Key issues for people with dementia living in rural Ireland: social exclusion, models of care and policy change

2020 ◽  
pp. 127-148
Author(s):  
Eamon O’Shea ◽  
Kieran Walsh
Keyword(s):  
Rural Communities ◽  
Social Exclusion ◽  
Holistic Approach ◽  
Models Of Care ◽  
Production Model ◽  
Social Production ◽  
The People ◽  
People With Dementia ◽  
Societal Participation ◽  
Multiple Challenges

The way we think about older people’s lives at the intersection of dementia and rurality, and our recognition of the importance of their world, is crucial to ensuring the delivery of more effective public supports that can enable them to realise full personhood and citizenship, connected to the people that they love and the places where they live. This chapter uses a social exclusion conceptual framework to unpack complex and multiple challenges facing rural older people with dementia and highlights the importance of adopting a multifaceted holistic approach to support full societal participation. The analysis provides an argument for the recalibration of current dementia policy towards a genuine social production model for rural dwelling people with dementia; one that focuses on supporting them to continue to enjoy active and connected lives in rural communities through practical social policies, such as additional home supports, innovative psychosocial provision and integrated transport arrangements.

Met and unmet care needs of older people with dementia living at home: Personal and informal carers’ perspectives

Dementia ◽  
2017 ◽  
Vol 18 (6) ◽  
pp. 1963-1975 ◽  
Author(s):  
Justyna Mazurek ◽  
Dorota Szcześniak ◽  
Katarzyna Urbańska ◽  
Rose-Marie Dröes ◽  
Joanna Rymaszewska
Keyword(s):  
Older People ◽  
Daily Living ◽  
Multidisciplinary Treatment ◽  
Holistic Approach ◽  
Care Needs ◽  
The People ◽  
People With Dementia ◽  
Moderate Dementia ◽  
Informal Carers ◽  
At Home

In Poland, there are few reports of the holistic approach to caring for older people with dementia. The aim of this study was to assess the needs of people with dementia living at home. This was done by evaluating the perspective of people with dementia themselves and that of their carers. The study included 47 people diagnosed with mild to moderate dementia and 41 informal carers, all living in Wroclaw in Poland, involved in the MeetingDem project. The needs were assessed using the CANE. Other scales used were: the MMSE, the GDS and the QOL-AD. The carers reported significantly more needs, both met and unmet, than the people with dementia themselves. The most frequent reported unmet needs both by the people with dementia and their carers included activities of daily living, psychological distress and the need for company. Based on this study’s findings, tailored multidisciplinary treatment, adjusted to their needs and wishes, can be offered thus creating integrated and individualised support.

scholarly journals Exploring societal participation in making cities smart

2020 ◽  
Vol 170 ◽  
pp. 06011
Author(s):  
Shraddha Mahore Manjrekar ◽  
Manali Deshmukh
Keyword(s):  
Smart Cities ◽  
Holistic Approach ◽  
City Development ◽  
Indian Government ◽  
The People ◽  
Societal Participation ◽  
Development Plans ◽  
Education And Awareness ◽  
Smart Education ◽  
Development Structure

The word ‘Future’ has been synonymous to ‘Development’ for most of the people. Architects of the Nation strive for a well-developed state, where it reaches towards enhanced living conditions than the present. In this regard of development, structure of Indian government is well defined. The policies designed at central level envision the total development. These policies make the local bodies function on the same lines. They make an impression in common people’s life that there are some positive changes in the cities. These policies also mark an identity, e.g., after implementation of city Development Plans under JNNURM (Jawaharlal Nehru, National Urban Renewal Mission), the buses bought for BRT (Bus Rapid Transport) had become identity of this policy. The meaning of Smart Cities in India also has been interpreted by people in many ways. For cities to become smarter it needs a holistic approach in developing a sustainable urban eco system and thus the roles of various stakeholders become very important in executing this mission. Not only the investors, financial organizations, planners, architects and people in construction industry but the citizens too have role in making cities smart. People of all age, gender, ability and disability are responsible in making a city smart. Education and awareness is the key for making them aware of their participation in the process of development. This paper also mentions the role of educational institutes to make people understand the essence of development.

scholarly journals ’Borta bra men hemma bäst’? – Das schwedische miljonprogram in literarischen Darstellungen von seinen Anfängen bis in die Gegenwart

2020 ◽  
Vol 50 (1) ◽  
pp. 200-220
Author(s):  
Hannah Tischmann
Keyword(s):  
Social Exclusion ◽  
Contemporary Society ◽  
Housing Program ◽  
Housing Shortage ◽  
Social Democratic ◽  
The People ◽  
The Social ◽  
Divided Society ◽  
The Impact ◽  
Welfare Politics

AbstractThis article analyses literary approaches to the relation between the folkhem, the Swedish welfare state, and the miljonprogram (a public housing program between 1965 and 1974 implemented by the social democratic government with the aim to build 1 million homes to solve the housing shortage). Since its initiation, this housing program has been subjected to critique addressing, among others, issues with quality and the promotion of segregation and social exclusion. Literary discussions since the mid-1960s have both responded to this critique and challenged it. They have questioned the impact of welfare politics on a still divided society by drawing on negative aspects of miljonprogram-areas. Recent texts that negotiate class and ethnicity, however, reclaim these areas with positive descriptions. They highlight their meaning as homes for a large part of Swedish contemporary society and thereby re-connect to the original idea of the folkhem – a home for the people.

Care at home for people with dementia: as in a total institution?

2006 ◽  
Vol 27 (1) ◽  
pp. 3-24 ◽  
Author(s):  
JANET ASKHAM ◽  
KATE BRIGGS ◽  
IAN NORMAN ◽  
SALLY REDFERN
Keyword(s):  
Intimate Relationships ◽  
Social Relationship ◽  
Intimate Relationship ◽  
Total Institution ◽  
Home Life ◽  
The People ◽  
People With Dementia ◽  
Custodial Care ◽  
Care At Home ◽  
At Home

This article examines three kinds of social relationship likely to be present when people with dementia are cared for at home by relatives or friends: custodial care, an intimate relationship, and home-life. Using Goffman's three defining aspects of custodial care – routinisation, surveillance and mortification of the self – the paper examines whether these characterised the care of people with dementia at home and, if so, whether they conflicted with the intimate relationship and with home-life. The study involved sustained observations and interviews with 20 people with dementia and their carers in and around London, and qualitative analysis of the data. It was found that all three aspects of custodial care were present although not fully realised, and that they led to difficulties, many of which were associated with the concurrent pursuit of an intimate relationship and home-life. In all cases, daily life was routinised partly to help accomplish care tasks but was found monotonous, while surveillance was usual but restrictive, and prevented both the carers and those with dementia from doing things that they wished to do. Those with dementia were distressed by the denial of their former identities, such as car-driver or home-maker, and by being treated like children. Both the carers and the people with dementia had various ways of balancing custodial care, their intimate relationships and home-life, such as combining routines with other activities, evading surveillance or carrying it out by indirect means, and there were many attempts to maintain some semblance of former identities.

scholarly journals Holistic Approach to Design, Test, and Optimize Stand-Alone SOFC-Reformer Systems

Processes ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 348
Author(s):  
Michael Höber ◽  
Benjamin Königshofer ◽  
Philipp Wachter ◽  
Gjorgji Nusev ◽  
Pavle Boskoski ◽  
...  
Keyword(s):  
Rural Communities ◽  
High Efficiency ◽  
Diffusion Processes ◽  
Holistic Approach ◽  
Maximum Error ◽  
Gas Diffusion ◽  
Electrochemical Analysis ◽  
Internal Reforming ◽  
Operation Conditions ◽  
Wide Range

Reliable electrical and thermal energy supplies are basic requirements for modern societies and their food supply. Stand-alone stationary power generators based on solid oxide fuel cells (SOFC) represent an attractive solution to the problems of providing the energy required in both rural communities and in rurally-based industries such as those of the agricultural industry. The great advantages of SOFC-based systems are high efficiency and high fuel flexibility. A wide range of commercially available fuels can be used with no or low-effort pre-treatment. In this study, a design process for stand-alone system consisting of a reformer unit and an SOFC-based power generator is presented and tested. An adequate agreement between the measured and simulated values for the gas compositions after a reformer unit is observed with a maximum error of 3 vol% (volume percent). Theoretical degradation free operation conditions determined by employing equilibrium calculations are identified to be steam to carbon ratio (H2O/C) higher 0.6 for auto-thermal reformation and H2O/C higher 1 for internal reforming. The produced gas mixtures are used to fuel large planar electrolyte supported cells (ESC). Current densities up to 500 mA/cm2 at 0.75 V are reached under internal reforming conditions without degradation of the cells anode during the more than 500 h long-term test run. More detailed electrochemical analysis of SOFCs fed with different fuel mixtures showed that major losses are caused by gas diffusion processes.

Reflections from the Margins: Complexities, Transitions and Developmental Challenges - The Case of the Eastern Cape Province, South Africa

2021 ◽  
Keyword(s):  
Citizen Participation ◽  
Historical Analysis ◽  
The State ◽  
Eastern Cape ◽  
The People ◽  
Role Of The State ◽  
Leadership Accountability ◽  
Multiple Challenges ◽  
Colonial Oppression

Since the dawn of colonialism in Southern Africa, the province of the Eastern Cape emerged as the cradle of African resistance against colonial oppression. A closer look at the province reveals opportunities for progress and ultimate resurgence of economic and social development, yet conflated by a myriad of challenges. This book brings together different perspectives and realities of the post-apartheid Eastern Cape to provide an in-depth exploration of the developmental dilemmas that the province faces. This book provides insightful reflections on development and its sustainability some 25 years since democracy, and specifically focuses on sociological and demographic realities in the areas of migration and its impact on families. The book further grapples with the role of the state in developing culture and heritage in the province, pointing to fundamental and multiple challenges of deprivation, unemployment and subsequent community resilience in a variety of sectors including health and education. While it provides a historical analysis of contextual issues facing the province, the book also highlights the agency of the people of the Eastern Cape in confronting challenges in leadership, accountability, citizen participation and service provision. The book will be useful for development scholars and practitioners who are interested in understanding the state of the province, and similar settings, and the degree to which it has emerged from the shadows of its colonial and apartheid legacies.

Clinician and healthcare managers’ perspectives on the delivery of secondary and tertiary pediatric weight management services

2021 ◽  
pp. 136749352110521
Author(s):  
Jennifer Cohen ◽  
Shirley Alexander ◽  
Christina Signorelli ◽  
Kathryn Williams ◽  
Kyra A Sim ◽  
...  
Keyword(s):  
Weight Management ◽  
Holistic Approach ◽  
Models Of Care ◽  
Public Hospitals ◽  
High Risk Population ◽  
Management Service ◽  
Structured Interviews ◽  
Optimal Care ◽  
Pediatric Weight Management ◽  
Management Services

Clinician and healthcare managers' (HCMs) views on weight management service delivery are imperative for informing the nature of future services to treat children with obesity. This qualitative study used semi-structured focus groups and one-on-one semi-structured interviews. Participants were 27 clinicians (medical, nursing, or allied health) and nine HCMs (senior executives in the hospital) who worked in six secondary or tertiary pediatric weight management clinics across five public hospitals in New South Wales, Australia. Clinicians reported that using a combination of group and individual sessions improved engagement with families and reduced attrition rates. Clinicians and HCMs recommended integrating clinics into community centers and providing specific programs for sub-groups, such as children from culturally and linguistically diverse communities or children with developmental delay. Many clinicians and HCMs stressed the importance of pediatric weight clinics using a holistic approach to treatment. To improve the likelihood of future funding for pediatric weight management clinics and to optimize models of care, centers must embed research into their practice. Addressing common barriers to current pediatric weight management services and designing future models of care based on key stakeholders’ preferences is critical to achieving optimal care provision for this high-risk population.

It’s more than money: policy options to secure medical specialist workforce for regional centres

2017 ◽  
Vol 41 (6) ◽  
pp. 698 ◽  
Author(s):  
Jennifer May ◽  
Judi Walker ◽  
Mathew McGrail ◽  
Fran Rolley
Keyword(s):  
Rural Communities ◽  
Local Governments ◽  
Medical Training ◽  
Critical Mass ◽  
Models Of Care ◽  
Hub And Spoke ◽  
Recruitment And Retention ◽  
Modifiable Factors ◽  
State And Local

Objectives Regional centres and their rural hinterlands support significant populations of non-metropolitan Australians. Despite their importance in the settlement hierarchy and the key medical services provided from these centres, little research has focused on their issues of workforce supply and long-term service requirements. In addition, they are a critical component of the recent growth of ‘regional’ hub-and-spoke specialist models of service delivery. Methods The present study interviewed 62 resident specialists in four regional centres, seeking to explore recruitment and retention factors important to their location decision making. The findings were used to develop a framework of possible evidence-informed policies. Results This article identifies key professional, social and locational factors, several of which are modifiable and amenable to policy redesign, including work variety, workplace culture, sense of community and spousal employment; these factors that can be targeted through initiatives in selection, training and incentives. Conclusions Commonwealth, state and local governments in collaboration with communities and specialist colleges can work synergistically, with a multiplicity of interdigitating strategies, to ensure a positive approach to the maintenance of a critical mass of long-term rural specialists. What is known about the topic? Rural origin increases likelihood of long-term retention to rural locations, with rural clinical school training associated with increased rural intent. Recruitment and retention policy has been directed at general practitioners in rural communities, with little focus on regional centres or medical specialists. What does this study add? Rural origin is associated with regional centre recruitment. Professional, social and locational factors are all moderately important in both recruitment and retention. Specialist medical training for regional centres ideally requires both generalist and subspecialist skills sets. Workforce policy needs to address modifiable factors with four groups, namely commonwealth and state governments, specialist medical colleges and local communities, all needing to align their activities for achievement of long-term medical workforce outcomes. What are the implications for practitioners? Modifiable factors affecting recruitment and retention must be addressed to support specialist models of care in regional centres. Modifiable factors relate to maintenance of a critical mass of practitioners, training a fit-for-purpose workforce and coordinated effort between stakeholders. Although remuneration is important, the decision to stay relates primarily to non-financial factors.

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