Everyday Ethical Challenges and Informal Ethics Support Structures of Migrant Caregivers in Older Adult Care in England

2021 ◽  
Vol 66 (Special Issue) ◽  
pp. 32-32
Author(s):  
Kumeri Bandara ◽  
◽  
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Support Systems ◽  
Ethical Challenges ◽  
Adult Care ◽  
Ethics Support ◽  
Unexplored Area ◽  
Anthropological Fieldwork ◽  
The Uk

"This paper builds on anthropological fieldwork I conducted in 2019 while living for over two months with migrant caregivers of older adults in Epsom, England. Caregivers’ experiences resonated with existing literature on everyday ethical challenges in caregiving: navigating divergent perspectives on good care, negotiating professional disagreements on treatments, dealing with older adults’ verbal and physical abuse appropriately, and telling older adults ‘white lies’ to avoid mental distress. Caregivers also faced unique ethical challenges because of their migrant identities: dealing with racism, conscientious objecting of certain requests made by older adults, struggling with language when following training and defending themselves against exploitative managers, and carrying the burden of being a translator to fellow migrant colleagues. Based on insight into ethical challenges unique to migrant caregivers, this paper focuses on informal ethics support systems on which migrants relied ‒ an unexplored area in the literature on ethics support within social care ‒ and explores formal ethics support systems that could support migrant caregivers in the future. Existing literature shows that the UK in general lacks ethics support systems to help caregivers recognize and appropriately address ethical challenges. The literature goes on to explore kinds of formal ethics support systems that could address ethical challenges. However, the literature completely overlooks needs and challenges unique to migrant caregivers who increasingly constitute the older adult care workforce in the UK. Understanding everyday ethical challenges and informal support systems of migrant caregivers are important steps in ensuring wellbeing of caregivers, and thus, quality of care. "

scholarly journals EMERGING ADULT CAREGIVERS: PERCEPTIONS OF OLDER ADULT CARE RECIPIENTS, QUALITY OF CONTACT, AND AGEISM

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S952-S952
Author(s):  
Anastasia E Canell ◽  
Grace Caskie
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Social Role ◽  
Emerging Adult ◽  
Care Recipient ◽  
Adult Care ◽  
Care Recipients ◽  
Adult Caregivers ◽  
Quality Of Contact

Abstract Approximately 12-18% of family caregivers to older adults in the U.S. are 18-25 years old (i.e., emerging adulthood), yet minimal research has focused on this subgroup of caregivers (Levine, 2005; Smyth, Blaxland, & Cass, 2011). Individuals’ perceptions of an older adult’s social role relate to their attitudes toward older adults as a group (Hummert, 1999; Kite & Wagner, 2002). However, whether perceptions that emerging adult caregivers hold of older adults are specific to the social role of “care-recipient” has not been studied. A sample of 210 informal caregivers (ages 18-25) were surveyed to collect qualitative responses regarding perceptions of an older adult care-recipient (age 65+) and to assess quality of contact with the care-recipient and ageist attitudes. Participants were asked to provide five adjectives describing their older adult care-recipient. Approximately 43% provided a set of adjectives in which 80%-100% were coded as positive adjectives (e.g., “active”, “wise”); similarly, half of the sample’s adjective sets contained 0%-25% negative adjectives (e.g., “helpless”, “obnoxious”). The quality of contact with the care-recipient was significantly correlated (p<.001) with the percentage of positive (r=.47) and negative (r=-.49) adjectives. Scores on the Fraboni Scale of Ageism were also significantly correlated (p<.01) with the percentage of positive (r=-.19) and negative (r=.20) adjectives. Overall, these emerging adult caregivers had generally positive perceptions of their older adult care-recipients, and these perceptions reflected the positive quality of contact with the care-recipient. Less ageist attitudes’ relationship with more positive and less negative perceptions may have implications for experiences within a caregiving dyad.

A Scoping Review of the Evidence About the Nurses Improving Care for Healthsystem Elders (NICHE) Program

2019 ◽  
Author(s):  
Allison Squires ◽  
Komal Patel Murali ◽  
Sherry A Greenberg ◽  
Linda L Herrmann ◽  
Catherine O D’amico
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Quality Of Care ◽  
Work Environment ◽  
Older Adult ◽  
Patient Outcomes ◽  
Scoping Review ◽  
Adult Care ◽  
Program Adoption

Abstract Background and Objectives The Nurses Improving Care for Healthsystem Elders (NICHE) is a nurse-led education and consultation program designed to help health care organizations improve the quality of care for older adults. To conduct a scoping review of the evidence associated with the NICHE program to (a) understand how it influences patient outcomes through specialized care of the older adult and (b) provide an overview of implementation of the NICHE program across organizations as well as its impact on nursing professionals and the work environment. Research Design and Methods Six databases were searched to identify NICHE-related articles between January 1992 and April 2019. After critical appraisal, 43 articles were included. Results Four thematic categories were identified including specialized older adult care, geriatric resource nurse (GRN) model, work environment, and NICHE program adoption and refinement. Specialized older adult care, a key feature of NICHE programs, resulted in improved quality of care, patient safety, lower complications, and decreased length of stay. The GRN model emphasizes specialized geriatric care education and consultation. Improvements in the geriatric nurse work environment as measured by perceptions of the practice environment, quality of care, and aging-sensitive care delivery have been reported. NICHE program adoption and refinement focuses on the methods used to improve care, implementation and adoption of the NICHE program, and measuring its impact. Discussion and Implications The evidence about the NICHE program in caring for older adults is promising but more studies examining patient outcomes and the impact on health care professionals are needed.

Enhancing Wellbeing for Older Adults With Serious Mental Illnesses: Co-Producing a Positive Psychology Course With Certified Older Adult Peer Specialists

2021 ◽  
pp. 104973232199204
Author(s):  
Lydia P. Ogden
Keyword(s):  
Older Adults ◽  
Positive Psychology ◽  
Older Adult ◽  
Mental Illnesses ◽  
Subjective Experiences ◽  
Individual Interviews ◽  
Peer Specialists ◽  
Psychology Course ◽  
Serious Mental Illnesses

Compared to peers in the general population, persons aging with serious mental illnesses (SMIs) face physical health disparities, increased isolation, and decreased subjective experiences of quality of life and wellbeing. To date, limited intervention research focuses on addressing specific needs of persons aging with SMIs and no interventions targeted for that population are informed by the theory and science of positive psychology. With the aim of co-producing a positive-psychology-based program to enhance wellbeing for older adults with SMIs, the author held a series of focus groups and individual interviews with six certified older adult peer specialists. Analysis of the data developed in-depth insights into helpful processes, values, and priorities of individuals aging with SMIs, as well as the creation of a wellbeing-enhancing course curriculum.

‘Who Ya Gonna Call …?’ Ethical and legal dilemmas in specialist children centres and district general hospitals

2021 ◽  
pp. 147775092110366
Author(s):  
Harika Avula ◽  
Mariana Dittborn ◽  
Joe Brierley
Keyword(s):  
Intensive Care ◽  
Clinical Ethics ◽  
Ethical Issues ◽  
General Setting ◽  
Daily Practice ◽  
Paediatric Intensive Care ◽  
Ethical Challenges ◽  
Legal Cases ◽  
Ethics Support ◽  
The Uk

The field of Paediatric Bioethics, or ethical issues applied to children's healthcare, is relatively new but has recently gained an increased professional and public profile. Clinical ethics support to health professionals and patients who face ethical challenges in clinical practice varies between and within institutions. Literature regarding services available to paediatricians is sparse in specialist tertiary centres and almost absent in general paediatrics. We performed a mixed-methods study using online surveys and focus groups to explore the experiences of ethical and legal dilemmas and the support structures available to (i) paediatric intensive care teams as a proxy for specialist children's centres and (ii) paediatricians working in the general setting in the UK. Our main findings illustrate the broad range of ethical and legal challenges experienced by both groups in daily practice. Ethics training and the availability of ethics support were variable in structure, processes, funding and availability, e.g., 70% of paediatric intensive care consultants reported access to formal ethics advice versus 20% general paediatricians. Overall, our findings suggest a need for ethics support and training in both settings. The broad experience reported of ethics support, where it existed, was good – though improvements were suggested. Many clinicians were concerned about their relationship with children and families experiencing a challenging ethical situation, partly as a result of high-profile recent legal cases in the media. Further research in this area would help collect a broader range of views to inform clinical ethics support's development to better support paediatric teams, children and their families.

scholarly journals The Psychological and Demographic Factors of Quality of Life in Older Adults

2020 ◽  
Vol 2 (1) ◽  
pp. 45-59
Author(s):  
Indra Yohanes Kiling ◽  
Johana Endang Prawitasari
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Regression Analysis ◽  
Older Adult ◽  
Psychological Factors ◽  
Positive Relationship ◽  
Demographic Factors ◽  
The Relationship ◽  
Major Hypothesis

This research aims to determine the relationship between psychological and demographic factors, which are dispositional optimism, and self-efficacy are the psychological factors, meanwhile home, sex and ethnicity as the demographic factors of quality of life in the older adults. The major hypothesis of this research proposed that there are positive relationship from both psychological factors and demographic factors to the quality of life in older adults. This study involved 53 older adult peoples. The result of multiple regression analysis shows that there is a positive relationship from all five variables to the quality of life in older adults as big as 76,5% (Adjusted R2= 0,765). This result means that both the psychological and demographic factors do have effective contributions to the quality of life in older adult people. The results of t-tests are also discussed.

scholarly journals Quality of Life in Older Adult Care Homes: Comparing Office Hours with Out-of-Office Hours

2019 ◽  
Vol 0 (2019) ◽  
pp. 153
Author(s):  
N. Smith ◽  
A.-M. Towers ◽  
S. Palmer ◽  
G. Collins
Keyword(s):  
Quality Of Life ◽  
Older Adult ◽  
Care Homes ◽  
Adult Care

scholarly journals Collaborative Development of an Older Adult Experience Survey for Specialized Geriatric Services

2021 ◽  
Vol 24 (2) ◽  
pp. 96-110
Author(s):  
Ronaye Gilsenan ◽  
Rhonda Schwartz ◽  
Iris A. Gutmanis ◽  
Adam M.B. Day ◽  
David P. Ryan ◽  
...  
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Patient Experience ◽  
Item Analysis ◽  
Cognitive Interviews ◽  
Study Objective ◽  
Specific Patient ◽  
Experience Survey ◽  
Survey Research Methods

Background While generic, site, and disease-specific patient experience surveys exist, such surveys have limited relevance to frail, medically complex older adults attending appointment-based specialized geriatric services (SGS). The study objective was to develop and evaluate a patient experience survey specific to this population. Methods Using established survey research methods, this study was conducted collaboratively with older adults (patients and family members/friends) at three Ontario sites offering SGS. The study was done in three phases: Phase One—literature review, evi­dence alignment, and operationalization of core survey items; Phase Two—cognitive interviews and refinement; and Phase Three—pilot testing, survey item analysis, and refinement. Results Based on an evidence-informed framework, the “Older Adult Experience Survey” includes 12 core items, two global rat­ing items, two open-ended questions, and two demographic questions. The summed 12 core items demonstrated accept­able internal consistency (Cronbach’s alpha: 0.83), and the correlation between the summed score and a global question was 0.59, providing evidence of construct validity. The survey also demonstrated face and content validity. Conclusion This open access, collaboratively developed, psychometrically sound patient experience survey can be used to assess, then improve, the clinical experience and quality of care of older adults attending appointment-based SGS clinics/programs.

scholarly journals Older Adult Segmentation According to Residentially-Based Lifestyles and Analysis of Their Needs for Smart Home Functions

2020 ◽  
Vol 17 (22) ◽  
pp. 8492
Author(s):  
Jiyeon Yu ◽  
Angelica de Antonio ◽  
Elena Villalba-Mora
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
General Population ◽  
Older Adult ◽  
Smart Home ◽  
Social Care ◽  
Social Events ◽  
Care Systems ◽  
Different Characteristics

Globally, the percentage of older people in the general population is growing. Smart homes have the potential to help older adults to live independently and healthy, improving their quality of life, and relieving the pressure on the healthcare and social care systems. For that, we need to understand how older adults live and their needs. Thus, this study aims to analyze the residentially-based lifestyles (RBL) of older adults and segment them to compare and analyze the real needs of smart home functions for each group. To identify a person’s RBL, a questionnaire was designed to include questions about activities at home, social events, quality of life, etc. This study surveyed 271 older Koreans. As a result of the survey on RBL, five groups with different characteristics were clustered. Finally, each groups’ features and the differences in their needs for smart home functions were compared and analyzed. The priority of needed functions for each group was found to be significantly different. In a total of 26 smart home functions, there were meaningful differences in the needs for 16 functions among the groups. This study presents the results in South Korea, according to older adults’ RBL and their smart home needs.

Anticipatory care planning for older adults: a trans-jurisdictional feasibility study

2020 ◽  
Vol 70 (suppl 1) ◽  
pp. bjgp20X711197
Author(s):  
Dagmar Corry ◽  
Julie Doherty ◽  
Adrienne McCann ◽  
Frank Doyle ◽  
Christopher Cardwell ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Primary Care ◽  
Action Plan ◽  
Randomised Trial ◽  
Cluster Randomised Trial ◽  
Care Planning ◽  
Healthcare Needs ◽  
The Uk

BackgroundAs the population of older adults’ increases, the complexity of care required to support those who choose to remain in the community has also increased. Anticipatory Care Planning (ACP) through earlier identification of healthcare needs is evidenced to improve quality of life, decrease the number of aggressive futile interventions, and even to prolong life.AimTo determine the feasibility of a cluster randomised trial to evaluate the implementation and outcomes of Anticipatory Care Planning (ACP) in primary care to assist older adults identified as at risk for functional decline by developing a personalised support plan.MethodGP practices were randomised into control/intervention groups stratified by jurisdiction [Northern Ireland (UK) and the Republic of Ireland (RoI)], and by setting (urban and rural). Participants were included if they were a) aged ≥70 years, b) 2 or more chronic medical conditions, c) 4 or more prescribed medications. The Anticipatory Care Plan consisted of home visits where the study nurse discussed patients’ goals and plans. An action plan was put in place following consultation with patient’s GPs and study Pharmacist.ResultsEight primary care practices participated; four in the UK and four in the RoI. Sample n = 64. Data was collected pertaining to patient quality of life, mental health, healthcare utilisation, costs, perception of person-centred care, and the use of potentially inappropriate medication.ConclusionUnique insights relating to the trans-jurisdictional delivery of healthcare services in the UK and RoI were observed which has implications on service delivery for older adults.

The quality of self, social, and directive memories

2013 ◽  
Vol 37 (5) ◽  
pp. 395-406 ◽  
Author(s):  
Nicole Alea ◽  
Mary Jane Arneaud ◽  
Sideeka Ali
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Age Groups ◽  
Social Function ◽  
Autobiographical Memories ◽  
Middle Aged ◽  
Younger Adults ◽  
Directive Function ◽  
Middle Aged Adults

The quality of functional autobiographical memories was examined in young, middle-aged, and older adult Trinidadians ( N = 245). Participants wrote about an event that served a self, social, and directive function, and reported on the memory’s quality (e.g., significance, vividness, valence, etc.). Across age groups, directive memories were the most negative, and social function memories were the most positive. Social function memories were also talked about most. Compared to younger adults, older adults’ functional memories, regardless of the type of function, were positive and talked about often, and middle-aged adults’ memories were significant and vivid. The discussion encourages researchers to continue to simultaneously consider both why humans remember so much of their life, and what they remember when doing so.

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