arts not only improve personal feelings of well-being but also key physiological measures. The arts are increasingly recognised as playing a major potential role in the delivery of health and social care interventions. Greater recognition and action are needed from policy makers, commissioners and care providers in health and social care that the arts are not a marginal and elitist avenue but a mainstream tool supporting older people to remain active, healthy and independent. Importantly, they represent a powerful source of motivation, agency and confidence. Originality/value An important research challenge remains, namely to plot cause (arts intervention) and effect (reduced demand on health and care services), if the creative arts are to occupy a central place in commissioning investment at a time of acute financial stringency in the public sector.

scholarly journals ‘Waiting and Wanting’: older peoples’ initial experiences of adapting to life in a care home: a grounded theory study

2020 ◽  
pp. 1-25 ◽  
Author(s):  
Marie O'Neill ◽  
Assumpta Ryan ◽  
Anne Tracey ◽  
Liz Laird
Keyword(s):  
Grounded Theory ◽  
Data Analysis ◽  
Social Care ◽  
Care Home ◽  
Theory Approach ◽  
Structured Interviews ◽  
Policy And Practice ◽  
Senior Member ◽  
Care Home Staff ◽  
Health And Social Care

Abstract A grounded theory approach, consistent with the work of Strauss and Corbin, was used to undertake semi-structured interviews with 17 older people, to explore their experiences of living in a care home, during the four- to six-week period following the move. Purposive sampling was initially adopted, thereafter, theoretical sampling was employed to recruit individuals identified by care managers within older peoples’ community teams and care home managers within a large Health and Social Care Trust in the United Kingdom. Consistent with grounded theory methodology, data collection and analysis occurred simultaneously. Constant comparative analysis underpinned data analysis and data management techniques. Data analysis revealed five distinct categories that captured these experiences. These were: (a) wanting to connect – ‘I am so lost here’, (b) wanting to adapt – ‘Well mentally you have to make the best of it’, (c) waiting for assistance – ‘it's a frustration for me’, (d) ‘waiting on the end’ – I am making no plans’ and (e) wanting to re-establish links with family and home – ‘I love getting home and I like getting out to the town’. Together these five categories formed the basis of the core category, ‘Waiting and Wanting’, which encapsulates the initial adaptation experiences of the men and women in the study. Findings indicate that individuals were dependent on others to create a sense of belonging, independence and wellbeing. Moreover, risk aversive practices were perceived as a threat to individuals’ independence and autonomy. Recommendations include the need to amend policy and practice for the development of a bespoke induction programme for each resident facilitated by a senior member of the care home staff working in partnership with individuals and families, in addition to the health and social care team, to support a more positive transition for new residents, relatives and care home staff.

scholarly journals Are you delivering trans positive care?

2016 ◽  
Vol 17 (1) ◽  
pp. 50-59 ◽  
Author(s):  
Serena Mackenzie Jones ◽  
Paul Willis
Keyword(s):  
Elder Care ◽  
Aged Care ◽  
The Body ◽  
Care Providers ◽  
Content Type ◽  
Care Services ◽  
Trans People ◽  
Care And Support ◽  
Health And Social Care ◽  
Design And Practice

Purpose – For the vast majority of cisgendered people who experience alignment between the sex they were assigned at birth, the body they have and their gender identity they are comfortable with (Schilt and Westbrook, 2009), the experience of trans people is a distant one. More of us share an experience of aging and the associated concerns about reduced independence, deterioration of health and increased need for care and support. The paper aims to discuss these issues. Design/methodology/approach – For trans elders, the experience of aging has specific features that have a major impact on their lives if not understood, planned for and responded to appropriately. This paper presents findings from a qualitative study exploring trans peoples experiences, concerns and suggestions for how agencies providing elder care can better meet their expectations (Jones, 2013). Findings – The research revealed low confidence in the ability of current aged care services to meet the needs of trans elders due to a limited understanding of the relationship between health and social care specific to trans people; undervaluing the networks in trans people’s lives; the need to demonstrate culturally competent services and real concerns regarding tackling discrimination and abuse. Despite legislative advancements, there was a sense that activism is central to tackling these issues and trans people are articulating their demands for shaping future provision. The research identifies a number of recommendations for care providers and future areas of research. Originality/value – In response to identifying an absence of trans voices being heard on the subject of trans elder care, this study sought to understand expectations of services, amplify the voices of the participants and share the priorities they articulated to influence future service design and practice.

Video remote interpreting for home-based cognitive assessments

Interpreting ◽  
2021 ◽  
Author(s):  
Andrew Simon Gilbert ◽  
Samantha Croy ◽  
Kerry Hwang ◽  
Dina LoGiudice ◽  
Betty Haralambous
Keyword(s):  
Social Care ◽  
Video Quality ◽  
Linguistically Diverse ◽  
Aged Care ◽  
Structured Interviews ◽  
Cognitive Assessments ◽  
Face To Face ◽  
Care Services ◽  
Home Based ◽  
Health And Social Care

Abstract Many health and social care services are implementing video remote interpreting (VRI) to deal with supply shortages and high costs of language interpreting for linguistically diverse clients. This qualitative study examines stakeholders’ perspectives on using VRI for home-based cognitive assessments, which are routinely performed with older people during aged care assessments in Australia. We conducted 25 semi-structured interviews with clients, assessors and interpreters in Melbourne and a regional Victorian city. We found that across stakeholder groups participants usually regard VRI as an acceptable alternative to face-to-face interpreting when the latter is not possible. Freelance interpreters said VRI saved on travel time and expenditure and afforded them financial and practical benefits that enabled them to better meet the high demand for their work. However, stakeholders also pointed to the limitations of VRI, including technical challenges, sound and video quality, and difficulties with positioning equipment optimally during interviews. The assessors and interpreters agreed that VRI was inappropriate when clients are known to be cognitively impaired, and that face-to-face interpreting is necessary to support these clients and ensure assessment accuracy. We suggest that plans by health or social care services to replace face-to-face interpreting with VRI should be balanced against the needs of clients and any impacts on professional practice.

scholarly journals Recognition of the complexity facing residential care homes: a practitioner inquiry

2018 ◽  
Vol 19 (6) ◽  
pp. 584-590 ◽  
Author(s):  
Jenny Dudman ◽  
Julienne Meyer ◽  
Cheryl Holman ◽  
Wendy Moyle
Keyword(s):  
Residential Care ◽  
Care Home ◽  
Assessment Tools ◽  
Care Staff ◽  
Care Homes ◽  
Structured Interviews ◽  
Care Home Staff ◽  
Healthcare Needs ◽  
Health And Social Care

AbstractAimTo explore the experiences and challenges for residential care home staff when managing the healthcare needs of their residents, in particular those living with dementia.BackgroundIncreasing number of older people, with complex health and social care needs are living in residential care homes. Yet there is limited appreciation of why staff sometimes struggle to manage residents’ healthcare needs, or understanding of their working relationship with district nurses (DNs), whose responsibility it is to provide nursing support.MethodsThis PhD study, in a metropolitan area in the United Kingdom, was conducted by an experienced DN and involved three phases. This paper focuses on the first two phases. Phase 1 data included: semi-structured interviews (n=8), reflective field notes based on non-participant observation, documentary analysis of policies, procedures and assessment tools and other contextual data from one care home (case study site). The practitioner researcher reflected on the findings from the case study, in relation to her own knowledge and experience as a DN, focusing in particular on findings that were familiar, or which surprised. In Phase 2 she fed these findings back to other care homes (n=11) to check whether the findings from the single case study were unique or resonated with others. She gathered their feedback through semi-structured interviews with senior care staff (n=14). Data were analysed using thematic data analysis.FindingsFindings highlight the complexity facing residential care homes: high levels of healthcare needs amongst residents, the demands of caring for residents living with dementia, variations in the knowledge and skill set of care staff, inequity in the level of healthcare support, the challenges of building a good relationship with DNs, and funding pressures facing care homes.ImplicationsAny, or all of these factors can prevent care home staff from managing the healthcare needs of their residents.

scholarly journals Care home residents who die in hospital: exploring factors, processes and experiences

2020 ◽  
Vol 49 (3) ◽  
pp. 468-480
Author(s):  
Gemma Alcorn ◽  
Scott A Murray ◽  
Jo Hockley
Keyword(s):  
Hospital Admission ◽  
Care Home ◽  
External Support ◽  
Care Homes ◽  
Teaching Hospitals ◽  
Structured Interviews ◽  
Care Needs ◽  
Care Home Staff ◽  
Health And Social Care ◽  
Acute Changes

Abstract Background Care home residents are increasingly frail with complex health and social care needs. Their transfer to hospital at the end-of-life can be associated with unwanted interventions and distress. However, hospitals do enable provision of care that some residents wish to receive. We aimed to explore the factors that influence hospital admission of care home residents who then died in hospital. Methods This study combined in-depth case note review of care home residents dying in two Scottish teaching hospitals during a 6-month period and semi-structured interviews with a purposive sample of 26 care home staff and two relatives. Results During the 6-month period, 109 care home residents died in hospital. Most admissions occurred out-of-hours (69%) and most were due to a sudden event or acute change in clinical condition (72%). Length of stay in hospital before death was short, with 42% of deaths occurring within 3 days. Anticipatory Care Planning (ACP) regarding hospital admission was documented in 44%. Care home staff wanted to care for residents who were dying; however, uncertain trajectories of decline, acute events, challenges of ACP, relationship with family and lack of external support impeded this. Conclusions Managing acute changes on the background of uncertain trajectories is challenging in care homes. Enhanced support is required to improve and embed ACP in care homes and to provide rapid, 24 hours-a-day support to manage difficult symptoms and acute changes.

Sign in / Sign up

Export Citation Format

Share Document