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The Green Paper's vision for the future of adult social care confirms New Labour's subsumption of the specific social problem of ‘elder abuse’ under a generic adult protection strategy, explicitly located within an overarching policy and legislative framework of social care generally.

The transition from pediatric to adult health care is challenging for youth with autism spectrum disorder (ASD). Many tools have been developed to facilitate transition but studies have not assessed their utility or readiness to be implemented in primary care practices. The purpose of this paper is to rate existing health care transition tools to identify tools ready for use in primary care clinics and develop a set of transition principles.

Four pediatric and family medicine providers from community health centers reviewed 12 transition tools and provided ratings and in-depth responses about the usefulness and feasibility of each tool through online surveys and telephone interviews. A conference call was used to discuss the findings and develop a set of transition principles.

The top rated tools included three youth self-management tools, two tools focused on ASD information and one tool focused on communication. No one tool was top rated by all providers and none of the tools was ready to be implemented without revisions. The transition principles developed focused on the use of selected tools to involve all youth in regular conversations about transition at every well child visit beginning at age 14 and adapting that process for youth with special needs.

This study is unique in asking primary care providers to assess the applicability of incorporating existing and publicly available transition tools in their own practices and developing a set of transition principles.

The purpose of this paper is to consider the role of the Mental Health Act (MHA) 1983 in safeguarding adults at risk of abuse and neglect. The author has undertaken a thematic review of Safeguarding Adults Reviews (SARs) commissioned in England and Adult Practice Reviews (APRs) commissioned in Wales where the MHA 1983 was a central aspect to the review.

Reviews were included based on specific determinants, following analysis of SARs, APRs and executive summaries. This should not affect the credibility of the research, as themes were identified in conjunction with analysis of literature regarding use of the MHA in the context of adult safeguarding. Consequently, this review has been underpinned by evidence-based research in the area of study.

The interaction between statutes, such as the MHA 1983 and Care Act 2014, signify challenges to professionals, with variable application of mental health legislation in practice.

Lack of a complete national repository for review reports means that it is likely that the data set analysis is incomplete. It was noted that limitations to this research include the fact that Safeguarding Adults Boards in England may not publish SAR reports or may choose to publish an executive summary or practice brief instead of the full SAR report, therefore limiting the scope of disseminating learning from SARs, as this is difficult to achieve where the full report has not been published. The author aimed to mitigate this by undertaking comprehensive searches of Local Authority and SAB websites, in addition to submitting Information requests to ensure that this research encompassed as many relevant review reports as possible.

This is an important and timely topic for debate, given that the UK Government is proposing reform of the MHA 1983. In addition, existing thematic reviews of SARS tend to be generalised, rather than specifically focused on the MHA.

This study aims to examine primary care physicians who are in a tenable position to identify signs of abuse in older adults as well as provide an opportunity to safeguard them from abuse. Yet little is known about their clinical decision-making process during a clinic visit to detect abuse of older adults and provide adequate support in the Caribbean.

Fourteen primary care physicians working in a government operated free clinic were interviewed about their clinical decision-making process, in a narrative analysis format on the small island state of Trinidad and Tobago.

Primary care physicians expressed lack of knowledge about the primary health-care clinics’ protocols and procedures regarding abuse of older adults. Lack of attendance to educational in-service programs on recognizing and reporting abuse of older adults. A hands-off approach with non-medical abuse issues. Last there is no uniform assessments among the different types of physicians.

Although these findings are among primary care physicians located in Trinidad and Tobago, the context may be applied to primary care settings in other Caribbean islands. Major focus should be geared towards increasing awareness among the public and health-care professionals.

Sparse research on small island states regarding safeguarding policies for older adults who experience abuse.

Barbados is at a very advanced stage of population aging. Health care services are designed to ensure universal access for all Barbadians but the contributing factors for older adults’ health care utilization are not well explored. This chapter examines gender differences in the correlates of seeking medical care among older adults in Barbados.

Logistic regression models were applied to data drawn from the 2000 Survey of Health, Well-Being and Aging of Older Adults in Latin America and the Caribbean (SABE), Bridgetown sample (n = 1,068).

Health needs, based on chronic conditions, were positively associated with seeking medical care for men and women. Different forms and directions of intergenerational support were associated with men and women seeking care. Among men, receiving financial support was positively associated with seeking care. Among women, providing financial support was associated with lower odds of seeking care while receiving instrumental support was associated with higher odds of seeking care.

Medical care is only one form of health care use and there is no specification of the nature of care or consultation. The sample is cross-sectional and limited to older adults in urban areas. The relative importance of enabling factors and health needs, especially, may differ across time and space within Barbados.

The study contributes to the literature on health care utilization among older adults within developing countries and highlights the pertinence of family relations influencing gender differences in health care utilization.

This paper argues for a case management rationale in adult protection management and practice, drawing insights from a series of linked training initiatives and an evaluation of the role of the specialist adult protection co‐ordinator. An explicit case managed approach contrasts with much current practice for adult protection, where responsibilities often vary widely within, between and across agencies and professional and worker roles.

The purpose of this paper is to explore the lived experiences of adapting to care dependency among adults receiving health and social care in ordinary housing.

This was done by conducting a phenomenological study by interviewing ten adults, receiving home care services in ordinary housing.

Participants not only adapted by becoming a “good patient” but they had four strategies they used: sociability, distance, competence and compliance, contributing to a sense of dignity and personal safety.

Further research is needed regarding how to preserve quality of care with adults with various ways of adapting to care dependency.

The relationship between professionals and adults in care dependency is a dynamic process where a need for understanding different modes of adaptation is vital. Good treatment and quality care may be different things to different adults, depending on what aspects of the process of adaptation concern them the most, and depending on their individual adaptation strategy.

This paper contributes to the understanding of modes of adaptation to care dependency from the perspective of adults indicating that working person centered may include respecting strategies not traditionally being associated with “the good patient.”

This study examines the effect of a Medicaid disenrollment on employment, sources of health insurance coverage, and health and health care utilization of childless adults using longitudinal data from the 2004 Panel of the Survey of Income and Program Participation. From July to September 2005, TennCare, the Tennessee Medicaid program, disenrolled approximately 170,000 adults following a change in eligibility rules. Following this eligibility change, the fraction of adults in Tennessee covered by Medicaid fell by over 5 percentage points while uninsured rates increased by almost 5 percentage points relative to adults in other Southern states. There is no evidence of an increase in employment rates in Tennessee following the disenrollment. Self-reported health and access to medical care worsened as hospitalization rates, doctor visits, and dentist visits all declined while the use of free or public clinics increased. The Tennessee experience suggests that undoing the expansion of Medicaid eligibility to adults that occurred under the Affordable Care Act likely would reduce health insurance coverage, reduce health care access, and worsen health but would not lead to increases in employment.

The purpose of this paper is to provide an overview of the process of commissioning adult social care services in England. It reflects the literature on commissioning at the strategic level followed by a section on operational or micro-commissioning. The rest of the paper focusses on the emergence of ideas about outcomes-based commissioning (OBC) in the field of adult social care and ends with critical consideration of the effectiveness of OBC in adult social care as applied to support and care provided in extra care housing.

The review of strategic and operational commissioning in adult social care in England (and Scotland in brief) is based on both policy documents and a review of the literature, as are the sources addressing OBC in adult social care particularly in extra care housing settings.

The core of this paper focusses on the challenges to the implementation of OBC in adult social care in the context of provision for residents in extra care housing. Of central importance are the impact of the squeeze on funding, increasing costs as a result of demographic change and the introduction of a national living wage plus the focus on the needs of service users through the idea of person-centred care and resistance to change on the part of adult social care staff and workers in other relevant settings.

Addressing the implementation of OBC in adult social care in England in the context of extra care housing.

This study focuses on the adoption of wearable technologies in a context where care-providing organizations can offer, in collaboration with caregivers, better care. Drawing on dual-factor theory and from the caregiver perspective, this study identifies and examines factors of technology adoption in four developing countries.

This study was undertaken using a quantitative approach. A survey was distributed among 1,013 caregivers in four developing countries in Asia including Iran, Azerbaijan, Turkmenistan and Iraq and collected quantitative data for model validation and hypotheses analysis. Building on the technology adoption literature, we identified six constructs that impact the behavioral intention of caregivers to use wearable technologies in aged care-providing organizations.

Our dual-factor model was successfully validated, and all hypotheses were supported. However, different results were found in the selected countries within the cross-country analysis.

This study has significant implications for the study of emerging technologies in aged care service operations. It provides a theoretical framework that may be adapted for future research, enabling practitioners in aged care to better understand the crucial role of technology adoption in service operations. Less attention was paid to the adoption of wearable technologies in aged care, particularly in developing countries, where healthcare services in aged care impose heavy costs on care providers.