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In order to improve the quality of life of older people, whether they live in care homes or domestic settings, new strategies are required that will allow people to have greater control over their own lives as well as promote interdependence rather than dependence on their families and wider communities. The revised, statutory, regulatory framework for care homes in England introduces new ways of judging care services. Greater attention will be paid to service users' views about the service. Care home managers will be expected to supply annual quality assurance reports that include feedback from residents and their relatives. This paper advocates that care homes should establish ‘friends of the care home’ groups as one approach that will facilitate better communication, encourage participation and improve relations between staff, residents and their families and friends. Some of the mutual benefits for the manager and ‘friends’ are identified and guidance on how to set up and sustain a group is offered.

Man has been seeking an ideal existence for a very long time. In this existence, justice, love, and peace are no longer words, but actual experiences. How ever, with the American preemptive invasion and occupation of Afghanistan and Iraq and the subsequent prisoner abuse, such an existence seems to be farther and farther away from reality. The purpose of this work is to stop this dangerous trend by promoting justice, love, and peace through a change of the paradigm that is inconsistent with justice, love, and peace. The strong paradigm that created the strong nation like the U.S. and the strong man like George W. Bush have been the culprit, rather than the contributor, of the above three universal ideals. Thus, rather than justice, love, and peace, the strong paradigm resulted in in justice, hatred, and violence. In order to remove these three and related evils, what the world needs in the beginning of the third millenium is the weak paradigm. Through the acceptance of the latter paradigm, the golden mean or middle paradigm can be formulated, which is a synergy of the weak and the strong paradigm. In order to understand properly the meaning of these paradigms, however, some digression appears necessary.

The purpose of this paper is to explore the concept of homelikeness from the perspective of family members and friends of nursing home residents across different models of nursing homes.

This mixed-methods study examined survey data collected from 397 family members and friends of residents living in 23 nursing homes representing three models of care (traditional, new augmented, and full scope). Participants completed a homelikeness scale and a measure of the importance of nursing home spaces to family members and friends. This study also involved conducting three focus groups with 20 family members and friends to provide further insights into the findings.

Analysis of survey data indicated quite high levels of homelikeness overall. Significant differences did emerge between traditional model nursing homes compared to new full-scope and new augmented models for all items in the homelikeness scale and for many items about nursing home spaces. Qualitative results provided insights into how homelikeness can be fostered through public and private spaces and through care and relationships.

As this study was conducted in one Canadian province, the results may not be applicable to other geographic areas. In addition, there are limitations in survey response rate.

Homelikeness can be supported across models of care by fostering relationships between residents and staff, ensuring that that family and friends feel welcome, and creating public and private physical spaces that are conducive to new and ongoing relationships.

The results provide evidence to nursing home decision makers about how to foster a homelike environment in various models of nursing homes.

The purpose of this paper is to gain a better understanding of the meal context and the food offering in Quebec public nursing homes for non-autonomous seniors, particularly with respect to first-generation immigrants.

A focused ethnography approach was used. Semi-structured interviews were conducted with three distinct groups: non-Quebec-born residents (n=26), their families (n=24) and frontline care staff (n=51). Structured non-participative observations were made in facilities.

First-generation immigrants, however, long ago they arrived in Quebec, adapted with difficulty and often not at all to the food offering. Resident’s appetite for food offer was a problem for reasons related primarily to food quality, mealtime schedules, medication intake, physical and mental condition, and adaptation to institutional life. Family/friends often brought in food. Care staff tasks were becoming increasingly tedious and routinized, impacting quality of care.

Institutions should render procedures and processes more flexible and adapt their food offering to the growing diversity of their client groups. For residents, the meal experience is profoundly transformed in nursing homes in terms of form, conditions, rituals and meaning. A better understanding of lived situations shaped by a more refined cultural sensitivity would go a long way toward achieving a better quality of life not only for residents but also for their families and friends. Care aides, on whose shoulders rests the responsibility of ensuring that meals are safe and pleasant moments for socializing and maintaining social dispositions, are ambivalent about their work.

The paper is based on an original study. To the authors’ knowledge, the literature on the meal context and food offering in Quebec public nursing homes, regardless of population type, was non-existent. Analyzing and interpreting the results by crossing the discourses of immigrant residents, their family and friends, and frontline care staff made it possible to reveal different aspects of the phenomenon, which, if considered together, shed light on the meal context in public nursing homes.

An increase in the ageing UK population is leading to new ways of looking at how we deliver health and social care services in the UK. The use of assisted living technology (ALT) and telecare is already playing a part in these new models of care. Yet despite the current advances in the range of technology and networking capabilities in the home, ALT and telecare solutions have not been taken up as eagerly as might have been anticipated. The study reported here used scenario‐based focus groups with a wide variety of stakeholders in home care to identify the existing barriers to the successful uptake of ALTs and telecare in Scotland. Six focus group sessions were conducted with individual stakeholder groups (social care workers, policy makers, telecare installation technicians, older users, informal carers) and five conducted with mixed stakeholder groups. The focus groups used the same home care scenario to identify and categorise the different perceptions, attitudes, and expectations of the various stakeholders when discussing telecare implementation for a fictitious older couple. The emerging themes from the focus groups were analysed and categorised according to the Framework Analysis approach. We present a synthesised list of the current barriers to the uptake of ALTs and telecare ‐ and discuss how each of these barriers might be overcome. If these barriers are addressed, we believe telehealthcare technologies will be better designed, more usable, easier to prescribe effectively, more acceptable to more users in more contexts, and ultimately more common place in homes throughout the UK.

This chapter presents the findings of a participatory research project on the impact of COVID-19 and the lockdown on the lives of people with intellectual disabilities in Madrid, Spain. It provides a brief overview of the social policy framework with regards to people with disabilities, and how the government responded to the needs of people with disabilities during the pandemic. The research was conducted by seven co-researchers with intellectual disabilities, who explored how people with intellectual disabilities in Madrid had experienced the lockdown and sanitary restrictions from March 2020 to November 2021. Participants included people living at home with their families, in group homes and in residential care. The findings are contrasted with other studies on the impact of the pandemic in Spain. The pandemic revealed the precariousness of the care system, and the urgent need to shift towards a human rights compliant service provision. Our study shows that people with intellectual disabilities experienced restrictions in different aspects of their lives during a longer period, that people living in residential care were more isolated and that there is a general concern with the future. People living in congregated settings were subject to higher restrictions. Some people had become care providers to their parents, and digital skills had been essential to keep in touch with partners, friends and family. Furthermore, people expressed a desire to regain their freedom, meet new people and a concern with lack of employment.

The purpose of this study was to re-examine racial and gender differences in home and community-based services utilization. Using the 1999 National Long Term Care Survey, the Anderson-Newman (1995) health behavioral model, social supports and structural factors were used to examine predictors of service use among four in-home and two community-based services. The results showed that race did not have a significant main effect on service use, but gender had a significant main effect for housework, home delivered meals, and congregate meals. Using an interaction term, older white women reported higher usage of housework. Among the predictors, enabling factors had the strongest effect on the use of personal care/nursing, home delivered meals, transportation and senior centers’ services. The results also indicated the importance of social supports and structural factors, particularly service awareness, in predicting service use. Implications for policies and practice to improve community outreach, access and utilization of services by different racial groups of elders are discussed.

This paper discusses findings from qualitative research exploring young asylum seekers' (aged 18‐25) definitions and experiences of ‘home’ and ‘belonging’ at a time of transition to adulthood and adjustment to life in a new country. Previous research on refugees and asylum seekers has focused largely on either children or adults, often failing to highlight the particular experiences of those in young adulthood. It will be argued that young asylum seekers of this age have specific needs and experiences associated with the dual transition they face, in both adapting to life in the UK and becoming adults, and the changing support network and entitlements available to them as they go through this process.

The purpose of this paper is to explore whether relatives of care home residents are best placed to act as “champions” or advocates for their family members, as is often the expectation.

Focus groups and interviews were conducted with 25 relatives of residents in four care homes for older people in the South East of England. Two rounds of focus groups were held in each participating care home: the first was to discuss any issues arising from the care received, or concerns about the home itself; the second was to enable a deeper exploration of the key themes that arose from the first round and explore why relatives, in this case, failed to complain.

Thematic analysis revealed a complex range of emotions experienced by relatives that contributed to a conflict between what they believed to be the correct response and how they behaved in reality, which led to a culture of acceptance. Analysis revealed some relatives were reluctant to “interfere” for fear of possible negative repercussions, thus they downplayed issues in an attempt not to “rock the boat”.

This paper discusses the flaws in the policy emphasis on personalisation and the reliance on family members as advocates, and concludes with suggestions on how care homes may foster an environment where relatives, and indeed residents, feel comfortable to raise issues and concerns.