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Open Access
Article
Publication date: 25 April 2020

Ailsa Cameron, Eleanor K Johnson and Simon Evans

This paper explores residents' perceptions and experiences of extra care housing as an integrated model of housing with care.

1253

Abstract

Purpose

This paper explores residents' perceptions and experiences of extra care housing as an integrated model of housing with care.

Design/methodology/approach

Data were collected in a longitudinal qualitative study based on four extra care housing schemes. Data from interviews with residents, care workers, managers and local commissioners were analysed thematically.

Findings

The integration of housing with care enabled many older people to manage their care proactively. However, the increasing number of residents with complex health and care needs, including chronic illness, led some residents to question the ability of the model to support residents to live independently.

Research limitations/implications

The study struggled to recruit sufficient residents from the specialist dementia setting who were able to communicate their consent to take part in the research. In addition, the quality of qualitative data collected in interviews with participants at this setting reduced over successive rounds of interviews.

Practical implications

The study suggests the need to ensure that residents are fully informed about levels of care and support is available when considering a move into extra care housing.

Originality/value

This paper provides a timely opportunity to consider extra care housing as an example of an integrated housing service, particularly in light of the current challenges facing the sector.

Details

Journal of Integrated Care, vol. 28 no. 3
Type: Research Article
ISSN: 1476-9018

Keywords

Open Access
Article
Publication date: 11 October 2022

Anna Laura Hidegh, Carmen Svastics, Zsuzsanna Győri and Sara Csillag

While it is argued that entrepreneurship provides considerable freedom, it is also underlined that it might have the potential for exclusion and oppression. The study contributes…

1666

Abstract

Purpose

While it is argued that entrepreneurship provides considerable freedom, it is also underlined that it might have the potential for exclusion and oppression. The study contributes to this debate and aims to investigate how entrepreneurs with disabilities (EWD) ascribe meaning to freedom in a contested terrain informed by entrepreneurial autonomy as well as constraints due to impairments and an ableist social environment.

Design/methodology/approach

The study uses a qualitative approach and builds upon the critical concepts of negative, positive and social freedom as a theoretical lens for the in-depth analysis of the twenty-nine semi-structured interviews with EWD in Hungary.

Findings

Findings indicate that EWD experiences freedom in ambivalent ways. Engaging in the discourse of entrepreneurship offers a subversive discursive toolkit to debunk the constraints established by ableism, enabling both negative and positive freedom. However, individualism being at the heart of entrepreneurship results in othering and undermines social freedom. Thus, while entrepreneurship offers greater individual freedom in both a negative and a positive sense for people with disabilities (PWD), it nevertheless fails to promote collective social change.

Originality/value

Contributing to the critical disability literature, findings contrast the view that having an impairment only reduces a person's abilities and highlight that it also affects the very nature of liberty. Contributing to critical studies on entrepreneurship, the case of EWD provides empirical evidence for understanding the simultaneous emancipatory and oppressive character of entrepreneurship through the interplay of the subjective experience of freedom related to disability and entrepreneurship.

Details

International Journal of Entrepreneurial Behavior & Research, vol. 28 no. 9
Type: Research Article
ISSN: 1355-2554

Keywords

Open Access
Article
Publication date: 12 July 2023

Anna-Mari Juutinen

The goal of integrated, multidisciplinary and person-centered care is on the welfare policy agenda in many countries, but how about integrated service delivery in action? This…

Abstract

Purpose

The goal of integrated, multidisciplinary and person-centered care is on the welfare policy agenda in many countries, but how about integrated service delivery in action? This paper describes a three-year service journey of an elderly person from home to a nursing home through home care, specialized hospital and inpatient care. The aim of this viewpoint paper is to consider how customer orientation and integration are realized when an older lady living an active life becomes seriously ill and loses the ability to conduct daily functions.

Design/methodology/approach

The service path will be described from the perspective of a relative.

Findings

The paper raises questions related to governance as well as multidisciplinary and customer orientation in integrated care.

Originality/value

The paper discusses a real-life experience of an elderly care journey from active senior life to a nursing home in Finland. When making visible an elderly care journey, this gives real-life information about the challenges and the needs for development. Better practical understanding helps to remove inter-organizational barriers toward more integrated and patient safe care.

Details

Journal of Integrated Care, vol. 31 no. 5
Type: Research Article
ISSN: 1476-9018

Keywords

Open Access
Article
Publication date: 20 September 2023

Sarah Wigham, Eileen Kaner, Jane Bourne, Kanar Ahmed and Simon Hackett

Mental well-being is associated with positive outcomes throughout the life course. This study aims to examine interventions delivered by allied health professionals (AHPs) to…

Abstract

Purpose

Mental well-being is associated with positive outcomes throughout the life course. This study aims to examine interventions delivered by allied health professionals (AHPs) to alleviate community stressors adversely impacting public mental health and well-being.

Design/methodology/approach

Review inclusion criteria comprised experimental and qualitative process evaluations of public mental health interventions delivered by AHPs. Electronic searches in Cinahl, Embase, Medline, PsycINFO and the Cochrane Library, were combined with grey literature searches of National Institute for Health and Care Excellence public health guidance. A narrative synthesis and the Effective Public Health Practice Project appraisal tool were used to evaluate the evidence.

Findings

A total of 45-articles were included in the review describing AHP-delivered interventions addressing social disadvantage, trauma, bullying, loneliness, work-related stress, transitional stress, intersectionality, pain and bereavement. No articles were identified evaluating interventions delivered by operating department practitioners or orthoptists. A conceptual map was developed summarising the stressors, and a typology of public mental health interventions defined including: place-based interventions, discrete/one-off interventions, multi-component lifestyle and social connector interventions and interventions targeting groups at risk of mental health conditions.

Research limitations/implications

Many mental health conditions begin in childhood, and a strength of the review is the life course perspective. A further strength is compiling a compendium of public mental health outcome measures used by AHPs to inform future research. The authors excluded many articles focussed on clinical interventions/populations, which did not meet review inclusion criteria. While playing a key role in delivering public mental health interventions, clinical psychologists are not defined as AHPs and were excluded from the review, and this may be construed a limitation. Given heterogeneity of study designs and interventions evaluated numerical analyses of pooled findings was not appropriate.

Practical implications

The review highlights the breadth of community stressors on which AHPs can intervene and contribute in public mental health contexts, stressors which correspond to those identified in UK Government guidance as currently important and relevant to address. The findings can inform developing community public mental health pathways that align with the UK National Health Service (NHS) Long Term Plan, on prevention and early intervention to protect community mental health and well-being. Further can inform the NHS strategic direction for AHPs including informing ways of increasing utilisation of core AHP skills to optimise contributions in public mental health agendas.

Social implications

It is surprising there were not more AHP delivered evaluations of interventions for other stressors important to address in public mental health settings, for example gambling, domestic violence or that used digital technology, and these are areas for future research. Future research should identify the most active/effective dimensions of multi-component interventions which could be informed by frameworks to guide complex intervention development. The relative paucity of research identified, highlights the predominant focus of research to date on interventions for clinical mental health conditions and populations. The lack of preventative approaches is evident, and an important area for future research to align with UK health and social care priorities.

Originality/value

The review highlights AHP-delivered interventions impacting diverse community stressors across the life course. The findings can inform developing public mental health pathways aligned with government health service priorities to protect mental health and well-being, prioritise prevention and early intervention and increase utilisation of AHP skills across public mental health settings.

Details

Journal of Public Mental Health, vol. 22 no. 4
Type: Research Article
ISSN: 1746-5729

Keywords

Open Access
Article
Publication date: 24 July 2020

Anu Helkkula, Alexander John Buoye, Hyeyoon Choi, Min Kyung Lee, Stephanie Q. Liu and Timothy Lee Keiningham

The purpose of this investigation is to gain insight into parents' perceptions of benefits vs burdens (value) of educational and healthcare service received for their child with…

5927

Abstract

Purpose

The purpose of this investigation is to gain insight into parents' perceptions of benefits vs burdens (value) of educational and healthcare service received for their child with ASD. Parents are the main integrators of long-term educational and healthcare service for their child with ASD.

Design/methodology/approach

Design/methodology/approach included (1) a sentiment analysis of discussion forum posts from an autism message board using a rule-based sentiment analysis tool that is specifically attuned to sentiments expressed in social media and (2) a qualitative content analysis of one-on-one interviews with parents of children diagnosed with ASD, complemented with interviews with experienced educators and clinicians.

Findings

Findings reveal the link between customized service integration and long-term benefits. Both parents and service providers emphasize the need to integrate healthcare and educational service to create holistic long-term care for a child with ASD. Parents highlight the benefits of varied services, but availability or cost are burdens if the service is not publicly provided, or covered by insurance. Service providers' lack of experience with ASD and people's ignorance of the challenges of ASD are burdens.

Practical implications

Ensuring health outcomes for a child with ASD requires an integrated service system and long-term, customer-centric service process because the scope of service covers the child's entire childhood. Customized educational and healthcare service must be allocated and budgeted early in order to reach the goal of a satisfactory service output for each child.

Originality/value

This is the first service research to focus on parents' challenges with obtaining services for their child with ASD. This paper provides service researchers and managers insight into parents' perceptions of educational and healthcare service value (i.e. benefits vs. burdens) received for their child with ASD. These insights into customer-centric perceptions of value may be useful to research and may help service providers to innovate and provide integrated service directly to parents, or indirectly to service providers, who serve children with ASD.

Details

Journal of Service Management, vol. 31 no. 5
Type: Research Article
ISSN: 1757-5818

Keywords

Open Access
Article
Publication date: 10 August 2020

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…

1420

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.

Details

Facilities, vol. 38 no. 9/10
Type: Research Article
ISSN: 0263-2772

Keywords

Open Access
Article
Publication date: 2 October 2017

Donald Hirsch

The purpose of this paper is to describe how the voluntary living wage (LW) in the UK is set. It examines how this calculation relates to contemporary approaches to setting wage…

3325

Abstract

Purpose

The purpose of this paper is to describe how the voluntary living wage (LW) in the UK is set. It examines how this calculation relates to contemporary approaches to setting wage floors, both in relation to their goal of supporting adequate living standards and in relation to the place of wage floors in the labour mark.

Design/methodology/approach

The paper examines how compulsory and voluntary wage floors are being determined, in the UK and in particular the role of public consensus in contributing to the calculation and adoption of a LW. It then reflects on the future sustainability of a system of wage floors in which the concept of the LW plays a significant role.

Findings

The central finding is that widespread support for wages delivering socially acceptable minimum living standards has transformed the context in which low pay is being addressed in the UK. The LW idea has stimulated more decisive efforts to do so; however, if a compulsory version of a LW were to reach a level shown to be harming jobs, this could seriously undermine such efforts. Moreover, the extent to which adequate wages are compatible with high employment levels can also be influenced by state support for households, especially tax credits and Universal Credit.

Originality/value

The paper clarifies how the setting of the UK LW contributes to objectives related both to living standards and to labour markets, and critically addresses some key issues raised.

Details

Employee Relations, vol. 39 no. 6
Type: Research Article
ISSN: 0142-5455

Keywords

Open Access
Article
Publication date: 14 June 2022

Joyce Hlungwani and Adrian D. van Breda

The purpose of this study is to explore the contribution of what the authors have termed, “managed opportunities for independence” (MOI) in building the resilience of young people…

Abstract

Purpose

The purpose of this study is to explore the contribution of what the authors have termed, “managed opportunities for independence” (MOI) in building the resilience of young people in care.

Design/methodology/approach

The study used a qualitative, grounded theory methodology. Nine child and youth care workers were purposively sampled from various child and youth and care centres in South Africa.

Findings

Findings indicate that MOI contribute to the development of resilience of young people in care.

Originality/value

Care-leaving literature recognizes that too much protection does not adequately prepare young people for independent living. There is also increasing attention to the resilience processes that enable care-leavers to thrive during the transition from care to independent living. However, there is limited empirical research that looks at how in-care programmes develop young people’s resilience. In addition, very little is said about what it means for child and youth care practice. This study’s focus on the contribution of “managed opportunities for independence” in building the resilience of young people in care provides a foundation for understanding the care-leaving process better.

Details

Journal of Children's Services, vol. 17 no. 2
Type: Research Article
ISSN: 1746-6660

Keywords

Open Access
Book part
Publication date: 4 October 2023

Andrea Rácz and Dorottya Sik

This chapter discusses how to involve children and young people in decisions and encourage them to express their needs and participate in the decision-making process to develop a…

Abstract

This chapter discusses how to involve children and young people in decisions and encourage them to express their needs and participate in the decision-making process to develop a quality intervention. By describing the different aspects of projects involving a participatory approach, it shows how giving voice to children and young people unlocked new perspectives regarding the Hungarian child protection system. Participation of children in research is limited in Hungary, partly due to the challenging legislation and authorisation process. This chapter shows how research to develop child-friendly digital tools can contribute to collecting children's views on their needs related to child protection support, and how the process of listening to children can improve parenting and caregiving responses to the needs of younger and older children living with their families or in the child protection system. The chapter analyses the effect of digital applications on children's and young people's capacity to advance towards autonomy, including applications and a video campaign with short video clips created by young people. These projects gave an opportunity for children and youth in the public care system to describe their lives and wishes for the future. The analysis found: (a) for a functional child protection system and to promote development for children and young people, children's voices need to be amplified; (b) by expressing their voices, children become more autonomous; (c) children's voices contribute to decreasing social prejudices against children and young people in public care; and (d) listening to children and youth who age out of care can help professionals working in the child protection system better understand their beneficiaries.

Details

Participatory Research on Child Maltreatment with Children and Adult Survivors
Type: Book
ISBN: 978-1-80455-529-3

Keywords

Open Access
Article
Publication date: 2 October 2018

James Sanderson and Nicola Hawdon

The purpose of this paper is to outline how personal health budgets and a universal, integrated model of support, can positively transform the way in which individuals with a…

2834

Abstract

Purpose

The purpose of this paper is to outline how personal health budgets and a universal, integrated model of support, can positively transform the way in which individuals with a learning disability experience their health and support needs.

Design/methodology/approach

The review recognises that Integrated Personal Commissioning, as a policy approach, provides the framework to offer personalised care, and enables people to live an independent, happy, healthy and meaningful life.

Findings

Evidence suggests that a personalised and integrated approach to both health and social care not only offers better outcomes on all levels for the individual, but also benefits the system as a whole.

Originality/value

The study reveals that a personalised care leads to people to have choices and control over decisions that affect in better health and wellbeing outcomes for people.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 13 no. 1
Type: Research Article
ISSN: 2044-1282

Keywords

1 – 10 of over 3000