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In Sweden, the care of older people and people with disabilities is increasingly carried out by informal carers, often family members, who are unpaid and outside a professional or formal framework. While there is an increasing awareness of the role of carers within service systems and their own needs for support, their involvement in research is underexplored. The purpose of this paper is to explore carers’ views and experiences of involvement in research and development (R&D) work.

A qualitative study was conducted, consisting of 12 individual interviews with carers from different local Swedish carer organizations.

Core findings included carers’ discussions of the perceived challenges and benefits of their involvement in research, both generally and more specifically, in the context of their involvement in the development of a national carer strategy.

Limitations included the relative lack of male carer participants and the convenience sample.

Authentic carer involvement in research demands a high level of engagement from researchers during the entire research process. The provided CRAC framework, with reference to the themes community, reciprocity, advocacy and circumstantiality, may help researchers to understand and interpret carer involvement in research and provide the prerequisites for their involvement.

There is a dearth of studies that systematically examine carer involvement in research. This paper attempts to redress this gap by providing a nuanced analysis of carer involvement in R&D work from the perspective of carers themselves.

The purpose of this paper is to explore the link between one aspect of primary care in England – the annual review by general practitioners for dementia patients – and length of hospital stay (LoS). The annual review should identify the needs of both patients and carers and co-ordinate services across health and social care to address those needs. If this is done well, timely discharge from hospital may be facilitated.

The study uses linked national data from 2006/2007 to 2010/2011 on over 36,000 patients, employing sophisticated statistical techniques to isolate the effect of the annual dementia review on LoS.

Hospital patients discharged to the community have significantly shorter stays if they are cared for by practices that reviewed a higher percentage of their patients with dementia. However, this effect is small and is not evident for patients discharged to care homes or who died in hospital. Longer LoS is associated with a range of co-morbidities, markers of low availability of social care and with intensive provision of informal care.

Although the dementia review has only a modest effect on LoS, the components of the review could improve the health and well-being of those with dementia and their carers.

The study is the first to employ a robust methodology to investigate the impact of the annual dementia review on hospital LoS, an important aspect of the interface between primary and secondary care. There are implications for clinical and financial aspects of health and social care policy.

The aim of this action research was to explore, from a workforce and a patient/carer perspective, the skills and the capacity required to deliver integrated care and to inform future workforce development and planning in a new integrated care system in England.

Semi-structured interviews and focus groups with primary, community, acute care, social care and voluntary care, frontline and managerial staff and with patients and carers receiving these services were undertaken. Data were explored using framework analysis.

Analysis revealed three overarching themes: achieving teamwork and integration, managing demands on capacity and capability and delivering holistic and user-centred care. An organisational development (OD) process was developed as part of the action research process to facilitate the large-scale workforce changes taking place.

This study did not consider workforce development and planning challenges for nursing and care staff in residential, nursing care homes or domiciliary services. This part of the workforce is integral to the care pathways for many patients, and in line with the current emerging national focus on this sector, these groups require further examination. Further, data explore service users' and carers' perspectives on workforce skills. It proved challenging to recruit patient and carer respondents for the research due to the nature of their illnesses.

Many of the required skills already existed within the workforce. The OD process facilitated collaborative learning to enhance skills; however, workforce planning across a whole system has challenges in relation to data gathering and management. Ensuring a focus on workforce development and planning is an important part of integrated care development.

This study has implications for social and voluntary sector organisations in respect of inter-agency working practices, as well as the identification of workforce development needs and potential for informing subsequent cross-sector workforce planning arrangements and communication.

This paper helps to identify the issues and benefits of implementing person-centred, integrated teamworking and the implications for workforce planning and OD approaches.

The comment addresses the idea of substituting professional elder care with informal care provided by early retirees to save economic costs.

The comment arose from reading “How to handle gerontocracy”, scientific research and critical, analytical thinking.

While having early pensioners deliver elderly care has positive implications, substituting professional with informal care must be challenged. First, the “unused reservoir” of early pensioners might be overestimated, as they often already have care responsibilities. Second, the substitution of professional services is already happening due to staff shortages. Third, untrained caregivers might struggle to provide the needed care quality, resulting in worse health outcomes (and higher follow-up costs). Finally, there are concerns of social sustainability: because of role expectations, mainly women may take on care tasks, reinforcing social inequality. Also, the third sector might lose hours of volunteer work.

The comment appeals to a critically rethinking of the idea of substituting professional services with informal care provision and argues for differentiated and well-tailored policy measures, taking into account the complex nature of (informal) caregiving.

The purpose of this paper is to share the learning concerning how services and the paid carers working in them can support people living with dementia (PLWD) and their unpaid carers to overcome social isolation. This learning comes from the key findings from a Social Return on Investment (SROI) evaluation of a Shared Lives (SL) Day support service, known as TRIO.

SROI is a form of cost-benefit analysis that captures and monetises stakeholder outcomes. The SROI evaluation included a rapid evidence review, an interview study and a questionnaire study. The learning shared is drawn from the interview and questionnaire data that explored the reported outcomes relating to social connection, which included data related to participating in meaningful activities, confidence and independence.

PLWD who accessed the SL Day support service experienced better social connection, a sense of control over their activities (including their social activities) and community presence. A key foundation of these outcomes was the meaningful relationship that developed between the PLWD, their unpaid carer and the paid carer.

This evaluation was a pilot study with a small, albeit representative sample size.

The learning suggests feasible and effective ways for paid carers to support the social connection of PLWD and their unpaid carers with their wider community.

There has been little exploration of how community-based short breaks (like SL Day support) can enhance social connection. The authors drew on a social relational model lens to illustrate how this service type had supported successful outcomes of community and social inclusion for PLWD.

Digital systems for independent aging, support and care are not being adopted as hoped. The purpose of this paper is to examine the results of three studies to derive key factors during the development and engineering process of care and support systems for older people that can impact acceptance and uptake to provide support to future projects.

The paper analyzed the results of three qualitative studies, including two detailed case studies and a further study with 35 participants, to derive key factors. Methods for deriving factors are based on thematic analysis to identify common factors across cases and participants.

The findings point to a broad set of interconnected factors that give developers of these types of systems specific recommendations. These highlight what makes these projects complex and identify implications for the development process. Furthermore, they show way the needed user-centered and iterative methods may be in conflict with funding processes.

While others have reported on single projects or looked at acceptance, these studies were the first to explore aspects of the development process that may contribute to the lack of success to date of these types of systems. The results here support more successful outcomes in the future, both by helping people involved in the development of these systems to avoid some of the issues others face and providing input to improve the performance of the engineering process.

The purpose of this paper is to test whether incorporating a 20-week Kundalini yoga programme into a residential home for children improves well-being outcomes.

This is a mixed methods feasibility study. Feasibility was assessed through recruitment and retention rates as well as participants’ self-report perceptions on social inclusion, mental health and well-being and through semi-structured interviews on the benefits of the study. Mutual recovery entailed that children in care (CIC), youth practitioners and management participated together in the Kundalini yoga sessions.

The study initially enrolled 100 per cent of CIC and 97 per cent (29/30) of eligible staff. Attendance was low with an average rate of four sessions per participant (SD=3.7, range 0-13). All the participants reported that the study was personally meaningful and experienced both individual (e.g. feeling more relaxed) and social benefits (e.g. feeling more open and positive). Pre- and post-yoga questionnaires did not show any significant effects. Low attendance was associated with the challenges faced by the children’s workforce (e.g. high levels of stress, low status, profile and pay) and insufficient consultation and early involvement of stakeholders on the study implementation process.

Because of the chosen research approach (i.e. feasibility study) and low attendance rate, the research results may lack generalisability. Therefore, further research with larger samples including a control or comparison group to pilot similar research questions is mandatory.

This study has generated a number of valuable guiding principles and recommendations that might underpin the development of any future intervention for CIC and staff working in children’s homes.

The concept of togetherness and mutuality within residential spaces is discussed in the paper.

The effects of Kundalini yoga have not been reported before in any peer-review publications. This paper fulfils an identified need (i.e. poor outcomes among CIC and residential staff) and shows how movement and creative practices can support the concept of mutual recovery.

The purpose of this paper is to compare home care workers' views of their employment conditions by provider type – private for-profit vs public and non-profit – using the case study of Ireland.

An online survey was distributed to care workers (n = 350) employed by private for-profit, public and non-profit home care providers in Ireland. Returned questionnaires were analysed statistically in R using chi-squared tests to systematically compare key aspects of employment conditions.

Analysis shows that conditions are perceived to be significantly worse for those employed by private for-profit providers (and to a lesser extent non-profit organisations) compared to the public provider. There are wide disparities between public and private sector conditions in terms of contracts, pensions, unsocial hours pay and travel time allowances. The main area of convergence is in relation to employer support, where although the public sector performed better, the difference between the three provider types is smaller.

Relatively little research compares working conditions in private for-profit providers vs public and non-profit providers in Ireland and other countries. The findings can be understood in the context of marketisation reforms and may partly be explained by a lack of regulation in Ireland's home care sector and low unionisation rates amongst care workers employed by private for-profit providers.

The child is at the centre of all Models of Child Health Appraised research and indeed all primary care delivery for children. Appraising models of primary care for children is incomplete without ensuring that experiences of primary care, design, treatment, management and outcomes are optimal for the child. However, the principle of child centricity is not implicit in many healthcare systems and in many aspects of life, yet it is extremely important for optimal child health service design and child health. By exploring the changing concept of ‘childhood’, we understand better the emergence of the current attitude towards children and their role in today’s Europe and the evolution of child rights. Understanding child centricity, and the role of agents acting on behalf of the child, allows us to identify features of children’s primary care systems that uphold the rights of a child to optimum health. This is placed against the legal commitments made by the countries of the European Union and European Economic Area to ensure that children’s rights are respected.

The global Covid-19 pandemic is posing considerable challenges for governments throughout the world and has and will have a significant influence on the shape of peoples social and economic life and wellbeing in the short and longer term. This opinion paper discusses the current health policy response adopted in England to control or manage the epidemic and identifies the key sociological and political influences which have shaped these policies. Drawing on the theoretical approach set out in his recent book, which emphasises the interplay of powerful structural and economic interest groups, the author will consider the influence of the key players. Government policy has tied itself to scientific and medical evidence and protecting the NHS so the key roles of the medical profession, public health scientific community and NHS management and their respective and relative powerful influences will be discussed. The government needs the support of the public if their policies are to be successful, so how have the government addressed maintaining public trust in this “crisis” and how much trust do the public have in the government and what has influenced it? The strong emphasis on social distancing and social isolation in the national government policy response to Covid-19 has placed an increasing public reliance on the traditional and social media for sources of information so how the media has framed the policy will be considered. One policy aim is for an effective vaccine and the influence of the drug industry in its development is discussed. Finally, the role of the state will be discussed and what has shaped its social and economic policies.