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The purpose of this paper is to outline an approach being taken, to improve opportunities and increase levels of physical activity amongst residents in care homes in Scotland, which has the potential to make a significant difference to the quality of lives. The approach is designed to raise awareness about the importance of physical activity, increase skills, knowledge and capacity amongst the workforce.

The paper describes the reasons for promoting physical activity in care homes. It describes the challenge to this, associated issues and introduces you to a resource pack which offers solutions to care homes through a self-improvement process. It provides a case study which exemplifies how the ideas can be applied on a day-to-day basis.

The paper provides insights into the challenges in the care home sector to promoting physical activity and offers some ways round these. It describes two strategies within the new resource pack to support care home residents to make person centred physical activity choices.

This paper suggests that to promote physical activity in a care home the choices and needs of an individual must be the starting point. It requires partnership working and good leadership where staff have the permission to work in a new way. It suggests that risk enablement is key and the benefits of physical activity outweigh the risks even with frail older people.

This paper promotes a new resource pack for care homes in Scotland for promoting an active life based on a self-improvement process.

The purpose of this paper is to describe the development and application of the KIPP-list of care activities. The acronym KIPP stands for Knowledge and Insight into Primary Processes. The instrument is intended as a tool for family coaches to systematically report care activities conducted in the Dutch family support programme Ten for the Future (in Dutch: Tien voor Toekomst).

The design of the instrument was based on the components of the programme and a literature search for similar instruments used in the Netherlands, complemented by a staff survey. A series of three studies was carried out to test the instrument’s validity and user-friendliness, and to assess its potential for programme evaluation.

The majority of care activities were performed in cooperation with one or both parents alone, and less frequently with children or external professionals. Although the main focus of the work of the family coaches fell into the categories of “collecting information” and “working towards (behavioural) change” with families, the relatively high frequency of all the types of care contacts emphasises the intensity of this family support programme with a complex target group.

Data gathered with the instrument provided meaningful information by descriptive analysis. KIPP thereby proved its general feasibility in increasing insight into service provision. The instrument can be useful in several stages and on several levels of quality assurance and service optimisation, including reflective practice, supervision, team management and research.

This chapter describes gender differences in Montevideo through the study of daily mobility. Generally, mobility studies do not account for gender differences more than in a superficial way, distinguishing basic travel patterns by sex. However, different patterns and mobility behaviours can obscure situations of deeply entrenched gender inequality that have direct consequences on the opportunities that men and women are able to reach. To disentangle these inequalities, this work addresses some mainstream mobility indicators classified by gender but also some specific indicators, with special attention to care mobility as a factor that can restrain women’s ability to move. Moreover, a tour-based analysis is performed to shed light on gendered schedules and mobility patterns. Results show that women’s mode share comprises a larger proportion of transit trips, they travel shorter distances – investing more time – and they contribute in a greater proportion than men to care mobility, especially among the lower quintiles of income. While men’s commuting patterns have a defined ‘home-based work’ profile, women have a higher level of heterogeneity in their daily itineraries. Access to private motorised means of transport is a key variable in explaining the configuration of mobility patterns, and there is a persistent gender gap in this matter. The chapter concludes that, as several authors have reported, gender is a marker in terms of mobility. It sets specific conditions for urban life in general and mobility in particular that, in turn, may be the cause of further inequality.

Time pressures in paid work and household labor have intensified in recent decades because of the increase in dual-earner families and long and nonstandard employment hours. This analysis uses U.S. time-diary data from 1998 to 2000 to investigate the association of employment and household multitasking. Results indicate that mothers do more multitasking than fathers and the gender gap in household labor is largest for the most intense type of multitasking: combining housework and child care. In addition, mothers employed for long hours spend more time multitasking than mothers employed 35–40h per week. It appears that motivations for multitasking are heterogeneous: some multitasking is done out of convenience, whereas other multitaskings are a strategy used to manage too much work in too little time.

The benefits of “green dementia care”, whereby people living with dementia are supported to connect with nature, are increasingly being recognised. Evidence suggests that these benefits span physical, emotional and social spheres and can make a significant contribution towards quality of life. However, care settings often present specific challenges to promoting such connections due to a range of factors including risk-averse cultures and environmental limitations. The purpose of this paper is to report on a project that aims to explore the opportunities, benefits, barriers and enablers to interaction with nature for people living with dementia in residential care and extra care housing schemes in the UK.

Data were gathered from 144 responses to an online survey by managers/staff of extra care housing schemes and care homes in the UK. In depth-case studies were carried out at three care homes and three extra care housing schemes, involving interviews with residents, staff and family carers.

A wide variety of nature-based activities were reported, both outdoor and indoor. Positive benefits reported included improved mood, higher levels of social interaction and increased motivation for residents, and greater job satisfaction for staff. The design and layout of indoor and outdoor spaces is key, in addition to staff who feel enabled to promote connections with nature.

This paper is based on a relatively small research project in which the participants were self-selecting and therefore not necessarily representative.

The paper makes some key recommendations for good practice in green dementia care in extra care housing and care homes.

Outdoor activities can promote social interaction for people living with dementia in care settings. The authors’ findings are relevant to the recent policy focus on social prescribing.

The paper makes some key recommendations for good practice in green dementia care in extra care housing and care homes.

This paper aims to explore how food-focused social activities are a route for promoting intergenerational relationships, well-being and dietary benefits among residents in care homes and children in preschool/schools.

Using a case study methodology, this study undertook staff-focused research on a 26-month UK programme in 12 partnership clusters, involving a range of growing, cooking, eating and community activities.

Staff reported benefits for older people, including improved mood, surfacing positive memories, new personal connections and relief from feelings of boredom and loneliness. Children were reported to develop in-depth relationships, greater empathy and overcame negative preconceptions. Food-based activities enabled all parties to express caring and nurturing in tangible and often non-verbal ways.

Food-based activities appear to have specific material and emotive characteristics that resonate with the intergenerational interests of older people and children. Using mainly in-house resources, this study showed that it is feasible to generate novel food-based practices between children’s education and care home sectors. A “test-and-learn” programme model is recommended, given sensitivities and complexity associated with food-based activities and the limited organizational capacity of care home and early education service providers.

The purpose of this paper is to suggest a typology of customer value cocreation activities and explore the psychological drivers and quality of life outcomes of such activities in a complex health care service setting.

Focus groups with people with Type 2 diabetes and in-depth interviews with diabetes educators were conducted.

Four types of customer value cocreation activities were found (mandatory (customer), mandatory (customer or organization), voluntary in-role and voluntary extra-role activities). In addition, health locus of control, self-efficacy, optimism, regulatory focus and expected benefits are identified as key psychological factors underlying the customers’ motivation to be active resource integrators and resulting in physical, psychological, existential and social well-being.

The study highlights the various types of customer value cocreation activities and how these affect the various quality of life dimensions.

The provision of information and advice for older people arranging their own care is a policy objective. The purpose of this paper is to explore the range and scope of web-based information about care coordination activities for older people in the non-statutory sector in England.

Non-statutory organisations were identified through a structured internet search. Services were screened to identify those providing at least one care coordination activity. A postal survey of services was conducted in 2014 and results compared with the initial findings of the web search.

Almost 300 services were identified, most of which were provided by three organisations: Age UK; Alzheimer’s Society; and the British Red Cross. Brokerage was the most frequently reported care coordination activity; the majority of services focussed on help to stay at home; and carers and older people (including those with dementia) were the target groups most often identified. Comparison of the two information sources revealed a significant agreement between two care coordination’s activities: compiling support plans and monitoring and review.

Findings are based on a purposive sample of organisations and therefore care must be exercised in generalising from them.

This study is one of the first to systematically explore the nature and extent of information about care coordination activities provided by the non-statutory sector in England. It was conducted when policy advocated both an increased role for the non-statutory sector and an increase in self-directed support.

The Western New South Wales Integrated Care Strategy (ICS) was rolled out from November 2014 across three rural sites. The purpose of this paper is to assess its impact on general practices, and examine the feasibility of implementing an ICS, within a predominantly fee-for-service delivery model.

Mixed methods were used to analyse the implementation of the ICS, including practice-level patient data on changes in service provision. This includes unit-record data on 130 enroled patients across three rural sites, as well as qualitative data collection from providers.

There were significant increases in both revenue-generating and non-revenue-generating activities (primarily care coordination activities) associated with implementing the ICS. Each occasion of service involved greater contact time with practice staff other than GPs, as well as greater administration time. There is evidence that ICS activities such as case conferencing and team care planning substitute for traditional GP consultations. Overall, the study found that a significant investment of resources – namely staff time devoted to a range of activities – was required to support the implementation of the ICS. Such an investment was supported both externally and through revenue-generating practice-level activities.

The data collection and evaluation project is ongoing, with analysis based on the first wave of data from three sites.

At the practice level, a substantial commitment of resources is required to invest in, and sustain, a new model of integrated care (IC). This commitment can currently be supported both through higher revenue generation at the practice level, and externally by health system stakeholders, but changes in financial settings could impact on financial viability.

This paper provides evidence on the role of blended payment mechanisms in facilitating the implementation of IC in a rural setting where there are medical workforce constraints.

The significant increase in the number of older adults in the UK population is expected to continue. Physical and psychological problems associated with ageing often require older adults to move into residential care where opportunities to participate in previously enjoyed occupations may be limited. Engagement in self‐selected purposeful activities is positively related to physical and psychological well‐being. This paper aims to focus on some of these issues.

An ethnographic approach, a single case study of one care home in a semi‐rural area of Wales was designed to investigate the balance of occupation of residents. Occupations were observed and recorded using a time‐sampling frame over 12 hours on three consecutive days. Field notes were used to contextualise the data in reflecting the home environment.

The majority spent their time in the lounges and remained passive, interacting infrequently with staff and one another. Little opportunity or intervention has been afforded to residents to encourage or support participation in occupation.

A single case study may not be representative of the experiences of residents in other care homes. Time limited observation over different locations may miss activities. Future research could extend the scope of the study.

Older adults in residential care should be supported to engage in occupations. Employment of occupational therapists could allow support to be individually and appropriately focussed. There are implications for health and social care course design and also for the training of care workers.

The paper illustrates observation of activities in a care home over an extended period.