When the profession becomes personal: dementia care practitioners as family caregivers

2012 ◽  
Vol 24 (6) ◽  
pp. 902-910 ◽  
Author(s):  
Jill Manthorpe ◽  
Kritika Samsi ◽  
Joan Rapaport
Keyword(s):  
Decision Making ◽  
Care Home ◽  
Family Members ◽  
Legal Framework ◽  
Dementia Care ◽  
Clinical Supervisors ◽  
Professional Activities ◽  
Advance Decisions ◽  
Mental Capacity Act ◽  
The Impact

ABSTRACTBackground: Little is known about the impact of caring experience on the practice of dementia care professionals. Few research studies covering dementia practice ask about personal experiences of providing care or having a family member with dementia. In England and Wales, the Mental Capacity Act (MCA) 2005 provided a new legal framework for planning and decision-making in the event of possible loss of capacity. Professional activities in this area include advice and assistance with arranging proxy decision-making, establishing wishes, and advance decisions. The aim of this paper is to present interview data from dementia care professionals with family experiences of dementia and their reflections on decision-making frameworks.Methods: A total of 123 dementia care professionals working in community and care home settings were interviewed (2007–2010) about their experiences and expectations of the MCA 2005. Additional questions covered experiences of being family members or carers of a person with dementia and any use of the planning and decision-making provisions of the MCA in personal and family contexts. Data were analyzed thematically.Results: Seventy practitioners had experience of family members with dementia and family caring. Decision-making and planning were viewed as easier under the MCA but tensions could arise around loss of decision-making capacity or family dispute. Empathy for caregiving situations and how things could have been different were reflected upon.Conclusions: Trainers, clinical supervisors, and researchers in dementia care may build upon personal experience of some practitioners to promote empathy with other family carers and the provision of timely information and advice.

scholarly journals Global development of innovative financial services. Does family economic socialization influence investor behavior in real estate crowdfunding?

2021 ◽  
Vol 129 ◽  
pp. 02010
Author(s):  
Renata Legenzova ◽  
Gintarė Leckė
Keyword(s):  
Decision Making ◽  
Real Estate ◽  
Bounded Rationality ◽  
Financial Services ◽  
Family Members ◽  
Investor Behavior ◽  
Equation Modeling ◽  
Global Development ◽  
The Impact ◽  
Economic Socialization

Research background: Globalization, digitalization and growth of technological innovations trigger development of new financial services, such as real estate crowdfunding. Seeking better return opportunities individual investors often disregard neoclassical decision-making criteria, while behavioral factors, such as social influence, emotions, cognitive abilities are gaining importance. This paper addresses the role of family economics socialization as a complex process by which individuals acquire social skills, knowledge, behavior patterns needed to make investment decision by purposively or spontaneously interacting with their family members. Purpose of the article is to assess if and how family economic socialization impacts on investor behavior in real estate crowdfunding. Methods: Research data was collected through an online survey of Lithuanian real estate crowdfunding investors. Then structural equation modeling technique was employed to investigate the impact of family economic socialization on behavior of real estate crowdfunding investors. Findings & Value added: Findings revealed that majority of real estate crowdfunding investors make bounded rationality investment decisions. Family, as one of the main agents of the economic socialization, does not ensure rationality of the crowdfunding decision-making process. Purposive family economic socialization has no impact on the behavior of investors with bounded rationality, yet it has a significant impact on behavior of rational family members. Spontaneous family economic socialization proved to have a positive and significant impact on the behavior of investors with bounded rationality. Taking into consideration rapid global development of innovative financial services market, such results might be a troubling signal for the product developers and market regulators.

Legal issues in end-of-life care 2: consent and decision-making

2020 ◽  
Vol 12 (11) ◽  
pp. 1-6
Author(s):  
Helen Taylor
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
End Of Life Care ◽  
Legal Framework ◽  
Legal Issues ◽  
Decision Making Process ◽  
Life Care ◽  
General Requirement ◽  
Cardio Pulmonary Resuscitation ◽  
Advance Decisions

Paramedics are legally and professionally obliged to uphold their patients' right to dignity, respect and autonomy—and this includes the general requirement to obtain their consent before proceeding with any intervention. The first instalment of this two-part article considered the challenges that this might present to the paramedic. This second article develops this theme and further explores the legal framework underpinning the decision-making process when caring for a patient approaching the end of life. It also examines issues around consent and mental capacity in more depth and addresses matters such as such as advance decisions to refuse treatment (ADRT) and do not attempt cardio-pulmonary resuscitation (DNACPR) decisions.

Preparation for Caregiving: A Study of Multigeneration Families

1996 ◽  
Vol 42 (1) ◽  
pp. 43-63 ◽  
Author(s):  
S. Sörensen ◽  
S. H. Zarit
Keyword(s):  
Decision Making ◽  
Frail Elderly ◽  
Family Members ◽  
Future Research ◽  
Care Provision ◽  
Need For Care ◽  
Mothers And Daughters ◽  
Research And Practice ◽  
Future Care ◽  
The Impact

The impact of providing care to the frail elderly on individual caregivers and their families has been discussed at length, but few researchers have investigated (he events and circumstances preceding the onset of caregiving. In addition, although there is evidence that several family members are usually involved in planning and decision making about caregiving, the majority of studies in this area include only one generation. Based on a larger theoretical framework of preparation for caregiving [1, 2], the extent to which family members anticipate and plan for future caregiving is investigated. In addition, the extent to which they are satisfied with these preparations is studied. Interviews were conducted with mothers, daughters, and granddaughters in thirty-three multigeneration families. While substantial numbers of both mothers and daughters anticipated the need for care for the oldest generation, few made concrete plans about how to organize future care provision. Planners were more satisfied with the amount of discussion and planning in their family than non-planners. Implications for future research and practice applications are discussed.

The Impact of a Shared Decision-Making Training Program on Dementia Care Planning in Long-Term Care

2018 ◽  
Vol 64 (4) ◽  
pp. 1123-1135 ◽  
Author(s):  
Elena Mariani ◽  
Rabih Chattat ◽  
Giovanni Ottoboni ◽  
Raymond Koopmans ◽  
Myrra Vernooij-Dassen ◽  
...  
Keyword(s):  
Decision Making ◽  
Training Program ◽  
Shared Decision Making ◽  
Long Term Care ◽  
Dementia Care ◽  
Care Planning ◽  
Shared Decision ◽  
Term Care ◽  
The Impact

scholarly journals Unwell in hospital but not incapable: cross-sectional study on the dissociation of decision-making capacity for treatment and research in in-patients with schizophrenia and related psychoses

2018 ◽  
Vol 213 (2) ◽  
pp. 484-489 ◽  
Author(s):  
Benjamin Walter Jack Spencer ◽  
Tania Gergel ◽  
Matthew Hotopf ◽  
Gareth S. Owen
Keyword(s):  
Decision Making ◽  
Odds Ratio ◽  
Assessment Tool ◽  
Legal Framework ◽  
Cross Sectional Study ◽  
Competence Assessment ◽  
Sectional Study ◽  
Cross Sectional ◽  
Decision Making Capacity ◽  
Mental Capacity Act

BackgroundConsent to research with decision-making capacity for research (DMC-R) is normally a requirement for study participation. Although the symptoms of schizophrenia and related psychoses are known to affect decision-making capacity for treatment (DMC-T), we know little about their effect on DMC-R.AimsWe aimed to determine if DMC-R differs from DMC-T in proportion and associated symptoms in an in-patient sample of people with schizophrenia and related psychoses.MethodCross-sectional study of psychiatric in-patients admitted for assessment and/or treatment of schizophrenia and related psychoses. We measured DMC-R and DMC-T using ‘expert judgement’ clinical assessment guided by the MacArthur Competence Assessment Tool for Clinical Research, the MacArthur Competence Assessment Tool for Treatment and the legal framework of the Mental Capacity Act (2005), in addition to symptoms of psychosis.ResultsThere were 84 participants in the study. Half the participants had DMC-R (51%, 95% CI 40–62%) and a third had DMC-T (31%, 95% CI 21–43%) and this difference was statistically significant (P < 0.01). Thought disorder was most associated with lacking DMC-R (odds ratio 5.72, 95% CI 2.01–16.31, P = 0.001), whereas lack of insight was most associated with lacking DMC-T (odds ratio 26.34, 95% CI 3.60–192.66, P = 0.001). With the exception of improved education status and better DMC-R, there was no effect of sociodemographic variables on either DMC-R or DMC-T.ConclusionsWe have shown that even when severely unwell, people with schizophrenia and related psychoses in in-patient settings commonly retain DMC-R despite lacking DMC-T. Furthermore, different symptoms have different effects on decision-making abilities for different decisions. We should not view in-patient psychiatric settings as a research ‘no-go area’ and, where appropriate, should recruit in these settings.Declaration of interestNone.

Operationalising the Deprivation of Liberty Safeguards (DoLS) in support of brain injury survivors – views from practice

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Jade Scott ◽  
Stephen Weatherhead ◽  
Jill Manthorpe
Keyword(s):  
Decision Making ◽  
Brain Injury ◽  
Social Care ◽  
Legal Framework ◽  
Content Type ◽  
Health And Social Care ◽  
Mental Capacity Act 2005 ◽  
Decision Making Styles ◽  
Tentative Explanation ◽  
Mental Capacity Act

Purpose Deprivation of Liberty Safeguards (DoLS), as part of the Mental Capacity Act 2005 (DoLS, 2007), was established to provide a legal framework for decision-making in respect of adults who lack capacity to make decisions in relation to their care and residence in England and Wales. The purpose of this study was to explore the DoLS decision-making process from the perspectives of health and social care practitioners when working with individuals with an acquired brain injury (ABI). Design/methodology/approach A total of 12 health and social care practitioners were interviewed in 2019–2020 about their experiences of using and making or supporting decisions in the DoLS framework with ABI survivors. Data were analysed, and a tentative explanation of variations in DoLS decision-making was developed. Findings Three distinct approaches emerged capturing different decision-making styles (risk-averse, risk-balancing and risk-simplifying) which appeared to influence the outcome of DoLS assessments. A range of mediating factors seemed to account for the variability in these styles. The wider contextual challenges that impact upon practitioners’ overall experiences and use of DoLS processes in their ABI practice were noted. Research limitations/implications The findings highlight a need for changes in practice and policy in relation to how DoLS or similar processes are used in decision-making practice with ABI survivors and may be relevant to the implementation of the Liberty Protection Safeguards that are replacing the DoLS system. Originality/value To the best of the authors’ knowledge, this is the first study to explore accounts of DoLS decision-making practices in ABI service.

scholarly journals Does Employees’ Participation in Decision Making Increase the level of Corporate Social and Environmental Sustainability? An Investigation in South Asia

2019 ◽  
Vol 11 (2) ◽  
pp. 511 ◽  
Author(s):  
Omer Farooq ◽  
Mariam Farooq ◽  
Emmanuelle Reynaud
Keyword(s):  
Decision Making ◽  
Social Identity Theory ◽  
Environmental Sustainability ◽  
Organizational Identification ◽  
Employee Participation ◽  
Legal Framework ◽  
Process Data ◽  
Participation In Decision Making ◽  
The Impact

Although previous studies have explored the role of legal framework, industry norms, innovation, and the use of clean technologies to achieve sustainability, they have paid little attention to the role of employees in increasing a firm’s sustainability performance. This article develops a model based on social identity theory and proposes that employees whose organizational identification is rooted in the sustainability of the firm can influence the sustainability strategy of the firm through the participation process. Data were obtained from 421 employees of large fast-moving consumer goods manufacturers. The findings demonstrate that employee participation has a strong positive effect on all the components of sustainability (environmental and societal). Moreover, the findings show that the impact of employee participation on the components of sustainability is moderated by organizational identification in such a way that if employees have a strong sense of identification with their organization, their participation in decision making has a greater impact on the sustainability of their organization.

scholarly journals Capacity and Consent in England and Wales: The Mental Capacity Act under Scrutiny

2010 ◽  
Vol 19 (3) ◽  
pp. 344-352 ◽  
Author(s):  
PETER HERISSONE-KELLY
Keyword(s):  
Mental Health ◽  
Learning Disabilities ◽  
Mental Health Problems ◽  
Legal Framework ◽  
Mental Capacity ◽  
Decision Makers ◽  
England And Wales ◽  
Mental Capacity Act 2005 ◽  
Advance Decisions ◽  
Mental Capacity Act

The Mental Capacity Act 2005 came into force in England and Wales in 2007. Its primary purpose is to provide “a statutory framework to empower and protect people who may lack capacity to make some decisions for themselves.” Examples of such people are those with dementia, learning disabilities, mental health problems, and so on. The Act also gives those who currently have capacity a legal framework within which they can make arrangements for a time when they may come to lack it. Toward this end, it allows for them to make advance decisions (in effect, refusals of consent to certain forms of treatment) or to appoint proxy decision makers with lasting powers of attorney.

scholarly journals Carers and co-production: enabling expertise through experience?

2015 ◽  
Vol 20 (4) ◽  
pp. 232-241 ◽  
Author(s):  
Eleanor Bradley
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Professionals ◽  
Family Members ◽  
Mental Healthcare ◽  
Service Users ◽  
Content Type ◽  
The Impact

Purpose – The purpose of this paper is to provide a brief overview of the literature to date which has focused on co-production within mental healthcare in the UK, including service user and carer involvement and collaboration. Design/methodology/approach – The paper presents key outcomes from studies which have explicitly attempted to introduce co-produced care in addition to specific tools designed to encourage co-production within mental health services. The paper debates the cultural and ideological shift required for staff, service users and family members to undertake co-produced care and outlines challenges ahead with respect to service redesign and new roles in practice. Findings – Informal carers (family and friends) are recognised as a fundamental resource for mental health service provision, as well as a rich source of expertise through experience, yet their views are rarely solicited by mental health professionals or taken into account during decision making. This issue is considered alongside new policy recommendations which advocate the development of co-produced services and care. Research limitations/implications – Despite the launch of a number of initiatives designed to build on peer experience and support, there has been a lack of attention on the differing dynamic which remains evident between healthcare professionals and people using mental health services. Co-production sheds a light on the blurring of roles, trust and shared endeavour (Slay and Stephens, 2013) but, despite an increase in peer recovery workers across England, there has been little research or service development designed to focus explicitly on this particular dynamic. Practical implications – Despite these challenges, coproduction in mental healthcare represents a real opportunity for the skills and experience of family members to be taken into account and could provide a mechanism to achieve the “triangle of care” with input, recognition and respect given to all (service users, carers, professionals) whose lives are touched by mental distress. However, lack of attention in relation to carer perspectives, expertise and potential involvement could undermine the potential for coproduction to act as a vehicle to encourage person-centred care which accounts for social in addition to clinical factors. Social implications – The families of people with severe and enduring mental illness assume a major responsibility for the provision of care and support to their relatives over extended time periods (Rose et al., 2004). Involving carers in discussions about care planning could help to provide a wider picture about the impact of mental health difficulties, beyond symptom reduction. The “co-production of care” reflects a desire to work meaningfully and fully with service users and carers. However, to date, little work has been undertaken in order to coproduce services through the “triangle of care” with carers bringing their own skills, resources and expertise. Originality/value – This paper debates the current involvement of carers across mental healthcare and debates whether co-production could be a vehicle to utilise carer expertise, enhance quality and satisfaction with mental healthcare. The critique of current work highlights the danger of increasing expectations on service providers to undertake work aligned to key initiatives (shared decision-making, person-centred care, co-production), that have common underpinning principles but, in the absence of practical guidance, could be addressed in isolation rather than as an integrated approach within a “triangle of care”.

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