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1 – 10 of over 2000Caroline Murphy and Thomas Turner
The undervaluing of care work, whether conducted informally or formally, has long been subject to debate. While much discussion, and indeed reform has centred on childcare, there…
Abstract
Purpose
The undervaluing of care work, whether conducted informally or formally, has long been subject to debate. While much discussion, and indeed reform has centred on childcare, there is a growing need, particularly in countries with ageing populations, to examine how long-term care (LTC) work is valued. The purpose of this paper is to provide an overview of the way in which employment policies (female labour market participation, retirement age, and precarious work) and social policies (care entitlements and benefits/leave for carers) affect both informal carers and formal care workers in a liberal welfare state with a rapidly ageing population.
Design/methodology/approach
Drawing the adult worker model the authors use the existing literature on ageing care and employment to examine the approach of a liberal welfare state to care work focusing on both supports for informal carers and job quality in the formal care sector.
Findings
The research suggests that employment policies advocating increased labour participation, delaying retirement and treating informal care as a form of welfare are at odds with LTC strategies which encourage informal care. Furthermore, the latter policy acts to devalue formal care roles in an economic sense and potentially discourages workers from entering the formal care sector.
Originality/value
To date research investigating the interplay between employment and LTC policies has focused on either informal or formal care workers. In combining both aspects, we view informal and formal care workers as complementary, interdependent agents in the care process. This underlines the need to develop social policy regarding care and employment which encompasses the needs of each group concurrently.
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Frida Andréasson, Jan Aidemark, Lennart Magnusson, Anna Strömberg and Elizabeth Jane Hanson
The purpose of this paper is to reflect on carers’ experiences of being involved in the development of a web-based support programme for carers of people with heart failure…
Abstract
Purpose
The purpose of this paper is to reflect on carers’ experiences of being involved in the development of a web-based support programme for carers of people with heart failure (CPwHF), and discuss the challenges related to their involvement in the development process. The focus was on the different phases in the project as well as the methodological challenges and opportunities that occurred in the user group sessions conducted.
Design/methodology/approach
This research adopt an explorative design studying a co-design process to develop an information and communication technology based support programme for and with CPwHF. Habermas’ concepts of lifeworld and system are used as a theoretical framework to analyse the co-design process employed in the study.
Findings
Reflecting on the co-design approach adopted, the findings highlight the methodological challenges that arise with carer involvement and the possible tensions that occur between researchers’ ambitions to include users in the design process, and the goal of developing a product or service, in the different phases of the design process.
Originality/value
Findings highlight that there is a tension between the system and lifeworld in the co-design process which are not totally compatible. The paper highlights that there is a need to develop flexible and reflexive human-centred design methodologies, able to meet carers’ needs and ideas, and at the same time balance this with proposed research outcomes.
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The paper argues that some conventional tools guiding innovation processes inadequately analyse problems arising from blending telematics with public service integration in areas…
Abstract
The paper argues that some conventional tools guiding innovation processes inadequately analyse problems arising from blending telematics with public service integration in areas of complex service provision. Also uses Molina’s diamond of alignment, and Nicoll’s contextual usability conceptual approaches to analyse a case study on the introduction of smart housing in West Lothian, Scotland.
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This paper considers cash for care as reflected in direct payments and the more recent development of individual budgets in England. While the momentum to roll out individual…
Abstract
This paper considers cash for care as reflected in direct payments and the more recent development of individual budgets in England. While the momentum to roll out individual budgets gathers pace in England, Wales has embarked on a more cautious approach in wishing to evaluate the impact of individual budgets on social services. The paper identifies some of the far reaching implications of cash for care in general and individual budgets in particular, for service users, carers ‐ both paid and informal ‐ and for the social work profession. The policy incoherence in relation to risk and safeguarding is highlighted. This paper supports the approach currently adopted by the Welsh Assembly Government in relation to the ‘rolling out’ of individual budgets. The Assembly's 10‐year strategy for social services focuses on the rights of citizens and the needs of communities. This paper argues that fulfilling that vision should not be wholly contingent upon an unproven extension into the field of individual budgets.
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Cath McGrother, Cathy Thorp, Nick Taub and Orlando Machado
Evidence from a variety of sources suggests that there has been an increase of around 1% per annum in the prevalence of learning disability (LD) in adults over the last 35 years…
Abstract
Evidence from a variety of sources suggests that there has been an increase of around 1% per annum in the prevalence of learning disability (LD) in adults over the last 35 years, due mainly to increases in survival. This trend is likely to continue for at least another ten years. Ninety‐six percent of adults notified to the Leicestershire LD register have an estimated IQ below 50 or need supervision every day to remain safe. Three‐quarters have additional significant disabilities including behaviour problems, psychological symptoms, physical dependencies or epilepsy. In one quarter the behaviour problem poses a major challenge to the achievement of an ordinary life. Two‐thirds indicate a need for help from one or other specialist. Informal carers are actively providing care for nearly half the adults, but a quarter are not content with care‐giving. Carers Report 40% more limiting health problems than their counterparts in the general population, in particular depression in women and cardiovascular problems in men. The specific areas of unmet need among carers Reporting depression are for financial help, long‐term social support and medical advice. Resource allocation for this client group needs to be reviewed in the light of substantial and unrecognised increases in prevalence which are continuing to occur, and the need for long‐term support.
Felicity Small, Michael Mehmet and Jodie Kleinschafer
People living with a disability (PWD) are often a marginalized vulnerable group who are economically and socially disadvantaged. This paper aims to explore the implementation of…
Abstract
Purpose
People living with a disability (PWD) are often a marginalized vulnerable group who are economically and socially disadvantaged. This paper aims to explore the implementation of new social and financial policy reforms aimed at transforming the disability sector. Using the capabilities approach, the authors explore the experience of carers and evaluate how this sector may have become more exposed and vulnerable as a consequence of the new policy.
Design/methodology/approach
This is a qualitative study with two rounds of semi-structured interviews; at initial-phase (n = 18) and post-phase (n = 14). Thematic analysis was applied to the capabilities and vulnerabilities framework to categorize and analyze the interview data.
Findings
The findings show that there are many ways PWD and carers are experiencing increased levels of vulnerability because of their capabilities. There is evidence of increased vulnerability in the intersections between PWD/carers’ inherent nature, the disruption to vital social relationships and conflicting values and interests of stakeholders and the complexity of situational policy changes.
Practical implications
Practical implications developed from the findings include identifying ways the government can improve its social marketing communication strategies. They also highlight the importance of building effective social support networks and provide guidelines for measuring capacity building to address some of the underlying factors leading to vulnerability.
Originality/value
This paper introduces into social marketing, the three-factor vulnerability framework, which conceptualizes the nature of vulnerability, and examines and evaluates the intersections of these factors in relation to the capabilities approach.
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Graydon Davison and Paul Hyland
This paper is the first in a series that will examine the management of innovation by cross‐functional, multi‐disciplinary patient care teams in a palliative care environment…
Abstract
This paper is the first in a series that will examine the management of innovation by cross‐functional, multi‐disciplinary patient care teams in a palliative care environment. This highly innovative environment is singularly focused on relieving the suffering of patients and their socially related carers during an end of life experience. The singular focus enables and encourages palliative care practitioners to break through and diminish or accommodate professionally‐based paradigm conflicts and organisational politics. This facilitates collaborative team‐based efforts, including the patient and the patient’s social support group, to address the multi‐causal uncertainties that characterise end of life in palliative care. The continuous innovation model used in the European Union funded CIMA project is used as a starting point for this research. While many businesses have struggled to implement self‐regulating teams and have invested considerable resources in attempting to gain some advantage from teamwork it appears palliative care professionals have adopted self‐regulating work teams in a highly uncertain environment as the most suitable human resource structure and practice.
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Ryan Woolrych and Judith Sixsmith
Policy has identified the need for integrated dementia services for older people. However, the role of the formal carer within an integrated framework of service delivery has not…
Abstract
Purpose
Policy has identified the need for integrated dementia services for older people. However, the role of the formal carer within an integrated framework of service delivery has not been well articulated in practice. The aim of this paper is to understand the experiences of formal carers working with the context of an integrated dementia service by exploring findings from a research‐based evaluation.
Design/methodology/approach
The evaluation captured the experiences of formal carers working within the service via observations, semi‐structured interviews and focus groups.
Findings
Working with an integrated service brings about individual, social and organisational challenges to the role of the formal carer, in terms of: delivering flexibility and responsiveness, providing continuity of care, ensuring cross‐organisational working and acquiring skills, knowledge and expertise.
Originality/value
To facilitate the successful delivery of integrated care, the emerging role of the formal carer needs to be more clearly articulated and supported within a service context.
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Currently there is no research that explores professionals’ perspectives in supporting carers of a person with an intellectual disability during their relatives admission to a…
Abstract
Purpose
Currently there is no research that explores professionals’ perspectives in supporting carers of a person with an intellectual disability during their relatives admission to a specialist in-patient setting. The purpose of this paper is to report the findings from the second stage of a study that explored the experiences of family carers whose relative was admitted to a specialist National Health Service assessment and treatment unit (ATU) in Wales, UK (James, 2016).
Design/methodology/approach
Aim: to obtain the views of professionals in relation to what they consider are the barriers and facilitators to addressing some of the experiences discussed by carers. Methods: nine professionals working in intellectual disability-specific services participated in four semi-structured interviews and one focus group (n=5) and the data were analysed using a descriptive thematic analysis process.
Findings
Three major themes were developed to represent what professionals identified as a number of individual, organisational and practical facilitators and barriers to the provision of support to carers at this time. Professionals recognised the important role they have in developing relationships with carers during the admission. Key to this relationship is effective communication, collaboration, involvement and the need to be consistently open and honest.
Research limitations/implications
The small sample size could be said to be a weakness and unrepresentative and practice of other professionals. However, what professionals reported had similarities to the findings from other related research. Importantly, the findings have a practical significance in that they can be used to raise awareness and be used to inform the development of future research and practice. The sample could also be criticised for not having representation from a wider range of professionals from across the multi-disciplinary team. However, a strength of the sample is that it did have representation from three different professional disciplines with different roles and responsibilities.
Practical implications
Currently there is very limited research exploring the experiences of professionals in respect of supporting carers during the admission of a relative to a specialist in-patient setting. Professionals demonstrated an understanding of the impact that the additional needs and admission of their relative to an ATU could have on carers. Accordingly, they were able to recognise the important role that they, and other professionals, play in developing relationships as part of providing support to them during this time. Key to these relationships was effective communication and in particular the need to be consistently open and honest.
Social implications
The findings from this study illustrate a gap between the rhetoric of policy, legislation and carer strategies, and practice of valuing and respecting the role that carers. Of particular concern is that some of the relationships that carers have had with professionals have threatened rather than positively endorsed and augmented their role and identity. These engagements with professionals therefore have had a profound effect on the way in which they have understood their value as a carer and their own sense of self. Significantly, the actions and behaviours of professionals play a key role in shaping carers views of themselves and their identity.
Originality/value
Currently there is no research that has explored the views of professionals in respect of support and relationships with carers at this time. The synthesis of findings from stage one of this study with professionals’ perspectives of resulted in the identification of similarities and differences in experiences as well as facilitators and barriers to support provision. In so doing, it has given clear application of the studies findings to practice. This study therefore provides an original contribution to the understanding of this area of carer experience, from the perspectives of professionals and adds to the wider literature exploring the family carer experience.
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Julia S Clark and Kenneth J. Turner
The purpose of this paper is to evaluate an approach to automating goals for supporting home care, with a view to understanding user experience when defining such goals and hence…
Abstract
Purpose
The purpose of this paper is to evaluate an approach to automating goals for supporting home care, with a view to understanding user experience when defining such goals and hence identifying improvements that could be made to the approach.
Design/methodology/approach
The study was designed to answer the key research question of whether users can understand, formulate and relate to automated goals for home care. In order to do this, a fictional text-based scenario was used about a couple with care needs. This helped to explore the feasibility, acceptability and usability of goals to manage care at home. Face-to-face qualitative interviews were undertaken with ten participants with a background in social care: four social care professionals; one health care professional; one formal carer; one informal carer; and three end users.
Findings
Overall, participants were positive about being able to control the MATCH (Mobilising Advanced Technologies for Care at Home) system through the use of goals. The results from the participant interviews will be used to help guide potential improvements to the home care system. The main issue that emerged from the study is that it would be valuable to think in terms of outcomes as a higher level than goals. A second consideration is that it would be desirable to adopt terminology that can be understood by all stakeholders.
Research limitations/implications
The study has demonstrated that automated goals for home care have a useful role to play and can be successfully used by end users and carers. Although the range of participants in the study was limited, it has allowed confidence to be built in the approach and has identified useful pointers for future development.
Practical implications
With the evaluation and validation of the goal-based approach, it has encouraged the developers to make automated goals more widely available in future deployment of the home care system.
Social implications
The use of automated goals to support home care has been shown to be acceptable to end users and carers. This will allow future home care systems to offer more personal and better customised services to those receiving telecare.
Originality/value
The study provides a unique evaluation of the use of automated goals to support home care. Previous use of goals in the literature has been for highly technical applications, so their application to home care is novel and speculative. The study has demonstrated that the approach is viable, useful, and usable by end users and carers.
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