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Extending expectations of older peoples’ services and research
International policy and political trends seem to reflect many peoples’ need to be better recognised and listened to. Countries such as the UK have seen distinctive contributions made by older people, a group acknowledged as committed citizens and voters and who have articulated their concern that they should take their chances to actively defend their sense of community and values. As a journal, Quality in Ageing and Older Adults seeks to ensure that the diversity of voices and range of experiences of older peoples’ lives and supports can be articulated in ways and places that can shift the boundaries of expectations. The articles in this issue present some notable examples of extending expectations for older people and for research to reflect these, sometimes through remarkable intellectual and personal commitment.
In an international context, Park’s findings from the most recent wave of the Korean Retirement and Income Study demonstrate in detail, highly gendered effects on economic wellbeing which reflect the very different history of labour market participation and personal income of men and women, and consequently, in access to pensions benefits. These findings highlight that even where a government has been able to develop a comprehensive public pension system, further policies will be needed to mitigate gender inequalities.
Innovations in supported housing to offer older people more integrated and cost-effective options to through a hub approach to coordinate community services, are considered by four case studies from different settings presented by Evans et al. using data from the UK Adult Social Services Environments and Settings project. Their findings suggest the need for such schemes to be adaptable to local circumstances and individual concerns.
Examining the usefulness of discrete choice experimental methods to compare preferences for home care provision of carers of people with dementia, may offer a means to strengthen both the evidence base and carers’ voice. The study reported here by Chester et al. builds on partnerships with voluntary organisations and lay involvement to identify relevant attributes of home care likely to be relevant in using such findings to inform the development of policies and services.
As people with dementia are increasingly likely to spend later life stages in long-term care, more research is becoming available to judge the implications of this care option for the quality of life of individuals and their family caregivers. A review of such research identified in American, European and Asian countries by Moon et al. suggests differing quality of life outcomes for service receivers and family caregivers following a move into long-term care and the need for more detailed evidence of how individuals are supported to choose and to adapt to different types of residential care environments.
In response to the pressures on many long-term care providers, in some countries individual companions are employed, often on low pay and insecure terms, as a means to supplement the limitations of their residential and nursing care systems. The study carried out in Ontario, Canada uses a feminist political economy framework to identify micro-level experiences, meso-level facilities and macro-level policies, to make visible and explain effects of moral distress experienced by nursing staff and the less professionally regulated staff producing relational care within this care system. The authors argue for a “larger conversation” about how to meet the increasingly complex care needs of people living in long-term care.
Creative use of arts is becoming recognised as having potential to dramatically improve the quality of life of people with dementia including those living in residential care. Improvised music making can encourage in-the-moment attunement to group dynamics involving care homes staff, musicians and music therapists with people with dementia. The evaluation study reported here by Keady et al. of the effects on inclusion, of offering opportunities to improvise music making highlighted the potential to stimulate and engage embodied meanings as a means of making new communication pathways available in such care settings.
In the final contribution to this issue, Justin Rogers remembers the outstanding commitment of Beatrice Godwin “researcher, social worker and activist” to exploring and evidencing novel ways to recognise the voice and creativity of people with dementia to shape both services and research. Her final article “Bedlam and Bliss” was remarkable in tenaciously presenting important findings from her doctoral research conducted despite long-term ill health and institutional limitations on the participation in research of people with dementia. This was completed and published in her final months, in Issue 16.4 of this journal (Godwin and Poland, 2015). The impact of her life and work will continue to offer inspiration to those seeking to continue her quest to extend recognition of the potential of older people.
Godwin, B. and Poland, F. (2015), “Bedlam or bliss? Recognising the emotional self-experience of people with moderate to advanced dementia in residential and nursing care”, Quality in Ageing and Older Adults, Vol. 16 No. 4, pp. 235-48.