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The purpose of this paper is to compare data from national social care statistics on day services and home care for people with learning disabilities across England, Scotland, Wales and Northern Ireland.

National social care statistics (England, Scotland, Wales and Northern Ireland) reporting the number of adults with learning disabilities accessing day services and home care were reviewed, with data extracted on trends over time and rate of service use.

Regarding day services, despite some variations in definitions, the number of adults with learning disabilities in England, Scotland and Wales (but not Northern Ireland) using building-based day services decreased over time. Data from Scotland also indicate that adults with learning disabilities are spending less time in building-based day services, with alternative day opportunities not wholly compensating for the reduction in building-based day services. Regarding home care, there are broadly similar rates of usage across the four parts of the UK, with the number of adults with learning disabilities using home care now staying static or decreasing.

Similar policy ambitions across the four parts of the UK have resulted (with the exception of Northern Ireland) in similar trends in access to day services and home care.

This paper is a first attempt to compare national social care statistics concerning day services and home care for adults with learning disabilities across the UK. With increasing divergence of health and social service systems, further comparative analyses of services for people with learning disabilities are needed.

The purpose of this paper is to examine trends over time in social care usage and expenditure for adults with learning disabilities in England.

Returns from councils with social services responsibilities in England concerning social care usage and expenditure were analysed to examine the national picture and trends over time for adults with learning disabilities.

In 2017/2018, 147,915 adults with learning disabilities were receiving long-term social care, an increase of 5.7 per cent from 2014/2015. Social care expenditure increased by 10.2 per cent from 2014/2015 to £5.54bn in 2017/2018; adjusted for inflation this was a 2.7 per cent increase. For adults with learning disabilities who receive social care, increasing numbers of people are living with families or in supported accommodation/living, with gradual declines in the number of people living in residential or nursing care. The number of adults with learning disabilities in temporary accommodation is small but increasing.

While councils appear to be attempting to protect social care for adults with learning disabilities in the face of cuts to council expenditure, social care expenditure and coverage are not keeping pace with likely increases in the number of adults with learning disabilities requiring social care.

This paper presents in one place statistics concerning long-term social care for adults with learning disabilities in England.

The purpose of this paper is to compare data from national social care statistics on the living situations of people with learning disabilities across England, Scotland, Wales and Northern Ireland.

National social care statistics (England, Scotland, Wales, Northern Ireland) reporting the living situations of adults with learning disabilities (residential and nursing care, living with family, other forms of accommodation) were accessed, with data extracted on trends over time and rate of service use.

There were substantial differences in the statistics collected across the UK. Overall, there were higher reported rates of adults with learning disabilities in residential/nursing accommodation in England than Scotland or Wales, but much lower reported rates of adults living in other forms of unsupported and supported accommodation and much lower reported rates of adults living with their families. In all three countries, trends over time suggest that reductions in residential care towards more independent living options may be stalling. In Northern Ireland reductions in currently extensive residential and nursing care services are continuing, unlike other parts of the UK.

Despite similar policy ambitions across the four parts of the UK, statistics on the living situations of adults with learning disabilities report substantial differences.

This paper is a first attempt to compare national social care statistics concerning the living situations of adults with learning disabilities across the UK. With increasing divergence of health and social service systems, further comparative analyses of services for people with learning disabilities are needed.

This paper seeks to set out the Law Commission's final recommendations for the reform of adult social care, including the community care assessment process, service provision, and the recommendations for a new legal framework for adult safeguarding in England and Wales.

The paper discusses each of the Law Commission's recommendations for adult social care and contrasts them with the proposals put forward at the consultation phase of the review.

The paper argues that a single legal framework for adult social care, including adult safeguarding, will have substantial benefits in terms of legal clarity, consistency, and efficiency. A clear and single legal framework is important for older and disabled people, and their carers, in order to understand fully their entitlements, and for local authorities and partnership agencies (such as the NHS and the police) in order to fully understand their responsibilities.

The paper provides a clear summary of the Law Commission's final report – in particular the recommendations for community care assessments and service provision and adult safeguarding.

Caring for older adults is an increasingly complex and multi-dimensional global concern. This article provides a comprehensive definition of the older adult care experience and discusses its key components to help practitioners deliver older adult-centered care to maximize well-being outcomes for older adults.

Based on prior research on service operations, service experience, person-centered care and the unique, evolving needs of older adults regarding their care, this paper develops a conceptual framework in which the older adult care experience is the central construct, and key dimensions of well-being are the outcomes.

The older adult care experience is shaped by older adults' perceptions and evaluations of the care that they receive. Older adult-centered care has autonomy, dignity, unique needs and social environment as its core dimensions and results in those older adults feel empowered, respected, engaged and connected as part of their experience. The article also discusses how such experience can be evaluated by using quality dimensions from service operations, hospitality and healthcare contexts, and challenges that service firms may face in creating older adult care experience.

Given the changing demographics and unique needs of older adults, it is an imperative for academics and practitioners to have an understanding of what determines older adult care experience to better serve them. Such understanding is important as by creating and fostering older adult care experience, service organizations can contribute to individual and societal well-being.

To the authors' best knowledge, this is the first paper to provide a comprehensive conceptualization of the older adult care experience.

This study illuminates the experiences of adults diagnosed with autism spectrum disorders (ASDs) and intellectual disabilities (IDs) and their challenges and successes in receiving quality healthcare services. Individuals with developmental disabilities often experience health issues associated with aging at earlier ages and at higher rates than the general population. This population has a higher incidence of chronic health conditions that require regular medical attention.

The intent of this project was to learn directly from adults and their caregivers how well healthcare providers understand autism, explore their experience with how well their care is coordinated between primary healthcare and other specialty services, and identify factors which could impact access to care and to discover what other barriers which may potentially influence health outcomes for ASD adult.

A qualitative study conducted with semi-structured interviews with 12 adults diagnosed with ASD and/or their guardians/caregivers.

Some of the adults interviewed experienced negative health outcomes and suboptimal relationships with healthcare providers; others seemed to have positive relationships. Clinical and communications accommodations were necessary to make healthcare provision more comfortable. Barriers to accessing healthcare services existed in many forms.

The healthcare needs of the growing population adults diagnosed with ASD/ID are anticipated to be significant. This challenge is further exacerbated given there are few trained healthcare providers who are prepared or dedicated to serve this population. Continuing to build awareness of the health needs of the ASD/ID adult population is critical.

This project is highly innovative as it is the first attempt to understand how the adult autism population accesses care and perceives their healthcare interactions. This study serves as a starting point to suggest new opportunities for further research for this growing population.

The purpose of this study is to explore the lived experiences of the constraints of older adult family caregivers with chronic diseases in caring for and accessing health services during the COVID-19 pandemic.

This study used the descriptive phenomenology qualitative method. The sampling method was purposive sampling involving 16 older adult family caregivers.

The results of this study showed three themes such as difficulties in health services in hospitals during the COVID-19 pandemic (complaints of services provided by doctors, older adult treatment control problems and difficulty getting to hospital health facilities); difficulties accompanying taking older adult medicine (older adult non-compliance response to taking medication and older adult medicine assistance); and psychosocial complaints caring for and accompanying the older adult (negative emotions for the older adult, difficulty interacting with the older adult and the economic burden of caring for the older adult).

Barriers to family caregivers in caring for older adults with chronic diseases can help health-care service providers understand and support families caring for and assisting older adults, which may contribute to the quality of life and care for both family caregivers and older adults.

This study showed that Indonesian family caregivers faced difficulties caring for and living with older adults with chronic diseases during the pandemic. Family caregivers’ experiences are essential when developing an intervention to support and manage health care for older adults with chronic illnesses.

Adults with autism spectrum disorder (ASD) are more likely to have a poor health status because of being diagnosed with a range of physical and mental health conditions and experience disparities in health care. The purpose of this study is to find barriers to health care experienced by adults with ASD and find gaps in health care which health-care providers can work to fill.

This scoping review aimed to identify studies that report on disparities in health and health-care service provisions experienced by adults with ASD. The authors included articles that described health-care disparities for patients with ASD and were published in peer-reviewed journals between January 2010 and April 2022. The authors searched the following databases and medical journals to search for eligible studies: Google Scholar, Pubmed, Elsevier, Sage Publications and Embase. The authors comprehensively searched key terms related to ASD, health care and disparities.

The core defining features of ASD, which include communication and social impairments and deficits in sensory processing, were found to be barriers in the health-care experience of adults with ASD. Continued research and changes in health care, such as developing interventions to empower patients, adequately training providers and increasing the accessibility of the health-care system, are necessary to ensure adults with ASD receive adequate medical care.

Additionally, clarifying the current literature on this topic can guide future research efforts to explore the influence of factors such as gender and the spectrum of autism itself leading to various levels of abilities and their influence on the health-care experience of adults with ASD.

Overall, the findings from this scoping review underline the importance of providing readily accessible evidence-based, age-appropriate primary and hospital health care for adults with ASD.

Further interventions are needed to empower patients, adequately train providers, increase the accessibility of the health-care system, increase support for ASD patients and decrease discrimination.

This paper is a scoping literature review of the original work done by researchers in the field of developmental disorders and health care.

Adults with autism spectrum disorder (ASD) experience significant health-care disparities across physical and mental health domains resulting in poorer health and quality of life. Poor transitions to adult care negatively impact the health of adults with ASD. Current research focuses on personal factors in research samples that lack diversity. The purpose of this study is to examine the lived health-care experiences of geographically and ethnically diverse young adults with ASD in adult care settings in the USA to understand provider and system-level factors affecting their health.

Nine caregivers of young adults with ASD participated in key informant interviews describing their experiences in navigating the health-care system. Data were analyzed using a grounded theory approach.

The data indicated that limited quantity of services, poor quality of services, and high cost of services had a negative effect on the health of adults with ASD. Issues cascaded to become more complex.

Practical implications for payors, providers, persons with ASD and their families are discussed in this paper.

To the best of the authors’ knowledge, this study answers the call to better understand system-level factors affecting the health of geographically and ethnically diverse people with ASD.

Current and predicted continued dramatic increases in international migration and ethnocultural diversity of older adult cohorts pose challenges for health care services. Review studies on ethnoculturally diverse older adults and health care show a lack of focus on their service use experiences. This study aims to report a meta-ethnography that addresses this knowledge gap through answering the review question: How do ethnoculturally diverse older adults who are immigrants experience health careservices?

The authors applied a seven-phase method of meta-ethnography to guide the review. The authors conducted two literature searches (April 2018 and June 2020) in MEDLINE, CINAHL, Embase, Sociological Abstracts and Abstracts in Social Gerontology that yielded 17 papers eligible for review.

“There’s always something positive and something negative” is the overarching metaphor for answering the review question. Findings highlight positive and negative tensions within ethnoculturally diverse older adults’ health care use experiences of understanding and being understood, having trust in providers and the health care system, having needs, preferences and resources met and desire for self-care over dependency. The majority of experiences were negative. Tipping points towards negative experiences included language, fear, provider attitudes and behaviours, service flexibility, attitudes towards Western and traditional health care and having knowledge and resources.

The authors propose concrete actions to mitigate the tipping points. The authors discuss policy recommendations for health care system changes at the micro, meso and macro service levels to promote positive experiences and address mainstream service policy inequities.