A commentary on the emerging literature on advocacy for older people

2007 ◽  
Vol 8 (4) ◽  
pp. 18-27 ◽  
Author(s):  
Peter Scourfield
Keyword(s):  
Older People ◽  
Service User ◽  
Minority Groups ◽  
Care Home ◽  
Mental Capacity ◽  
National Standards ◽  
Policy Documents ◽  
User Groups ◽  
Emerging Themes ◽  
The Uk

This paper comments on emerging themes derived from recent official publications on older people's advocacy in the UK. There is an examination of relevant policy documents and the responses from service user groups. Discussion includes: clarity in defining advocacy; the nature of the advocacy relationship; sustained and reliable financing of advocacy services; the uneven nature of provision; lack of inter‐agency connectivity; the need to establish national standards for advocacy; problems of mental capacity; and advocacy for care home residents and for minority groups. The need for and direction of further research is proposed.

Aging and Health: A New Relationship

2020 ◽  
pp. 1-7
Keyword(s):  
Older People ◽  
Health Professions ◽  
User Group ◽  
Neurological Problem ◽  
Aging And Health ◽  
User Groups ◽  
Mental Health Difficulties ◽  
The Uk ◽  
The Relationship ◽  
Active Citizen

Old age is not of itself a pure neurological ‘problem’, pathology or statement of need. ‘Older people’ or an ‘aging population’ are not a homogeneous group and categorisation as a distinct service user group is, arguably, contentious. Furthermore, since the advent of personalisation in the UK for, conceptualizing support by user groups is considered by many as obsolete. People do not receive health services by virtue of being ‘older’. Rather they are in need of a service - for example, because of ill health, physical impairment, mental health difficulties, addiction or offending. This article will enable us to consider the implications of the re-figuring of the relationship between the state, older people and health professions and social work. This constructs an ambiguous place for older people: they feature either as a resource - captured in the idea of the ‘active citizen’, as affluent consumers, volunteers or providers of childcare- or as a problem in the context of poverty, vulnerability and risk.

Care homes for older people

2013 ◽  
Author(s):  
Tom Dening ◽  
Alisoun Milne
Keyword(s):  
Older People ◽  
Residential Care ◽  
Physical Disability ◽  
Care Home ◽  
Developed Countries ◽  
Care Homes ◽  
Standards Of Care ◽  
Ageing Population ◽  
Behavioural Disturbance ◽  
The Uk

Although only 5% of the total over 65 population in developed countries lives in a care home, the lifetime risk of needing residential care is considerable. In the UK, 418 000 older people occupy nearly 12 000 care homes; the sector has a total value of around £14 billion. Care home residents tend to be very old, most are women, and most have complex co-morbid needs. Most people enter a care home because they can no longer live independently due to ill health, notably dementia. Dementia affects over two thirds of all residents; physical disability and functional impairment are also common. Behavioural disturbance is common as is depression. There are concerns about excessive reliance on medication, and more emphasis recently has been placed on improving standards of care. Evidence suggests that training and good leadership is effective. With the ageing population, the provision and the funding of care home places will come under increasing pressure. The solutions to this are yet to be determined.

Mental capacity assessments among general hospital inpatients referred to a specialist liaison psychiatry service for older people

2009 ◽  
Vol 21 (4) ◽  
pp. 729-737 ◽  
Author(s):  
Fedza Mujic ◽  
Maite Von Heising ◽  
Robert J. Stewart ◽  
Martin J. Prince
Keyword(s):  
Older People ◽  
General Hospital ◽  
Discharge Planning ◽  
Care Home ◽  
Mental Capacity ◽  
Admission Diagnosis ◽  
Liaison Psychiatry ◽  
Placement Decisions ◽  
Surgical Teams ◽  
Hospital Inpatients

ABSTRACTBackground: Mental capacity has been little studied among older general hospital inpatients.Methods: A retrospective analysis was undertaken of routinely collected data (age, gender, ethnicity, admission diagnosis, psychiatric diagnosis, Mini-mental State Examination score, whether capacity was assessed, the outcome of that assessment, and discharge destination) on referrals to a liaison psychiatry service for older people (2003–2006) from medical and surgical teams at a large London teaching hospital.Results: 1267 patients were referred to the service, of whom 379 (30%) were assessed for capacity. The most common mental capacity issues were placement (303 assessed of whom 54% lacked capacity), treatment (86 assessed, 59% lacking capacity) and finances (70 assessed, 79% lacking capacity). Cognitive impairment, dementia and delirium, rather than mental disorders were associated with incapacity. Those assessed and deemed to lack capacity for placement decisions were twice as likely to be placed in a care home, and four times as likely to be placed in an elderly mentally ill (EMI) facility, independent of dementia diagnosis and cognitive functioning.Conclusion: Referrals to a liaison psychiatry service for older people for assessment of mental capacity are common. The main mental capacity issues in older people were those linked to discharge planning. The relatively high proportion of those found to have capacity when capacity had been queried by referring clinicians attests to the important role of specialist liaison teams, particularly in complex cases, in protecting the autonomy of vulnerable older people, and avoiding institutionalization.

Culturally sensitive approaches to health and social care

2009 ◽  
Vol 52 (6) ◽  
pp. 773-784 ◽  
Author(s):  
Ruby C.M. Chau ◽  
Sam W.K. Yu
Keyword(s):  
Older People ◽  
Minority Groups ◽  
Social Care ◽  
Ethnic Minority Groups ◽  
Services De Santé ◽  
Care Services ◽  
Health And Social Care ◽  
Chinese Older People ◽  
The Uk ◽  
Los Grupos

English With the focus on how Chinese older people in the UK use health and social care services, this article demonstrates how these services’ sensitivity is undermined by mistaken assumptions about whether ethnic-minority groups organize health and care according to their cultural principles, and the unity of these principles. French Centré sur la façon dont les Chinois âgés utilisent les services de santé et d’accompagnement social en Grande Bretagne, cet article démontre comment la perception de ces services est biaisée par des représentations erronées selon lesquelles les groupes des minorités ethniques organisent la santé et l’accompagnement social selon leurs principes culturels et en vertu de l’unité de ces principes. Spanish Este artículo se centra en cómo las personas chinas de tercera edad usan los servicios sociales y de salud en Gran Bretaña. Hay suposiciones erróneas acerca de la unidad de principios culturales, y acerca de cómo los grupos étnicos organ izan el cuidado social y el cuidado de la salud. Estas suposiciones debilitan la sensibilidad cultural hacia estos grupos.

scholarly journals No pets allowed? Companion animals, older people and residential care

2019 ◽  
Vol 45 (2) ◽  
pp. 211-222 ◽  
Author(s):  
Marie Fox ◽  
Mo Ray
Keyword(s):  
Older People ◽  
Care Home ◽  
Companion Animals ◽  
Well Being ◽  
Animal Companionship ◽  
Environment Control ◽  
Vulnerability Theory ◽  
Adequate Provision ◽  
Definition Of ◽  
The Uk

This article is concerned with a particular site of inter-species relationships. Using the lens of liminality, it examines forced separation of older people from their companion animals when they move to a residential or nursing home in the UK. Such residential spaces frequently either exclude companion animals or fail to make adequate provision for them to accompany their human caretakers. We see such separation as a major bereavement for an older person at a stage of life when they experience significant other losses, and suggest it is often experienced as akin to the loss of a family member. We deploy vulnerability theory to argue that exclusion of companion animals from care spaces exemplifies a failure to understand the relational vulnerabilities of older age and the significance of animal companionship in mitigating those vulnerabilities. Equally, such separation fails to recognise the implications for excluded animals who can end up in unsuitable homes, being signed over to already over-stretched animal rescues or euthanised. Vulnerability theory highlights how companion species are always already vulnerable, given their liminal position between person and property, while older people are rendered particularly vulnerable in the ‘liminal zone’ of the care home, denied the ability to shape their environment, control their private space or form/sustain relationships of their own choosing. This article explores the potential of law to respond to and mitigate these shared vulnerabilities, suggesting that human rights arguments grounded in shared vulnerability may be invoked to argue for a re-definition of the family to recognise the significance of the human–animal relationship. We draw on the reasoning in a recent Court of Protection case which hints at law’s ability to recognise the value of interspecies relations and their role in sustaining health and well-being, and the ability to live well in old age.

Ethnic minority membership and depression in the UK and America

2017 ◽  
Vol 21 (1) ◽  
pp. 5-12 ◽  
Author(s):  
Sue Holttum
Keyword(s):  
African Americans ◽  
Older People ◽  
Physical Health ◽  
Ethnic Minority ◽  
Minority Groups ◽  
Well Being ◽  
Ethnic Minority Groups ◽  
Content Type ◽  
The Us ◽  
The Uk

Purpose The purpose of this paper is to discuss two recent studies on depression in members of ethnic minorities, one based in the UK with older people, and one in the USA. The aim was to examine what might lead to depression in these groups, and what might protect people from it. Design/methodology/approach The UK-based study examined depression and physical health in older members of the two largest ethnic minority groups in the UK: African Caribbean and South Asian. The US-based study examined whether a sense of belonging to the population group African Americans protected people from depression, as one social theory might predict, or whether racism prevented this protection, as predicted by another theory. Findings In London-based older South Asians, depression was explained by their poorer physical health compared to white Europeans. In older people of black Caribbean origin, depression was linked to their social disadvantage. The researchers did not measure people’s experience of discrimination, and other research suggests this can explain both physical illness and depression. The US-based study reported better well-being for people who identified with other African Americans, but not if they also felt negative about African Americans. However, these were weak links, so other things may affect well-being more, such as day-to-day relationships and a range of group memberships. Originality/value The London-based study was new in studying depression in older people belonging to the two largest ethnic minority groups in the UK and in white Europeans. The US study tested two competing social theories with different predictions about depression in relation to belonging to an ethnic minority. Both studies highlight the need for more research on discrimination and how to reduce it and its negative effects on both mental and physical health.

scholarly journals Defenders against Threats or Enablers of Opportunities: The Screening Role Played by Gatekeepers in Researching Older People in Care Homes

2015 ◽  
Author(s):  
Peter Scourfield
Keyword(s):  
Older People ◽  
Access To Care ◽  
Care Home ◽  
Care Homes ◽  
Research Subjects ◽  
Critical Account ◽  
The Uk

This paper emerges from a case study of the system of statutory reviews in older people’s care homes in the UK. Informed by a review of selected literature on gaining access, this paper provides a critical account of the process of negotiating access with gatekeepers (chiefly, care home managers). The negotiations were time-consuming and largely fruitless in terms of actually gaining access to care home residents. Nevertheless, much was learned about the field, in particular, about the attitudes of those with responsibility for caring for older care home residents. The residents in care homes became “hard to reach” research subjects not necessarily because of any cognitive or communicative impairments on their part, but by the defensive attitudes adopted by gatekeepers. It concludes by suggesting that, in this case, the ambiguous shades of meaning conveyed by the concept of “screener” make it a more appropriate term to describe the role than that of “gatekeeper”.

scholarly journals THE EFFECTS OF BUILT ENVIRONMENT DESIGN ON OPPORTUNITIES FOR WELLBEING IN CARE HOMES

2017 ◽  
Vol 11 (1) ◽  
pp. 138 ◽  
Author(s):  
Lesley J McIntyre ◽  
Ian Ruaraidh Harrison
Keyword(s):  
Built Environment ◽  
Older People ◽  
Care Home ◽  
Spatial Diversity ◽  
Care Homes ◽  
Environment Design ◽  
Social Connectivity ◽  
Future Improvement ◽  
The Uk ◽  
Insight Into

The built environment influences the wellbeing of older people in care homes. In order to design for enablement, physical activity, and social connectivity there are lessons to be learnt from current care home buildings. Uncovering this design information is key for the future improvement of environments for older people. To the field of architecture, this paper presents an analysis of ethnographic observations (utilising an adapted form of the AEIOU heuristic) from five urban care homes in the UK. Findings provide insight into the qualities of the built environment that have impact on the activity and potential wellbeing of older residents. Five significant qualities of the built environment are identified:  Spatial Legibility, Spatial Interconnectedness, Spatial Traversability, Spatial Diversity, and Spatial Aesthetics.

GPs’ experience of safeguarding in care homes: what do they see and what do they do?

2020 ◽  
Vol 70 (suppl 1) ◽  
pp. bjgp20X711269
Author(s):  
Elisabeth Alton ◽  
Caroline White
Keyword(s):  
Online Survey ◽  
Qualitative Data ◽  
Care Home ◽  
Health Needs ◽  
Care Homes ◽  
Electronic Records ◽  
Multiple Relationships ◽  
Home Context ◽  
Emerging Themes ◽  
Multiple Health

BackgroundAbuse of older people in care homes is an on-going problem. GPs, as the most frequent practitioner group visiting care homes, have an important role in detecting and reporting abuse. However, there is little research about GPs’ experiences of working in care homes and how they work to safeguard residents.AimTo explore the challenges experienced by GPs working in this unique environment and how these impact on safeguarding.MethodAn online survey collected qualitative data about GPs’ experiences as visiting professionals to care homes, with an emphasis on safeguarding. A thematic analysis identified key themes.ResultsIn total, 58 completed surveys were returned, with a range of practitioner experience represented (1–30 years). Approximately 70% were GP partners, with the remainder salaried and locum doctors. Over one third reported they had witnessed signs of definite or possible abuse within care homes. Emerging themes related to the complex care home context, in which residents had multiple health needs and GPs had to build multiple relationships with managers, carers, families, and residents. Difficulties in accessing information were reported; residents could not always provide information, GPs had to rely on others for information, and rarely had access to electronic records.ConclusionGP work in care homes is a complex and skilled role, in which GPs encounter evidence of poor care and abuse. Key themes in respect of barriers and facilitators of good care were highlighted. The reliance on others for information and the need to build relationships with staff/managers may raise tensions in respect of safeguarding practice.

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