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1 – 10 of 721Lisa Wood, Nicholas J.R. Wood, Shannen Vallesi, Amanda Stafford, Andrew Davies and Craig Cumming
Homelessness is a colossal issue, precipitated by a wide array of social determinants, and mirrored in substantial health disparities and a revolving hospital door. Connecting…
Abstract
Purpose
Homelessness is a colossal issue, precipitated by a wide array of social determinants, and mirrored in substantial health disparities and a revolving hospital door. Connecting people to safe and secure housing needs to be part of the health system response. The paper aims to discuss these issues.
Design/methodology/approach
This mixed-methods paper presents emerging findings from the collaboration between an inner city hospital, a specialist homeless medicine GP service and Western Australia’s inaugural Housing First collective impact project (50 Lives 50 Homes) in Perth. This paper draws on data from hospitals, homelessness community services and general practice.
Findings
This collaboration has facilitated hospital identification and referral of vulnerable rough sleepers to the Housing First project, and connected those housed to a GP and after hours nursing support. For a cohort (n=44) housed now for at least 12 months, significant reductions in hospital use and associated costs were observed.
Research limitations/implications
While the observed reductions in hospital use in the year following housing are based on a small cohort, this data and the case studies presented demonstrate the power of care coordinated across hospital and community in this complex cohort.
Practical implications
This model of collaboration between a hospital and a Housing First project can not only improve discharge outcomes and re-admission in the shorter term, but can also contribute to ending homelessness which is itself, a social determinant of poor health.
Originality/value
Coordinated care between hospitals and programmes to house people who are homeless can significantly reduce hospital use and healthcare costs, and provides hospitals with the opportunity to contribute to more systemic solutions to ending homelessness.
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David Bogataj, Valerija Rogelj, Marija Bogataj and Eneja Drobež
The purpose of this study is to develop new type of reverse mortgage contract. How to provide adequate services and housing for an increasing number of people that are dependent…
Abstract
Purpose
The purpose of this study is to develop new type of reverse mortgage contract. How to provide adequate services and housing for an increasing number of people that are dependent on the help of others is a crucial question in the European Union (EU). The housing stock in Europe is not fit to support a shift from institutional care to the home-based independent living. Some 90% of houses in the UK and 70%–80% in Germany are not adequately built, as they contain accessibility barriers for people with emerging functional impairments. The available reverse mortgage contracts do not allow for relocation to their own adapted facilities. How to finance the adaptation from housing equity is discussed.
Design/methodology/approach
The authors have extended the existing loan reverse mortgage model. Actuarial methods based on the equivalence of the actuarial present values and the multiple decrement approach are used to evaluate premiums for flexible longevity and lifetime long-term care (LTC) insurance for financing adequate facilities.
Findings
The adequate, age-friendly housing provision that is appropriate to support the independence and autonomy of seniors with declining functional capacities can lower the cost of health care and improve the well-being of older adults. For financing the development of this kind of facilities for seniors, the authors developed the reverse mortgage scheme with embedded longevity and LTC insurance as a possible financial instrument for better LTC services and housing with care in assisted-living facilities. This kind of facilities should be available for the rapid growth of older cohorts.
Research limitations/implications
The numerical example is based on rather crude numbers, because of lack of data, as the developed reverse mortgage product with LTC insurance is a novelty. Intensity of care and probabilities of care in certain category of care will change after the introduction of this product.
Practical implications
The model results indicate that it is possible to successfully tie an insurance product to the insured and not to the object.
Social implications
The introduction of this insurance option will allow many older adult with low pension benefits and a substantial home equity to safely opt for a reverse mortgage and benefit from better social care.
Originality/value
While currently available reverse mortgage contracts lapse when the homeowner moves to assisted-living facilities in any EU Member State, in the paper a new method is developed where multiple adjustments of housing to the functional capacities with relocation is possible, under the same insurance and reverse mortgage contract. The case of Slovenia is presented as a numerical example. These insurance products, as a novelty, are portable, so the homeowner can move in own specialised housing unit in assisted-living facilities and keep the existing reverse mortgage contract with no additional costs, which is not possible in the current insurance products. With some small modifications, the method is useful for any EU Member State.
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Rose Onyeali, Benjamin A. Howell, D. Keith McInnes, Amanda Emerson and Monica E. Williams
Older adults who are or have been incarcerated constitute a growing population in the USA. The complex health needs of this group are often inadequately addressed during…
Abstract
Purpose
Older adults who are or have been incarcerated constitute a growing population in the USA. The complex health needs of this group are often inadequately addressed during incarceration and equally so when transitioning back to the community. The purpose of this paper is to discuss the literature on challenges older adults (age 50 and over) face in maintaining health and accessing social services to support health after an incarceration and to outline recommendations to address the most urgent of these needs.
Design/methodology/approach
This study conducted a narrative literature review to identify the complex health conditions and health services needs of incarcerated older adults in the USA and outline three primary barriers they face in accessing health care and social services during reentry.
Findings
Challenges to healthy reentry of older adults include continuity of health care; housing availability; and access to health insurance, disability and other support. The authors recommend policy changes to improve uniformity of care, development of support networks and increased funding to ensure that older adults reentering communities have access to resources necessary to safeguard their health and safety.
Originality/value
This review presents a broad perspective of the current literature on barriers to healthy reentry for older adults in the USA and offers valuable system, program and policy recommendations to address those barriers.
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Åsa Vidman and Annika Strömberg
Employees in elderly care have a high rate of sick leave. One explanation is that employees that experience a low level of meaning of work are at a higher risk for long-term sick…
Abstract
Purpose
Employees in elderly care have a high rate of sick leave. One explanation is that employees that experience a low level of meaning of work are at a higher risk for long-term sick leave. The paper aims to discuss these issues.
Design/methodology/approach
This qualitative interview study aims to examine what employees in residential care facilities experience as the meaningful aspects of their work tasks. Interviews with 14 persons employed in residential care facilities were conducted.
Findings
The findings show that meaningful work tasks are about organizing the work to make use of the creativity and knowledge of the staff in order to support relations with older people.
Originality/value
The knowledge about what constitutes a healthy work environment is not as comprehensive as it is about what constitutes health risks. Furthermore, these issues have been considered by only a few qualitative studies about social care in the field of sick leave. Therefore, this qualitative interview study examines what employees in residential care facilities experience as meaningful aspects of their work tasks.
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Tapio Kaasalainen and Satu Huuhka
Ageing populations induce needs to adapt existing housing. With ageing, the number of frail old people, who require assistance in daily life, is also increased. Converting…
Abstract
Purpose
Ageing populations induce needs to adapt existing housing. With ageing, the number of frail old people, who require assistance in daily life, is also increased. Converting existing housing into assisted living enables them to remain in their community while receiving necessary support and care. The purpose is to investigate whether post-war mass housing is spatially appropriate for adaptation into group homes for older people.
Design/methodology/approach
The research material is attained from Finland. Spatial requirements for group homes are drawn from 130 units built or renovated during 2000–2015. Spatial characteristics of mass housing are mapped from 105 apartment buildings built in the 1970s. The latter are matched with the former by comparing the connectivity of layouts, sizes of units and the numbers and sizes of individual spaces.
Findings
Group homes typically utilize a linear layout, which can easily be created in apartment buildings. Individual spaces of a group home fit apartment buildings effortlessly. Whole group home units mostly prove to be spatially feasible but result in looser dimensioning than is typical in existing units. The mass housing stock can be considered a spatial reserve for adaptation into group homes.
Originality/value
This is the first study to employ a large-scale, multi-case spatial mapping approach to analyse the adaptability properties of mass housing into assisted living. The findings pertain primarily to the Finnish context, but a methodology is presented which can be applied to other countries and also to other spatial functions.
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This study aims to explore the calculations and valuations that unfold in everyday practices within social care settings. Specifically, the paper concerns the role of accounting…
Abstract
Purpose
This study aims to explore the calculations and valuations that unfold in everyday practices within social care settings. Specifically, the paper concerns the role of accounting in dealing with multiple calculable and non-calculable spaces within the case management process. The study sheds light on the multiplicity produced in constructing the client as an object through the calculations and valuations embedded in the costing and caring practices in social work.
Design/methodology/approach
This is a qualitative case study in a Swedish social care organisation, with a specific focus on the calculations and valuations within the case management process. The data have been gathered from 20 interviews with social workers, team leaders, managers and a management accountant, along with more than 36 h of on-site observations and internal organisational documents, including policy documents, guidelines and procedural lists.
Findings
The case management process involves interconnected practices in constructing the client as an object. While monetary calculations and those associated with worth are embedded in costing and caring practices, they interact and proliferate in various ways. Three elements are found: transforming service units into centres of calculation, constructing the accounts of calculation and establishing the cost-value calculations. Calculations and valuations are actuated in these elements in describing the need, matching the case with the unit and caseworker and deciding on the measure. The objectification of the client entails the construction of accounts, for example, ongoing qualifications, categorisations and groupings of units, juridical frameworks, case types, needs and measures. As an object multiple, the client becomes different objects at different stages, challenging the establishment accounts, and thus producing a range of calculations and valuations. Such diversity in calculations concomitantly produces more calculations to represent the present and absent multiple facets of the client, resulting in a multiplicity of costing and caring.
Practical implications
The study might flag up for practitioners the possible risks and unintended consequences of depending too much on fixed guidelines and (performance) indicators since social work involves object multiples, which are always in diversity and changeable in situ. Considering the multiple dimensions within the specific contexts could thus be helpful to mitigate such risks in the evaluation of social care processes and the design of (performance) metrics.
Originality/value
This study contributes to the literature on accountingisation by extending the concept as a part of ongoing organisational practices, materialised within the calculations of money and worth in everyday social care. Besides demonstrating their reconsolidation, this study shows a multiplicity of costing and caring practices depending on the way the client is constructed, resulting in the proliferation of accounting(s) and ultimately accountingisation of social work.
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Christopher Towers and Richard Howarth
With the context of changing global and local populations and, for example, their composition and distribution, this paper offers insight to food shopping in later life with a…
Abstract
With the context of changing global and local populations and, for example, their composition and distribution, this paper offers insight to food shopping in later life with a focus on Nottingham and Nottinghamshire in the East Midlands. The work is relevant and important due to the specific population makeup of this area and the challenges in achieving the UN Sustainable Development Goals (SDGs) as a result of population changes/challenges.
The work takes an interdisciplinary view and draws on literature from both social policy and social care and business and marketing. Using this work as a grounding, and insights to primary research from a wider study in this area, the paper offers discussion and comment on:
the importance of food and food shopping in later life;
issues of, and concerns for, health, well-being, identity and community maintenance and resilience (as a direct result of the challenge to SDG achievement); and
the role(s) and responsibility of business from a core business and wider business/corporate responsibility perspective as a reflection of the above and findings of the work.
the importance of food and food shopping in later life;
issues of, and concerns for, health, well-being, identity and community maintenance and resilience (as a direct result of the challenge to SDG achievement); and
the role(s) and responsibility of business from a core business and wider business/corporate responsibility perspective as a reflection of the above and findings of the work.
Using primary research undertaken by the authors, the paper supports findings from existing work from across social policy and care and business and management – related to the practicalities, challenges and the role of and approaches to food shopping in later life. It specifically offers insight to the efforts made by older food shoppers to maintain their independence and support their choices in a context of interdependence (e.g. within a family, community and environment). The importance social aspects of food shopping (as a counter to isolation and loneliness for example) are also identified and how, for example, the actions of business(es) may undermine the efforts (and resilience) of individuals and communities. “Better” understanding of food shoppers by business and other stakeholders is promoted.
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Marie-Therese Christiansson and Olof Rentzhog
Despite many efforts within organizations toward business process orientation (BPO), research on real-world experiences remains in its infancy. The purpose of this paper is to…
Abstract
Purpose
Despite many efforts within organizations toward business process orientation (BPO), research on real-world experiences remains in its infancy. The purpose of this paper is to redress the existing knowledge gap by analyzing a Swedish public housing company that has made notable effects regarding BPO and to explore lessons learned from the BPO journey (from 1998 to 2013).
Design/methodology/approach
The point of departure is principles in the BPO foundation, principles of successful BPM and effects in empirically based literature. The reconstruction of the narrative case study describes milestones and critical junctions, as well as effects based on quantitative and qualitative data.
Findings
Effects in BPO are demonstrated in terms of higher customer satisfaction, increased innovative ability, improved operational performance, higher employee satisfaction and, as a result of these, increased profitability. Theoretical constructs with implications for the theory building on BPO are suggested in a three-layer management framework – with capabilities and abilities emerging from the case study used as an illustrative example.
Practical implications
Lessons are learned regarding critical practices related to advancement in BPO. A strategy-building process based on eight design propositions is suggested to define the pre-conditions for BPO in an organization.
Originality/value
This is the first longitudinal case study to provide a comprehensive view and detailed insights of a BPO journey and top management performance toward a business process-oriented organization. Practitioners and BPM community get valuable insights into how the temporality and the context shape the BPO maturity process in terms of new organizational structure and roles during the journey.
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The purpose of this paper is to focus on the denial of social support to homeless persons and related societal effects of new local governance arrangements.
Abstract
Purpose
The purpose of this paper is to focus on the denial of social support to homeless persons and related societal effects of new local governance arrangements.
Design/methodology/approach
Analysis of new data and secondary evaluative and comparative data on the policies, administrative structures and management styles of Copenhagen, Glasgow and Amsterdam have brought better understanding of the elements of local governance arrangements that influence the number of homeless persons who are denied access to services and the number of persons sleeping rough who are not eligible for social support. Theoretical explanations for the impact of governance arrangements on these processes and societal effects are considered.
Findings
It appears that while the body of research, reports and policy documents on non-eligibility for homelessness services is growing, legal responses at best remain vague, and policies are still in the process of being developed. Modest progress on policy goals, and even more so on policy instruments, leading to less detrimental outcomes, can be explained by centralising and decentralising trends and the relationships between state and society. The latter may also be indicative of how the increased focus on the legal problems of some EU migrants can be explained.
Research limitations/implications
The two points in time documented for the case studies are relevant in understanding processes underlying the current circumstances of homeless persons and homeless migrants and offer an interdisciplinary insight into governance and politics, law, and public and health service perspectives.
Social implications
Good policy practice, as this paper shows, can lead to a difference in individual lives.
Originality/value
Much is unknown about considerations inside government. This paper contributes by combining theoretical and insider perspectives.
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Nadia Brookes, Sinead Palmer and Lisa Callaghan
The purpose of this paper is to report on the views and experiences of older people using Shared Lives (adult placement) in 2012/2013.
Abstract
Purpose
The purpose of this paper is to report on the views and experiences of older people using Shared Lives (adult placement) in 2012/2013.
Design/methodology/approach
As part of a survey collecting information about outcomes for older users of Shared Lives issues of whether it had made a difference to quality of life, and positive and negative experiences of support were explored.
Findings
Questionnaires were returned by 150 older people using Shared Lives services. Findings suggest that this model of community-based support has a number of advantages for some older people, such as reducing social isolation and loneliness, promoting independence, choice and control, providing emotional support and increased well-being.
Research limitations/implications
The questionnaire was self-completed and so responses were not followed up to provide deeper insights.
Practical implications
Shared Lives is not appropriate for everyone but it is suggested that this option should form part of local commissioning strategies, be part of a range of options for social care practitioners to consider in their work with older people and helps to meet various current policy imperatives.
Originality/value
The potential of Shared Lives for older people is under-researched and this paper contributes to the literature in exploring the views of older people about family-based support in the community.
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