Diagnosis of “acopia”: prescription for neglect?

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Zoe Hodges

Purpose This paper aims to reflect upon the usefulness of the word “acopia” as a diagnosis in relation to individuals in hospital. Design/methodology/approach A response to existing literature and consideration of application to practice with adults who may be vulnerable. Findings The term “acopia” is derived from medicine but has gained popularity throughout health and social care. It is a term that has no diagnostic tool or agreed characteristics. Practical implications Practitioners across a number of professional disciplines need to be aware of the individual circumstances, preferences and priorities of individuals to secure the most appropriate care and support for each person. Failure to acknowledge complexity of an individual’s presenting condition at hospital admission may have fatal consequences. Originality/value The importance of language used to refer to adults who are likely to be vulnerable may influence the quality of the care and treatment that they receive.

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.


2020 ◽  
Vol 28 (2) ◽  
pp. 53-63
Author(s):  
Charlotte Klinga ◽  
Johan Hansson ◽  
Henna Hasson ◽  
Magna Andreen Sachs ◽  
Carolina Wannheden

PurposeThe aim of this study was to identify key components of integrated mental health and social care services that contribute to value for service users in Sweden.Design/methodology/approachAn explorative research study design was used, based on data from four group interviews conducted in June and August 2017 with service user representatives.FindingsThe analysis resulted in eight subcategories reflecting components that were reported to contribute to value for service users. These subcategories were grouped into three main categories: (1) professionals who see and support the whole person, (2) organizational commitment to holistic care and (3) support for equal opportunities and active participation in society.Research limitations/implicationsThe findings are primarily transferable to integrated mental health and social care services, as they emphasize key components that contribute to value for service users in these specific settings.Practical implicationsThe complexity of integrated mental health and social care services requires coordination across the individual and organizational levels as well as ongoing dialogue and partnerships between service users, service user associations and health and social care organizations. In this integration, it is important that service users and service user associations not only are invited but also keen to participate in the design of care and support efforts.Originality/valueService User Associations (SUAs) can act as a bridge between county and municipal services through their participation in the development of local activities; at the regional and national levels, SUAs can help achieve more equitable integrated services. It is important that SUAs are not only invited but encouraged to actively participate in the design of such care and support efforts.


2014 ◽  
Vol 15 (4) ◽  
pp. 187-196 ◽  
Author(s):  
Anthea Tinker ◽  
Nesar Gilani ◽  
Isabella Luthra ◽  
Olivia Richardson ◽  
Alexander Howells ◽  
...  

Purpose – The purpose of this paper is to start a debate about older people who are in groups that are not readily visible to policy makers and practitioners. Design/methodology/approach – The paper is based on information obtained from academic literature, government statistics and other publications from relevant organisations. The authors investigated one “invisible” group each and comparisons and conclusions were then made collaboratively. Findings – Many groups of older people seem to be absent from statistics and from policy making. The paper suggests that there needs to be more research to identify the scale of any problems and how they may be solved. Research limitations/implications – This is not a systematic review but a preliminary account of the problem. Practical implications – There are practical implications for health and social care professionals if they do not recognise that there are groups in society about whom little is known. Lack of knowledge and empathy may affect their approach to these groups. Social implications – There are implications for society if these groups are not taken into account in decision making and especially over the allocation of resources. Originality/value – There is little written which brings together the lack of attention paid to these groups as a whole.


2014 ◽  
Vol 28 (5) ◽  
pp. 619-634 ◽  
Author(s):  
Johanna Andersson ◽  
Ewa Wikström

Purpose – The purpose of this paper is to analyse how accounts of collaboration practice were made and used to construct accountability in the empirical context of coordination associations, a Swedish form of collaboration between four authorities in health and social care. They feature pooled budgets, joint leadership and joint reporting systems, intended to facilitate both collaboration and (shared) accountability. Design/methodology/approach – Empirical data were collected in field observations in local, regional and national settings. In addition, the study is based on analysis of local association documents such as evaluations and annual reports, and analysis of national agency reports. Findings – Accountability is constructed hierarchically with a narrow focus on performance, and horizontal (shared) accountability as well as outcomes are de-emphasised. Through this narrow construction of accountability the coordination associations are re-created as hierarchical and accountability is delegated rather than shared. Research limitations/implications – Features such as pooled budgets, joint leadership and joint reporting systems can support collaboration but do not necessarily translate into shared accountability if accountability is interpreted and constructed hierarchically. Practical implications – When practice conforms to what is counted and accounted for, using the hierarchical and narrow construction of accountability, the result may be that the associations become an additional authority. That would increase rather than decrease fragmentation in the field. Originality/value – This research derives from first-hand observations of actor-to-actor episodes complemented with the analysis of documents and reports. It provides critical analysis of the construction and evaluation of accounts and accountability related to practice and performance in collaboration. The main contribution is the finding that despite the conditions intended to facilitate inter-organisational collaboration and horizontal accountability, the hierarchical accountability persisted.


2014 ◽  
Vol 22 (1) ◽  
pp. 4-9 ◽  
Author(s):  
Christopher Handy

Purpose – There are clear links between health, housing and social care. The homeless live much shorter lives as do those people living in poorer quality accommodation and areas of deprivation. Life expectancy and the quality of life in later years are both drastically affected by Marmot's (2010) social gradient, with people from poorer backgrounds often doing worse. A decent home is fundamental to a healthy and a good life. The paper aims to discuss these issues. Design/methodology/approach – The research approach reviewed existing articles, examples from the housing sector and analysis of a range of data from organisations including the NHS. Findings – Good housing helps to support better health but it is not the only answer – joined up working between agencies and Marmot's proposal of proportionate universalism are significant factors in finding solutions to this long-standing issue. Social implications – Costs to the government, health services and local authorities and other agencies could be reduced by wider thinking around the link between housing, health and other support. Originality/value – This paper focuses on the existing links between health, housing and social care.


2021 ◽  
Vol 26 (1) ◽  
pp. 9-13
Author(s):  
Edwin Jones

Purpose This paper aims to present a conceptual viewpoint highlighting the utility of active support in implementing capable environments and to extend this by presenting a three-tiered preventative model of positive behavioural support (PBS) in UK health and social care. Design/methodology/approach Provision of a commentary on “Building capable environments using practice leadership” by Linda Hume, Nadia Khan and Martin Reilly. Findings Capable environments and active support should be key, universal and essential PBS tier one supports in UK health and social care. Training staff in Active Support and developing practice leadership help implement capable environments. Originality/value The three-tiered PBS model was recently proposed by Leitch et al. (2020) and is worthy of further debate and refinement with the involvement of stakeholders. It has several practical implications including refocussing efforts on early intervention to get tier one supports implemented effectively in recognition that PBS is much wider than intense tier three supports. It could reinforce and motivate existing providers of quality support and indicate where and how other providers can commence the process of implementing PBS. Future research could consider the effectiveness of applying implementation science to the field of learning disabilities and PBS in particular.


2017 ◽  
Vol 11 (2) ◽  
pp. 47-53 ◽  
Author(s):  
Niall O’Kane ◽  
Ian Hall ◽  
Mo Eyeoyibo

Purpose The purpose of this paper is to review a case of a man with a mild learning disability and autistic spectrum disorder who successfully appealed against a Deprivation of Liberty Safeguards authorisation under English law. Design/methodology/approach The authors wanted to identify the factors contributing to the individual’s deprivation of liberty and subsequent successful appeal. The authors examined the accounts from the experts involved on each side of the case including different views on the person’s capacity to make certain decisions. The authors examined several of the individual’s psychological and psychiatric assessments. The authors interviewed the individual on two occasions: once during the appeals process, and following his successful appeal. Findings The authors identified several reasons as to why the individual was successful in appealing against the Deprivation of Liberty Safeguards. First, the individual was able to seek legal support to appeal independently. Second, experts involved on each side of the case had differing opinions regarding capacity to make certain decisions. Third, the indication for the Deprivation of Liberty Safeguards was subsequently declared not valid. Finally, the authors found that the quality of life and psychological well-being for the individual improved following removal of restrictions. Practical implications The authors highlight the wider issues relating to an individuals’ rights to challenge authorisations in the Court of Protection as well as to future considerations and directions of the Deprivation of Liberty Safeguards legislation in light of evolving case law. Social implications The authors highlight the importance of empowering patients in matters relating to their care and treatment, as well as protecting their human rights, dignity and autonomy. Originality/value The authors examine the barriers to challenging Deprivation of Liberty Safeguards authorisation and the ever-evolving Deprivation of Liberty Safeguards process.


2020 ◽  
Vol 22 (6) ◽  
pp. 361-369
Author(s):  
Michael Lyne ◽  
Jonathan Parker

Purpose This paper aims to examine advance decisions to refuse treatment (ADRTs) in the context of the COVID-19 (Coronavirus 2019) pandemic. This study considers the development of ADRTs, the lack of take up and confusion among the general public, clinicians and health and social care staff. Design/methodology/approach The paper is a conceptual piece that reflects on ADRTs in the particular context of COVID-19. It considers professional concerns and pronouncements on ADRTs. Findings ADRTs have a low take up currently. There is misunderstanding among public and professionals. There is a need for raising awareness, developing practice and a need to allay fears of misuse and abuse of ADRTs in clinical, health and social care settings. Practical implications The authors make recommendations that reflexive training and awareness become the norm in health and social care, that reform of ADRTs is undertaken to prevent misunderstandings and that the person becomes central in all decision-making processes. Originality/value This paper is original in considering ADRTs as a safeguarding issue from two perspectives: that of the person making the ADRT and being confident in respect for the decisions made; and that of clinicians and other professionals being reflexively aware of the need to accept advance decisions and not acting according to unconscious biases in times of crisis.


2019 ◽  
Vol 13 (1) ◽  
pp. 15-24
Author(s):  
James Sanderson ◽  
Nicola Hawdon

Purpose The purpose of this paper is to outline how personal health budgets and a universal, integrated model of support, can positively transform the way in which individuals with a learning disability experience their health and support needs. Design/methodology/approach The review recognises that Integrated Personal Commissioning, as a policy approach, provides the framework to offer personalised care, and enables people to live an independent, happy, healthy and meaningful life. Findings Evidence suggests that a personalised and integrated approach to both health and social care not only offers better outcomes on all levels for the individual, but also benefits the system as a whole. Originality/value The study reveals that a personalised care leads to people to have choices and control over decisions that affect in better health and wellbeing outcomes for people.


2019 ◽  
Vol 9 (1) ◽  
pp. 2-17 ◽  
Author(s):  
Denise Baker

Purpose The purpose of this paper is to critically reflect on evidence relating to the development and delivery of apprenticeships and its potential implications for pre-registration healthcare education. Design/methodology/approach An iterative review of English language literature published after 1995 to date relating to apprentices and apprenticeships was undertaken. In total, 20 studies were identified for inclusion. Only three related to the most recent apprenticeship initiative in the UK, and the majority were UK based. Findings Three key themes were identified: entering an apprenticeship, the learning environment and perceptions of apprenticeships. Successful completion of an apprenticeship relies heavily on both understanding the role the apprentice is seeking to inhabit, as well as well-structured and comprehensive support whilst on the programme. These findings are then discussed with reference to professional body requirements and pre-registration education in healthcare. Practical implications Appropriate work experience and support for learning are critical to apprenticeship success and apprenticeships should be given equal status to traditional healthcare education routes. Originality/value The introduction of the Apprenticeship Levy in April 2017 (Finance Act, 2016), acknowledgement that all National Health Service Trusts will be levy payers and the introduction of targets relating to apprenticeships for public sector employers have all contributed to growing interest in the apprenticeship agenda in health and social care.


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