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Article
Publication date: 27 September 2023

Teresa Atkinson and Rebecca Oatley

The purpose of this paper is to present the views of people living with dementia in extra care housing (ECH). This is a model of housing with care and support aiming to support…

Abstract

Purpose

The purpose of this paper is to present the views of people living with dementia in extra care housing (ECH). This is a model of housing with care and support aiming to support older people, including those with dementia, to live independently. Previous research identifies benefits but is predominantly derived from third-party accounts, with the voices of those living with dementia in ECH significantly absent.

Design/methodology/approach

This study adopted a qualitative approach conducting 100 interviews across 8 ECH schemes in England. Over half of the interviews were conducted with people living with dementia and their families with the remainder involving staff and commissioners.

Findings

Findings suggest there are a range of benefits including owning your own home, having a safe, age friendly location with flexible support, social interaction and continuing to live as a couple. Challenges included availability of staff, flexible resourcing, loneliness and the advancing symptoms of dementia.

Research limitations/implications

Despite efforts to create an inclusive, diverse sample, the participants were all White British. Participants involved were identified by gatekeepers, which may present some bias in the selection.

Practical implications

Whilst ECH offers benefits to people living with dementia, addressing the challenges is essential for effective dementia care. Improving staff training, promoting person-centred care and fostering an inclusive community are critical for enhancing residents’ well-being and quality of life.

Originality/value

This paper explored the lived experiences of residents and family members, providing new insight into the advantages and disadvantages of ECH for people living with dementia.

Details

Working with Older People, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1366-3666

Keywords

Article
Publication date: 18 November 2021

Simon Chester Evans, Teresa Atkinson, Mike Rogerson and Jennifer Bray

There is growing interest in and evidence for the benefits of connecting with nature for people living with dementia, sometimes known as “green care”, including reduced stress…

Abstract

Purpose

There is growing interest in and evidence for the benefits of connecting with nature for people living with dementia, sometimes known as “green care”, including reduced stress, improved sleeping and even enhanced cognition. However, many people living with dementia are denied such opportunities, often because of practitioner perceptions of risk and poor design of outdoor spaces. This paper reports on the evaluation of a project that worked with national providers to give people living with dementia opportunities and support to access the natural environment.

Design/methodology/approach

The evaluation adopted a mixed-methods approach, using a combination of bespoke and commonly used tools and in-depth case study work to identify the facilitators and challenges to delivering the project and explore the experiences of activity participants.

Findings

Qualitative measures indicated a significant improvement in mental well-being for participants with dementia and family carers following attendance at activity sessions. Research interviews indicated that participants enjoyed activities based on connecting with nature. Being outdoors was a major factor in the experience, along with taking part in activities that were meaningful and opportunities for social interaction.

Originality/value

This paper provides evidence for the benefits of connecting with nature for people living with dementia. This paper concludes that access to the outdoors is not a luxury, it is a basic human right and one which has become increasingly important in light of restrictions that have emerged as a result of the COVID19 pandemic.

Details

Working with Older People, vol. 26 no. 1
Type: Research Article
ISSN: 1366-3666

Keywords

Article
Publication date: 17 October 2023

Teresa June Atkinson, Rebecca Oatley and Simon Evans

The purpose of this paper is to report on a scoping review of the advantages and challenges of extra care housing (ECH) provision in the UK for people living with dementia. Access…

Abstract

Purpose

The purpose of this paper is to report on a scoping review of the advantages and challenges of extra care housing (ECH) provision in the UK for people living with dementia. Access to suitable housing is a fundamental right for people living with dementia and can enable people to live as well as possible (Twyford and Porteus, 2021). Understanding the advantages and disadvantages of different models of housing with care has been identified as a research priority by people living with dementia (Barrett et al., 2016) but “there is no current consensus on the best model of specialist housing for people with dementia” (Twyford and Porteus, 2021, p. 29).

Design/methodology/approach

This scoping review identifies the advantages and disadvantages of living in ECH for people with dementia. It is the preliminary stage of a study that seeks to develop knowledge about different models of ECH for people living with dementia (Atkinson et al., 2021).

Findings

Advantages include the promotion of independence, flexible staffing, safety and security, social inclusion, physical design and integrated service provision. Disadvantages include barriers to entry, tensions between independence and support, managing advanced dementia, resourcing flexible care, managing social exclusion, loneliness and stigma and a disabling environment.

Research limitations/implications

The scoping review reinforces the need for further research into different models of ECH provision in the UK for people living with dementia. The review provides insight that is of benefit to all stakeholders involved in ECH and contributes to the development of evidence-based provision called for in the recent All Party Parliamentary Group inquiry (Twyford and Porteus, 2021).

Originality/value

This scoping review summarises the current position for people living with dementia in ECH.

Details

Housing, Care and Support, vol. 26 no. 3/4
Type: Research Article
ISSN: 1460-8790

Keywords

Article
Publication date: 25 January 2024

Sarah Waller, Simon Chester Evans, Jennifer Bray and Teresa Atkinson

There is increasing interest in the UK in developing environments that support people who are neurodiverse. This paper aims to report on a project to develop a cognitively…

Abstract

Purpose

There is increasing interest in the UK in developing environments that support people who are neurodiverse. This paper aims to report on a project to develop a cognitively supportive environmental assessment tool to improve the design of health centres, where the majority of National Health Service consultations take place, for all users, including people living with dementia and those who are neurodiverse.

Design/methodology/approach

A three-stage process was used: a literature review; the development of a matrix of key design features for people living with dementia, autism and other neurodiverse conditions; and the development of an environmental assessment tool and guide for users, which included easy-to-read versions to maximise service user involvement.

Findings

The overarching concepts of dementia-friendly design can be adapted to create designs for everyone, including those who are neurodiverse.

Research limitations/implications

There is a paucity of research in environmental design for primary care from the patient’s perspective, and, more generally, further research on design for adults with learning disabilities and autism is needed.

Practical implications

The tools are free to download. With adaptation, they have potential applicability across health and care settings.

Originality/value

This project has confirmed that the principles of dementia-friendly design are applicable, with modifications, to a wider group of neurodiverse people. Critically, each person’s response to sensory stimuli is individual rather than determined by their condition.

Details

Working with Older People, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1366-3666

Keywords

Article
Publication date: 18 June 2019

Simon Chester Evans, Julie Barrett, Neil Mapes, June Hennell, Teresa Atkinson, Jennifer Bray, Claire Garabedian and Chris Russell

The benefits of “green dementia care”, whereby people living with dementia are supported to connect with nature, are increasingly being recognised. Evidence suggests that these…

Abstract

Purpose

The benefits of “green dementia care”, whereby people living with dementia are supported to connect with nature, are increasingly being recognised. Evidence suggests that these benefits span physical, emotional and social spheres and can make a significant contribution towards quality of life. However, care settings often present specific challenges to promoting such connections due to a range of factors including risk-averse cultures and environmental limitations. The purpose of this paper is to report on a project that aims to explore the opportunities, benefits, barriers and enablers to interaction with nature for people living with dementia in residential care and extra care housing schemes in the UK.

Design/methodology/approach

Data were gathered from 144 responses to an online survey by managers/staff of extra care housing schemes and care homes in the UK. In depth-case studies were carried out at three care homes and three extra care housing schemes, involving interviews with residents, staff and family carers.

Findings

A wide variety of nature-based activities were reported, both outdoor and indoor. Positive benefits reported included improved mood, higher levels of social interaction and increased motivation for residents, and greater job satisfaction for staff. The design and layout of indoor and outdoor spaces is key, in addition to staff who feel enabled to promote connections with nature.

Research limitations/implications

This paper is based on a relatively small research project in which the participants were self-selecting and therefore not necessarily representative.

Practical implications

The paper makes some key recommendations for good practice in green dementia care in extra care housing and care homes.

Social implications

Outdoor activities can promote social interaction for people living with dementia in care settings. The authors’ findings are relevant to the recent policy focus on social prescribing.

Originality/value

The paper makes some key recommendations for good practice in green dementia care in extra care housing and care homes.

Details

Working with Older People, vol. 23 no. 3
Type: Research Article
ISSN: 1366-3666

Keywords

Article
Publication date: 2 March 2022

Jennifer Bray, Simon Chester Evans and Teresa Atkinson

When new interventions are piloted, the implementation process often takes a back seat but can be key to ensuring that an intervention is successful. This paper aims to highlight…

Abstract

Purpose

When new interventions are piloted, the implementation process often takes a back seat but can be key to ensuring that an intervention is successful. This paper aims to highlight the enablers and challenges encountered when implementing a nature-based intervention for people living with dementia.

Design/methodology/approach

The evaluation adopted a mixed methods approach including case studies, telephone interviews with delegates and interviews with participants. Thematic analysis was used to identify overarching themes relating to the enablers and challenges of implementing the intervention.

Findings

Challenges related to understanding how the intervention fitted with existing work and practicalities of what an organisation can offer to support the implementation process. A stable underlying support structure for delegates is required, along with suitable advertising, transport and facilities to support participants. While there is no “one size fits all” approach to implementing an intervention, these findings will help organisations to consider where to focus their support.

Originality/value

The implementation of interventions is often poorly understood but is important when supporting the wider roll out of an intervention. While this paper reports on a nature-based intervention, the learning will be relevant and applicable more broadly for organisations aiming to implement a new intervention and complements previous work relating to the challenges of implementing arts activities.

Details

Working with Older People, vol. 26 no. 3
Type: Research Article
ISSN: 1366-3666

Keywords

Article
Publication date: 5 June 2017

Randall Smith, Robin Darton, Ailsa Cameron, Eleanor K. Johnson, Liz Lloyd, Simon Evans, Teresa June Atkinson and Jeremy Porteus

The purpose of this paper is to provide an overview of the process of commissioning adult social care services in England. It reflects the literature on commissioning at the…

Abstract

Purpose

The purpose of this paper is to provide an overview of the process of commissioning adult social care services in England. It reflects the literature on commissioning at the strategic level followed by a section on operational or micro-commissioning. The rest of the paper focusses on the emergence of ideas about outcomes-based commissioning (OBC) in the field of adult social care and ends with critical consideration of the effectiveness of OBC in adult social care as applied to support and care provided in extra care housing.

Design/methodology/approach

The review of strategic and operational commissioning in adult social care in England (and Scotland in brief) is based on both policy documents and a review of the literature, as are the sources addressing OBC in adult social care particularly in extra care housing settings.

Findings

The core of this paper focusses on the challenges to the implementation of OBC in adult social care in the context of provision for residents in extra care housing. Of central importance are the impact of the squeeze on funding, increasing costs as a result of demographic change and the introduction of a national living wage plus the focus on the needs of service users through the idea of person-centred care and resistance to change on the part of adult social care staff and workers in other relevant settings.

Originality/value

Addressing the implementation of OBC in adult social care in England in the context of extra care housing.

Details

Housing, Care and Support, vol. 20 no. 2
Type: Research Article
ISSN: 1460-8790

Keywords

Article
Publication date: 13 March 2017

Simon Evans, Teresa Atkinson, Robin Darton, Ailsa Cameron, Ann Netten, Randall Smith and Jeremy Porteus

The purpose of this paper is to explore the potential of housing with care schemes to act as community hubs. The analysis highlights a range of benefits, barriers and facilitators.

Abstract

Purpose

The purpose of this paper is to explore the potential of housing with care schemes to act as community hubs. The analysis highlights a range of benefits, barriers and facilitators.

Design/methodology/approach

Data are presented from the Adult Social Services Environments and Settings project which used a mixed methods approach including a review of the literature, surveys and in-depth case study interviews.

Findings

Most housing with care schemes have a restaurant or café, communal lounge, garden, hairdresser, activity room and laundrette, while many also have a library, gym, computer access and a shop. Many of these facilities are open not just to residents but also to the wider community, reflecting a more integrated approach to community health and adult social care, by sharing access to primary health care and social services between people living in the scheme and those living nearby. Potential benefits of this approach include the integration of older people’s housing, reduced isolation and increased cost effectiveness of local services through economies of scale and by maximising preventative approaches to health and wellbeing. Successful implementation of the model depends on a range of criteria including being located within or close to a residential area and having on-site facilities that are accessible to the public.

Originality/value

This paper is part of a very new literature on community hub models of housing with care in the UK. In the light of new requirements under the Care Act to better coordinate community services, it provides insights into how this approach can work and offers an analysis of the benefits and challenges that will be of interest to commissioners and providers as well as planners. This was a small scale research project based on four case studies. Caution should be taken when considering the findings in different settings.

Details

Quality in Ageing and Older Adults, vol. 18 no. 1
Type: Research Article
ISSN: 1471-7794

Keywords

Article
Publication date: 12 March 2014

Teresa June Atkinson, Simon Evans, Robin Darton, Ailsa Cameron, Jeremy Porteus and Randall Smith

Appropriate housing for the growing population of older adults is becoming an international concern. The purpose of this paper is to report on a review of UK and international…

Abstract

Purpose

Appropriate housing for the growing population of older adults is becoming an international concern. The purpose of this paper is to report on a review of UK and international literature carried out as part of a project exploring the commissioning and delivery of social care in housing with care settings. The paper also considers housing with care in the context of UK policy and practice.

Design/methodology/approach

The peer literature review process used a range of academic databases as well as government and third sector web sites, drawing on relevant material in English published from 1990 to 2012.

Findings

Findings are presented within three main themes: how care and support is provided; the role of the built environment; and the benefits for resident well-being. The review found a paucity of literature focusing specifically on care and support in housing with care settings, particularly in terms of how social care is delivered, but the evidence base suggests that housing with care is in a strong position to deliver on most if not all UK government aspirations.

Practical implications

Despite a growing literature both in the UK and internationally exploring the characteristics and benefits of housing with care for older people, substantial gaps remain in the research evidence.

Originality/value

This paper presents an up to date review of the housing with care literature in the context of current UK policy.

Details

Housing, Care and Support, vol. 17 no. 1
Type: Research Article
ISSN: 1460-8790

Keywords

Content available
Article
Publication date: 12 March 2014

Robin Johnson

258

Abstract

Details

Housing, Care and Support, vol. 17 no. 1
Type: Research Article
ISSN: 1460-8790

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