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1 – 10 of over 1000Interpersonal skills are increasingly important tools in long-term care with older people, especially against the backdrop of loneliness affecting older people and expectations…
Abstract
Purpose
Interpersonal skills are increasingly important tools in long-term care with older people, especially against the backdrop of loneliness affecting older people and expectations for a person-centred, joined-up approach. However, the term is used as a composite and its definition lacks shape and focus. In existing literature, participants appear to be selected on the basis of specific illnesses rather than age. Better understanding of the features of everyday communication processes associated with person-centred care can lead to improvements in policy and practice.
Design/methodology/approach
A scoping review examined communication features associated with person-centred care for older adults. This identified the extent and nature of literature. Several databases were searched; after screening and hand-searching, 31 were included. Findings were analysed for patterns and contradictions, against the objectives of person-centred and integrated care.
Findings
Emotional intelligence and the ability to employ various communication styles are crucial skills of person-centred communication. Such approaches can have positive effects on the well-being of older people.
Research limitations/implications
Some studies' validity was weakened by methodological designs being founded on value judgements.
Practical implications
Using personalised greetings alongside verbal and non-verbal prompts to keep residents emotionally connected during personal care is considered good practice. Stimulating feedback from people using services and their relatives is important.
Originality/value
The role of communication is highlighted in many professional guidance documents on person-centred and integrated care, but the process of implementation is decentralised to individual employers and workers. This paper draws on the findings of contemporary literature, grounded in naturalistic data, with implications for practice and policy.
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Madalyn Anne Scerri and Rajka Presbury
This paper offers an exploration of contextual factors that influence carer-to-resident talk in Australian residential aged care.
Abstract
Purpose
This paper offers an exploration of contextual factors that influence carer-to-resident talk in Australian residential aged care.
Design/methodology/approach
A qualitative exploratory multiple case study methodology and a theoretical framework of service language were applied to explore the perspectives of 21 registered nurses, assistants in nursing, leisure and lifestyle officers, general managers and care managers at three residential aged care homes in Australia.
Findings
The findings demonstrate contextual factors related to the care home environment, the carer and the relationship between carers and residents that impede or enable carer-to-resident talk in residential aged care. Multiple factors related to the care home environment were found to impede carer-to-resident talk, including time pressures, staffing levels, team culture and the prioritisation of tasks. Factors related to carers had potential to either impede or enable talk, including carers' awareness of the importance of communication, level of experience and individual characteristics, values and attitudes. A strong relationship between a carer and resident built on knowledge of individuals was a key enabling factor.
Originality/value
The paper advances an understanding of factors that influence talk and interaction in residential aged care in Australia from carers' and care home leaders' perspectives. The findings can be used to support verbal communication management strategies aligned with a person-centred care approach, including training and development of staff, cultural change interventions and a review of care delivery procedures.
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Rhonda Riachi and Sally Markwell
This paper aims to highlight the results and emerging themes from a study concerning the effect of communication techniques that were tailored to each client in relation to the…
Abstract
Purpose
This paper aims to highlight the results and emerging themes from a study concerning the effect of communication techniques that were tailored to each client in relation to the extent of their dementia. Dementia was viewed by the care workers primarily as a memory disability.
Design/methodology/approach
A short qualitative study of the communication techniques of care workers in England, who had received training in dementia care and some training in the SPECAL® method (Specialised Early Care for Alzheimer’s),was conducted through semi-structured interviews. Resulting data were analysed using a constructivist grounded theory approach.
Findings
Continued application of the SPECAL techniques appeared to reinforced clients’ sense of well-being and produced benefits for care workers’ own well-being.
Research limitations/implications
This small qualitative study suggests there can be beneficial effects for both clients and the care team when care workers tailor their communication behaviour to the needs of people with dementia. Further research on communication techniques in dementia care is needed and how these benefits might be translated into institutional settings.
Originality/value
Few research studies have been made of the SPECAL dementia care method, and this study was the first to look explicitly at the communication techniques that the care workers used with clients. Public health professionals are less likely to be aware of the SPECAL method.
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Kathy Kornas, Meghan O'Neill, Catherine Y. Liang, Lori Diemert, Tsoleen Ayanian, Melissa Chang and Laura Rosella
The purpose of this study is to understand health care providers' experiences with delivering a novel Integrated Care (IC) Program that co-ordinates hospital-based clinical…
Abstract
Purpose
The purpose of this study is to understand health care providers' experiences with delivering a novel Integrated Care (IC) Program that co-ordinates hospital-based clinical services and home care for thoracic surgery patients, including perceptions on the provision of person-centred care and quality of work life.
Design/methodology/approach
The authors conducted a process evaluation using qualitative methods to understand provider experiences in the Integrated Care (IC) Program and to identify areas for programme improvement. Study data were collected using a focus group with thoracic surgeons, open-ended survey with home care providers, and semi-structured interviews with lead thoracic surgeons and IC leads, who are nurses serving as the primary point of contact for one consistent care team. Data were analysed using thematic analysis.
Findings
The IC Program was successful in supporting a partnership between health care providers and patients and caregivers to deliver a comprehensive and person-centred care experience. Informational continuity between providers was facilitated by IC leads and improved over time with greater professional integration and adaptation to the new care delivery processes. Differential impacts were found on quality of work life for providers in the IC Program.
Originality/value
This study describes provider experiences with delivering integrated and person-centred care across the hospital to home continuum, which can inform future integrated care initiatives.
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Theoretical generalisation provides the basis for tackling problems of service complexity, fragmentation and disrupted care pathways.
Abstract
Purpose
Theoretical generalisation provides the basis for tackling problems of service complexity, fragmentation and disrupted care pathways.
Design/methodology/approach
Recent mental health service transformation in Wales, United Kingdom, has been stimulated by a policy programme underpinned by person-centred recovery values. This paper offers analysis informed by the perspectives of Niklas Luhmann and other noted theorists to examine escalating service system complexity related to this transformation. Analysis builds upon the findings of a qualitative study employing thematic discourse analysis of talk of people with mental illness and associated workers.
Findings
In total, three themes were constructed in participants' talk: “Competing versions of recovery”, “Misaligned service expectations” and “Disrupted care pathways.” Recovery may be understood as a form of moral communication and autopoietic meaning-making activity, according to Luhmann's radical constructionist epistemology. This has the potential to generate competing versions of recovery, a key contributor to escalating complexity.
Research limitations/implications
Findings could be developed further by continued investigation of the relationship between recovery implementation and service fragmentation.
Social implications
A more judicious, balanced policy-implementation may cultivate optimal conditions for recovery pluralism by avoiding polarisation towards either top-down, policy-based recovery implementation or a proliferation of approaches at the grassroots level. Findings have implications for healthcare settings beyond the scope of mental healthcare, given the prevalence of person-centred care internationally.
Originality/value
A simplistic view of recovery implementation should be challenged. Recovery should not be considered a “magic bullet” for mental healthcare delivery. Haphazard recovery-implementation may have detrimental effects of escalating complexity, service fragmentation and disrupted care pathways.
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The purpose of this article is to provide a commentary on Harding et al.'s article about the involvement of people with learning disabilities in university teaching and conference…
Abstract
Purpose
The purpose of this article is to provide a commentary on Harding et al.'s article about the involvement of people with learning disabilities in university teaching and conference presentations.
Design/methodology/approach
The article reviews research into communication strengths and needs and into communication partnerships between service users and members of staff with a view to identifying communication barriers to the involvement of people with learning disabilities.
Findings
The generally poor communication environments in which people are supported are likely to limit opportunities for involvement.
Originality/value
It is suggested that increased involvement is likely to result from increased quality of daily communication. This may best occur as part of general service‐wide approaches to improving service quality, such as person‐centred active support.
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– The purpose of this paper is to reflect on the findings from Koski et al.'s (2014) research around training staff to communicate effectively.
Abstract
Purpose
The purpose of this paper is to reflect on the findings from Koski et al.'s (2014) research around training staff to communicate effectively.
Design/methodology/approach
This commentary reflects on the needs of people with profound intellectual and multiple disabilities (PIMD). It uses the Five Good Communication Standards (Royal College of Speech and Language Therapists, 2013) as a framework for thinking about good communication.
Findings
Ongoing support is certainly important in enabling staff to develop and maintain good communication partnerships with the people they are working with. This first requires agreement from all involved regarding what good communication partnerships look like and how they can be measured.
Originality/value
This paper focuses on the Five Good Communication Standards and how these might be interpreted with people with PIMD. It uses information from Goldbart and Caton's (2010) review of communication and people with the most complex needs to reflect on what is known from research and practice about each of these five standards. It concludes that more research is needed and greater implementation is needed where evidence is strong. We need to know what “good” could look like with people with PIMD so services support staff can then be facilitated to build successful communication partnerships and maintain these over time.
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Susan Mary Benbow, Anna Tsaroucha, Maurice Ashley, Kathleen Morgan and Paul Kingston
Through consultation with people living with dementia and carers, this paper aims to identify skills that patients and carers feel need to be developed in the workforce. This work…
Abstract
Purpose
Through consultation with people living with dementia and carers, this paper aims to identify skills that patients and carers feel need to be developed in the workforce. This work is part of a project to develop competencies for the West Midlands dementia workforce.
Design/methodology/approach
People living with a dementia and carers were contacted through cafés, a carers' group and memory group, and two people contributed interviews to the analysis. All materials were analysed qualitatively using thematic analysis.
Findings
Feedback was received from 69 individuals. In total, six major themes were identified: knowledge about dementia, person centred care, communication, relationships, support and helping people engage in activities.
Originality/value
It is argued that people living with dementia and carers bring unique and valuable perspectives to an analysis of the skills of the dementia workforce, which grounds the required skills in the relationship between the worker and the person and family they are working with. This different emphasis needs to be considered and addressed throughout dementia training and education.
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