scholarly journals Delivering person-centred holistic care for older people

2017 ◽  
Vol 18 (2) ◽  
pp. 157-167 ◽  
Author(s):  
Roger Beech ◽  
Bie Nio Ong ◽  
Sue Jones ◽  
Vicky Edwards
Keyword(s):  
Older People ◽  
Social Care ◽  
Scoring Systems ◽  
Social Needs ◽  
Long Term Conditions ◽  
Content Type ◽  
Outcomes Of Care ◽  
Health And Social Care ◽  
Utilization Data ◽  
The Individual

Purpose This paper is an evaluated case study of the Wellbeing Coordinator (WBC) service in Cheshire, UK. WBCs are non-clinical members of the GP surgery or hospital team who offer advice and support to help people with long-term conditions and unmet social needs remain independent at home. The paper aims to discuss this issue. Design/methodology/approach A mixed method design assessed the outcomes of care for recipients and carers using interviews, diaries and validated wellbeing measures. Service utilization data, interviews and observations of WBC consultations enabled investigation of changes in processes of care. Data were analysed using simple descriptive statistics, established instrument scoring systems and accepted social science conventions. Findings The WBC complements medical approaches to supporting people with complex health and social care problems, with support for carers often a key service component. Users reported improvements in their wellbeing, access to social networks, and maintenance of social identity and valued activities. Health and social care professionals recognized the value of the service. Practical implications The WBC concept relieves the burden on health and social care professionals as the social elements of ill-health are addressed. A shift in thinking from ill-health to wellbeing means older people feel more able to regain control over their own lives, being less dependent on consulting professionals. Originality/value The WBC is a new service focussing on the individual in their health, social and economic context. Process and outcomes evaluations are rare in this field.

scholarly journals Developing a joint outcomes contracting model for integrated health and social care for older people

2016 ◽  
Vol 24 (5/6) ◽  
pp. 282-299
Author(s):  
Jenny Billings ◽  
Alison Davis
Keyword(s):  
Older People ◽  
Social Care ◽  
Local Development ◽  
Chronically Ill ◽  
Long Term Conditions ◽  
Content Type ◽  
Health And Social Care ◽  
Integrated Health ◽  
Contracting Model ◽  
Whole Systems

Purpose Current debates surrounding the NHS contract in England are suggesting that it is in need of change to support an integrated health and social care transformation agenda that meets the needs of an ageing chronically ill population. The purpose of this paper is to describe a three-phase project in England that sought to develop and validate a whole systems contracting model for integrated health and social care focusing on older people with long-term conditions, and based on joint outcomes. Design/methodology/approach A participative mixed-method approach for the development of the contracting model was used; this consisted of a literature review, a design phase drawing on consensus method through stakeholder discussions and an international validation phase. Findings The final contracting model consists of four overarching and interrelated core elements: outcomes; partnership, collaboration and leadership; financial: incentives and risk; and legal criteria. Each core element has a series of more detailed contracting criteria, followed by further specifications attached to each criteria. Research limitations/implications While the policy environment appears to be conducive to change and encourages the adoption of new ways of thinking, there are difficulties with the implementation of new innovative models that challenge the status quo, and this is discussed. Practical implications The paper concludes with reflections on the way forward for local development and implementation. Originality/value There is currently much discussion for the need to realign contracting for integrated care that has a better fit for the transformation agenda, but until now, there have been no attempts to develop a whole systems approach that focusses on joint outcomes. This research bridges the gap but recognizes the challenges to implementation.

scholarly journals The importance of a room with a view for older people with limited mobility

2018 ◽  
Vol 19 (4) ◽  
pp. 273-285 ◽  
Author(s):  
Charles Musselwhite
Keyword(s):  
Older People ◽  
Design Methodology ◽  
Social Care ◽  
Structured Interviews ◽  
Content Type ◽  
Limited Mobility ◽  
Human Element ◽  
Health And Social Care ◽  
Vantage Points ◽  
Practical Implications

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.

Challenging times: building a health, housing and social care local workforce strategy

2018 ◽  
Vol 21 (3/4) ◽  
pp. 108-122
Author(s):  
Patricia Dearnaley ◽  
Joanne E. Smith
Keyword(s):  
Service Delivery ◽  
Older People ◽  
Health Care Services ◽  
Social Care ◽  
Workforce Planning ◽  
Care Needs ◽  
Fiscal Impact ◽  
Content Type ◽  
Care Services ◽  
Health And Social Care

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.

Faith and spirituality in older people – a Jewish perspective

2015 ◽  
Vol 19 (3) ◽  
pp. 114-122 ◽  
Author(s):  
Sonia Douek
Keyword(s):  
Older People ◽  
Religious Affiliation ◽  
Jewish People ◽  
Psychological Needs ◽  
Systematic Research ◽  
Content Type ◽  
Faith Based ◽  
Health And Social Care ◽  
The Individual ◽  
The Way

Purpose – The purpose of this paper is to explore the role that faith and spirituality play for Jewish people as they age and examine how this is expressed and supported by a health and social care environment. Design/methodology/approach – This is a case study based on work at Jewish Care and supported by other Jewish networks. It also builds on qualitative research on Ageing Well carried out in 2012. Findings – As people age they have a need to connect with their community. Faith-based communities are ready made and often the first point of call for Jewish people. The way in which people express their faith or spirituality may not manifest itself in practice but be more about inclusion and connection. Life circumstances will determine people’s faith, identity and approach to spirituality – e.g. Holocaust survivors. There is a feeling that religious affiliation and the way it is expressed has polarised in the community which means that older people often do not connect with current ways of expressing or connecting to their faith. Research limitations/implications – This is not a systematic research but examines through practice different approaches to supporting people as they age via a faith-based provision. Practical implications – The approach could be replicated by other faith-based providers but also the approach and lessons should be considered by more generalist providers so that they ensure they meet the needs of the individual receiving their services. The inclusion principle reminds the author that care in a vacuum will not support the emotional and psychological needs of people. Social implications – Divisions within a faith group opportunities for younger people to learn from their older peers reminder of more established values around faith. Originality/value – Identifying the way in which faith is often an expression and connection to community and can reduce social isolation. The role that faith-based communities play in connecting and valuing people as they age. The reminder that ritual can be not only reassuring to people as they age but provide structure and purpose to a person’s life.

From the service user association's perspective

2020 ◽  
Vol 28 (2) ◽  
pp. 53-63
Author(s):  
Charlotte Klinga ◽  
Johan Hansson ◽  
Henna Hasson ◽  
Magna Andreen Sachs ◽  
Carolina Wannheden
Keyword(s):  
Mental Health ◽  
Service User ◽  
Social Care ◽  
Service Users ◽  
Content Type ◽  
Care Services ◽  
Care And Support ◽  
Health And Social Care ◽  
The Individual ◽  
Integrated Mental Health

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.

Why is it important to consider so-called “invisible” older people in UK healthcare?

2014 ◽  
Vol 15 (4) ◽  
pp. 187-196 ◽  
Author(s):  
Anthea Tinker ◽  
Nesar Gilani ◽  
Isabella Luthra ◽  
Olivia Richardson ◽  
Alexander Howells ◽  
...  
Keyword(s):  
Older People ◽  
Design Methodology ◽  
Social Care ◽  
Policy Makers ◽  
Content Type ◽  
Academic Literature ◽  
Health And Social Care ◽  
Preliminary Account ◽  
Government Statistics ◽  
Practical Implications

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.

scholarly journals Does a social prescribing ‘holistic’ link-worker for older people with complex, multimorbidity improve well-being and frailty and reduce health and social care use and costs? A 12-month before-and-after evaluation

2019 ◽  
Vol 20 ◽  
Author(s):  
Julian Elston ◽  
Felix Gradinger ◽  
Sheena Asthana ◽  
Caroline Lilley-Woolnough ◽  
Sue Wroe ◽  
...  
Keyword(s):  
Older People ◽  
Service Use ◽  
Social Care ◽  
Patient Activation ◽  
Well Being ◽  
Long Term Conditions ◽  
Social Prescribing ◽  
Health And Social Care ◽  
Before And After ◽  
The Impact

Abstract Aim: To evaluate the impact of ‘holistic’ link-workers on service users’ well-being, activation and frailty, and their use of health and social care services and the associated costs. Background: UK policy is encouraging social prescribing (SP) as a means to improve well-being, self-care and reduce demand on the NHS and social services. However, the evidence to support this policy is generally weak and poorly conceptualised, particularly in relation to frail, older people and patient activation. Torbay and South Devon NHS Foundation Trust, an integrated care organisation, commissioned a Well-being Co-ordinator service to support older adults (≥50 years) with complex health needs (≥2 long-term conditions), as part of its service redesign. Methods: A before-and-after study measuring health and social well-being, activation and frailty at 12 weeks and primary, community and secondary care service use and cost at 12 months prior and after intervention. Findings: Most of the 86 participants achieved their goals (85%). On average health and well-being, patient activation and frailty showed a statistically significant improvement in mean score. Mean activity increased for all services (some changes were statistically significant). Forty-four per cent of participants saw a decrease in service use or no change. Thirteen high-cost users (>£5000 change in costs) accounted for 59% of the overall cost increase. This was largely due to significant, rapid escalation in morbidity and frailty. Co-ordinators played a valuable key-worker role, improving the continuity of care, reducing isolation and supporting carers. No entry-level participant characteristic was associated with change in well-being or service use. Larger, better conceptualised, controlled studies are needed to strengthen claims of causality and develop national policy in this area.

scholarly journals Health and social work practitioners’ experiences of working with risk and older people

2019 ◽  
Vol 28 (2) ◽  
pp. 197-211
Author(s):  
Christian Beech ◽  
Fiona Verity
Keyword(s):  
Older People ◽  
Social Care ◽  
Complex Dynamics ◽  
International Perspective ◽  
Policy And Practice ◽  
Content Type ◽  
Relative Paucity ◽  
Health And Social Care ◽  
Multidisciplinary Working ◽  
Phenomenological Perspective

Purpose The purpose of this paper is to explore interprofessional and multidisciplinary working between health and social care practitioners providing services to older people through the prism of how risk is assessed and managed. It proposes that whilst interprofessional and multidisciplinary working is a broad and commonly researched topic, there is a relative paucity of evidence specifically regarding how health and social care practitioners work together across structural, cultural and ideological divides. The study aims to expand the domain of integrated health and social care by including perceptions, understanding and use of the concept of risk by professionals from different disciplines. Design/methodology/approach This paper is based upon an exploratory study using an interpretivist phenomenological perspective, including 23 semi-structured individual interviews with health and social care practitioners and 2 non-participant observations of multidisciplinary team meetings. Findings The paper provides empirical insights around the complex dynamics of interprofessional and multidisciplinary working between health and social care practitioners, in particular the saliency of the interconnectedness of individual practitioner Personalities with the Process of interprofessional and multidisciplinary working under the auspices of relevant Policy drivers. Research limitations/implications The research was conducted in Wales and, due to the increasingly divergent policy context within the UK, the research results may lack generalisability from a wider UK or international perspective. Therefore, researchers are encouraged to test the propositions of this research further. Practical implications The paper includes implications for both interprofessional and multidisciplinary policy and practice with older people. With new models of integrated care being sought, the findings of this study may offer a timely and valuable contribution, particularly from the inclusion of a social care perspective and in better understanding the interconnectedness of practitioner personalities with process and policy. Originality/value This paper fulfils an identified need to study the complex dynamics and interconnectedness between health and social care practitioners who work together to provide services to older people.

Health and social care for older people: progress, problems and priorities

2015 ◽  
Vol 16 (1) ◽  
pp. 27-31 ◽  
Author(s):  
Richard Humphries
Keyword(s):  
Older People ◽  
Social Care ◽  
Published Data ◽  
Ageing Population ◽  
Coordinated Care ◽  
Content Type ◽  
Track Record ◽  
Health And Social Care ◽  
Care For Older People ◽  
Care System

Purpose – The purpose of this paper is to describe the principal challenges facing the health and care system in England arising from an ageing population, assess the track record of the coalition government in addressing these and offer a perspective on the priorities likely to be faced by the next incoming government in relation to health and social care for older people. Design/methodology/approach – Assessment of key policy documents and legislation and interpretation of published data on trends in health and social care activity and expenditure. Findings – An ageing population requires a fundamental shift towards a new model of care that offers better coordinated care and promotes independence and healthy ageing. The Care Act 2014 is a significant achievement and NHS spending has been protected, but resulting cuts to local government budgets have since sharp reductions in social care for older people. The next incoming government will need to address a deepening financial crisis in health and care system; the increasingly unsustainability of means tested and rationed social care alongside universal free health care; and the need to make faster progress in developing a new models of integrated care closer to home. Originality/value – The issues raised in this paper affect older people as voters, tax payers and as existing or potential users of health and social care services. As a group they will attract significant attention from political parties in the next election campaign.

scholarly journals Supporting ex-service personnel moving to social care work with older people: a systematic rapid review of the role of education

2019 ◽  
Vol 23 (3) ◽  
pp. 127-141 ◽  
Author(s):  
Jill Manthorpe ◽  
Stephanie Bramley
Keyword(s):  
Older People ◽  
Social Care ◽  
Grey Literature ◽  
Care Work ◽  
Care Staff ◽  
Rapid Review ◽  
Content Type ◽  
Service Personnel ◽  
Health And Social Care

Purpose The purpose of this paper is to review evidence about the role of education in supporting ex-service personnel to move to social care work with older people. Social care has long-standing, well-recognised problems of staff recruitment and retention in many jurisdictions. Within ageing societies, the need for more social care staff is predicted to rise. Therefore, policy makers and employers are exploring if there are untapped sources of potential employees. Some ex-service personnel may be interested in exploring a move to social care work with older people but may need to gain additional qualifications. Design/methodology/approach Databases and grey literature were searched systematically to provide an overview of the evidence on this topic. Six articles were included in the review. Findings A narrative analysis revealed two themes: preparing ex-service personnel for enrolment onto health and social care programmes, and supporting ex-service personnel during health and social care programmes. Research limitations/implications This review was confined to English language studies published between 2008 and 2018. Few mentioned specific user or client groups. Originality/value This review identified evidence gaps relating to whether the skills, education, training and experience gained in the armed services are transferable to civilian social care work with older people; the types of support which are offered to ex-service personnel who are interested in completing qualifications necessary for social care roles and the views of ex-service personnel about their experiences of completing educational courses to facilitate a transition into social care work with older people.

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