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 ◽  
...  

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.

2006 ◽  
Vol 26 (3) ◽  
pp. 373-391 ◽  
Author(s):  
DEIRDRE HEENAN

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.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
S Ozcurumez ◽  
S Akyuz ◽  
H Bradby

Abstract Background Sexual and gender-based violence affects an unknown proportion of Syrians seeking refuge from the ongoing conflict. Exile implies a vulnerability to gendered harms with consequent health effects over the short- and long-term. Services for refugees tend to presume physical gendered harms accruing to women prior to exile, with little attention paid to the effects on refugees’ settlement in the new society. Methods Interviews with health and social care providers of services to refugees in Sweden (n = 20) and Turkey (n = 20), including international organisations, non-government agencies, municipal and other statutory agents. Results Definitions of sexual and gender-based violence that inform service delivery vary greatly between health and social care service providers, with these definitions proving critical for how services are configured and provided. Service providers may consider longer-term health problems arising from refugees’ experience of sexual and gender-based violence, but refugees’ prospects of integration are rarely explicitly addressed. Refugees’ own views on their health and social care needs do not inform the design or development of service provision. Conclusions The experience of sexual and gender-based violence by refugees from Syria is widely recognised among health and social care providers in Turkey and Sweden. However, the experience of such violence is rarely addressed as a public health problem, that is, as a social determinant of ill health and, furthermore, an impediment to successful integration. The long-term, ill effects of sexual and gender-based violence, as seen over the lifecourse, are over-looked when considering refugees. Key messages Services for refugees who have been subject to sexual and gender-based violence vary in terms of how that violence is understood and which of its outcomes are addressed. Sexual and gender-based violence when experienced by refugees is rarely seen as a public health problem.


2018 ◽  
Vol 19 (4) ◽  
pp. 273-285 ◽  
Author(s):  
Charles Musselwhite

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.


2018 ◽  
Vol 21 (3/4) ◽  
pp. 108-122
Author(s):  
Patricia Dearnaley ◽  
Joanne E. Smith

Purpose The purpose of this paper is to stimulate a wider debate around the coordination of workforce planning in non-statutory services (in this case, specialist housing for older people or those with long-term health and social care needs, such as learning disabilities). The authors argue that current NHS reforms do not go far enough in that they fail to include specialist housing and its workforce in integration, and by doing so, will be unable to optimise the potential efficiencies and streamlining of service delivery to this group. Design/methodology/approach The paper used exploratory study using existing research and data, enhanced by documentary analysis from industry bodies, regulators and policy think tanks. Findings That to achieve the greatest operational and fiscal impact upon the health care services, priority must be given to improving the efficiency and coordination of services to older people and those requiring nursing homes or registered care across the public and third sectors through the integration of service delivery and workforce planning. Research limitations/implications Whilst generalisable and achievable, the model proposed within the paper cannot be fully tested theoretically and requires further testing the in real health and social care market to evidence its practicality, improved quality of care and financial benefits. Originality/value The paper highlights some potential limitations to the current NHS reforms: by integrating non-statutory services, planned efficiency savings may be optimised and service delivery improved.


10.2196/31668 ◽  
2021 ◽  
Vol 23 (12) ◽  
pp. e31668
Author(s):  
Janna Nadav ◽  
Anu-Marja Kaihlanen ◽  
Sari Kujala ◽  
Elina Laukka ◽  
Pirjo Hilama ◽  
...  

Background Although the COVID-19 pandemic has significantly boosted the implementation of digital services worldwide, it has become increasingly important to understand how these solutions are integrated into professionals’ routine work. Professionals who are using the services are key influencers in the success of implementations. To ensure successful implementations, it is important to understand the multiprofessional perspective, especially because implementations are likely to increase even more. Objective The aim of this study is to examine health and social care professionals’ experiences of digital service implementations and to identify factors that support successful implementations and should be considered in the future to ensure that the services are integrated into professionals’ routine work. Methods A qualitative approach was used, in which 8 focus group interviews were conducted with 30 health and social care professionals from 4 different health centers in Finland. Data were analyzed using qualitative content analysis. The resulting categories were organized under the components of normalization process theory. Results Our results suggested 14 practices that should be considered when implementing new digital services into routine work. To get professionals to understand and make sense of the new service, (1) the communication related to the implementation should be comprehensive and continuous and (2) the implementation process should be consistent. (3) A justification for the service being implemented should also be given. The best way to engage the professionals with the service is (4) to give them opportunities to influence and (5) to make sure that they have a positive attitude toward the service. To enact the new service into professionals’ routine work, it is important that (6) the organization take a supportive approach by providing support from several easy and efficient sources. The professionals should also have (7) enough time to become familiar with the service, and they should have (8) enough know-how about the service. The training should be (9) targeted individually according to skills and work tasks, and (10) it should be diverse. The impact of the implementation on the professionals’ work should be evaluated. The service (11) should be easy to use, and (12) usage monitoring should happen. An opportunity (13) to give feedback on the service should also be offered. Moreover, (14) the service should support professionals’ work tasks. Conclusions We introduce 14 practices for organizations and service providers on how to ensure sustainable implementation of new digital services and the smooth integration into routine work. It is important to pay more attention to comprehensive and continuing communication. Organizations should conduct a competence assessment before training in order to ensure proper alignment. Follow-ups to the implementation process should be performed to guarantee sustainability of the service. Our findings from a forerunner country of digitalization can be useful for countries that are beginning their service digitalization or further developing their digital services.


2021 ◽  
Vol 4 ◽  
pp. 54
Author(s):  
Aisling M. O'Halloran ◽  
Peter Hartley ◽  
David Moloney ◽  
Christine McGarrigle ◽  
Rose Anne Kenny ◽  
...  

Background: There is increasing policy interest in the consideration of frailty measures (rather than chronological age alone) to inform more equitable allocation of health and social care resources. In this study the Clinical Frailty Scale (CFS) classification tree was applied to data from The Irish Longitudinal Study on Ageing (TILDA) and correlated with health and social care utilisation. CFS transitions over time were also explored. Methods: Applying the CFS classification tree algorithm, secondary analyses of TILDA data were performed to examine distributions of health and social care by CFS categories using descriptive statistics weighted to the population of Ireland aged ≥65 years at Wave 5 (n=3,441; mean age 74.5 (SD ±7.0) years, 54.7% female). CFS transitions over 8 years and (Waves 1-5) were investigated using multi-state Markov models and alluvial charts. Results: The prevalence of CFS categories at Wave 5 were: 6% ‘very fit’, 36% ‘fit’, 31% ‘managing well’, 16% ‘vulnerable’, 6% ‘mildly frail’, 4% ‘moderately frail’ and 1% ‘severely frail’. No participants were ‘very severely frail’ or ‘terminally ill’. Increasing CFS categories were associated with increasing hospital and community health services use and increasing hours of formal and informal social care provision. The transitions analyses suggested CFS transitions are dynamic, with 2-year probability of transitioning from ‘fit’ (CFS1-3) to ‘vulnerable’ (CFS4), and ‘fit’ to ‘frail’ (CFS5+) at 34% and 6%, respectively. ‘Vulnerable’ and ‘frail’ had a 22% and 17% probability of reversal to ‘fit’ and ‘vulnerable’, respectively. Conclusions: Our results suggest that the CFS classification tree stratified the TILDA population aged ≥65 years into subgroups with increasing health and social care needs. The CFS could be used to aid the allocation of health and social care resources in older people in Ireland. We recommend that CFS status in individuals is reviewed at least every 2 years.


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