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Demand for care at home is growing because of the increase in life expectancy, an ageing population and the chronic conditions that often accompany longevity. Daytime care at home services have been widely reported on, but less is known about overnight care at home. This paper aims to gather evidence about overnight social care for older adults in their homes.

Recent studies were identified through searches in three electronic databases. Studies published in English between January 2016 and June 2022 exploring overnight care at home for older adults were eligible for inclusion. An additional Google search identified home care services within the UK currently providing overnight support.

The review retrieved five relevant papers, highlighting the paucity of research in this area. A narrative review of the literature identified common themes that suggested domiciliary night care staff play an integral role in meeting the overnight care and support needs of older adults who wish to be cared for at home. Despite the limited evidence base in this area, the Google search for UK domiciliary services who provide overnight support identified several active programmes.

To the best of our knowledge, this is the first scoping review exploring the provision of overnight social care to older adults in their own homes. The review highlights the need for further research to inform commissioning and practice development.

The Healthy at Home (H@H) is an older adult day program that is in Toronto in Ontario, Canada. This is an integrated health and social care (IHSC) program that seeks to address the social isolation and health needs of a highly vulnerable older adult population living in the north Toronto communities. These are Russian-speaking Jewish older adult immigrants. The case provides a detailed description of the factors that enabled a diverse group of health and social care organizations to integrate their respective services to address the health and social care needs of their clients using a culturally appropriate and trauma-informed lens.

A case description comprised of key informant interviews, and a focus group was undertaken of representatives from health and social care organizations serving clients in the north Toronto area.

This case description identified eleven integration factors that enabled organizations to provide integrated care using a culturally appropriate and trauma-informed lens, and they include developing an aligned vision and goals, communications, an inter-organization culture of inter-dependence, champions, pre-existing relationships, and champions. In addition, operating in the not-for-profit sector, sector differences, enabling public policies and a strong sense of community have influenced integration of services across the organizational partners to serve its high-risk client group.

This case description lends insights into how IHSC can be leveraged to provide culturally appropriate and trauma-informed care for highly vulnerable client/patient populations. A lesson learnt is that social care partners can engage in successful integration leadership in joint health and social care integration efforts.

The purpose of this paper – the second of three – is to report the findings from a service user needs assessment in those who have contact with a local homelessness service in the North-West of England.

Data were collected using a semi-structured questionnaire that included a section exploring Adverse Childhood Experiences. Aggregated data from a total of 100 completed questionnaires were analysed to understand the nature and scope of those accessing the Homelessness and Vulnerable Adults Service (HVAS).

Homeless people accessing HVAS face a number of challenges, which reflect their upbringing and chaotic and complex lifestyles. Reports of multiple disadvantage, social isolation, physical and mental health problems were common among the cohort.

This was a small cohort study, and the authors accept that this may potentially limit the scope of the findings. Themes identified are, however, reflected in wider research and official data collection sources. Future research may seek to widen the data collection methods to offer a more representative cohort.

The provision of co-ordinated multi-agency support is essential to tackle health inequalities experienced by those who are homeless.

The complex issues often experienced by those who are homeless can further compound the impact of social exclusion on health and well-being. The reduction of statutory support and increased emphasis on self-reliance can further impact those people on the margins of society.

This study identifies how multiple deprivations and social isolation impacts upon health and well-being, further compounding a person’s ability and willingness to engage with services. It raises the question of the systems failure to respond effectively.

The purpose of this paper is to critically review the context of adult protection in Ireland with a focus on older people. The paper traces advances and current limitations in policy, regulation, practice and legislation.

A review of historical and current contexts in adult safeguarding in Ireland is presented with consideration of key public reviews and commentaries related to care provision, governance and the legislative status of adults at risk.

While Ireland’s journey to provide adult safeguarding responses for older people has progressed since 2002, there remain many gaps. Further work needs to be addressed urgently to enable a comprehensive alignment of fit-for-purpose, responsive legislation, practice and policy to meet the complex and diverse needs of an increasing ageing population who may require safeguarding support. This includes fostering robust inter-sectorial collaboration, safeguarding legislation and cultural change related to human rights approaches.

The paper is a discussion on the context of adults safeguarding in relation to practice, policy and legislation.

Identifies the need for significant reform in the Irish system of health service. Argues for an overarching, inter-sectorial approach to addressing adult safeguarding, which focuses on prevention as well as early intervention.

The paper offers a review of the current diverse elements comprising current adult safeguarding and older people in Ireland and integrates legislative, regulatory, policy and practice realities. Challenges are illustrated within the context of reactive rather than proactive safeguarding agendas which are linked to public scandals and debates. The paper argues for a more integrated and robust inter-sectorial approach to safeguarding underpinned by adult safeguarding legislation and an overarching governance structure.

This study aimed at exploring support for older people in protracted displacement in Nigeria, emphasising the available support and the gap in the support provided to them.

Qualitative interviews were used to collect data from ten displaced older people in New-Kuchingoro internally displaced persons (IDP) camp Abuja, Nigeria. The collected data were analysed thematically with NVivo 12.

Results show that older people received material, emotional and psychological supports from their families, neighbours, friends, religious organisations and non-governmental organisations. Several gaps were identified in the support provided to displaced older people. For example, their special nutritional or medical needs were neglected, and their support was primarily material, sporadic and spontaneous, as there is no existing framework guiding the care and support of older people in displacement.

This study provides a foundation for further research on older people in displacement, an area that has received minimal scholarly attention.

The paper recommends that researchers and displaced persons’ care providers should pay more attention to the peculiar support needs of this less visible vulnerable group and adopt the internal displacement policy for the long-term protection of older people in displacement.

Older people in displacement remain less visible as humanitarian aid programmes and research focus more on women and children. This lack of attention may put older people in displacement at more risk as their peculiar needs may not be met. To the best of the authors’ knowledge, this study is the first to examine the gap in support for older people in displacement in Nigeria.

This article draws upon our perspective as academic-practitioners working in the fields of food insecurity, food systems, and inequality to comment, in the early stages of the pandemic and associated lockdown, on the empirical and ethical implications of COVID-19 for socio-economic inequalities in access to food in the UK. The COVID-19 pandemic has sharpened the profound insecurity of large segments of the UK population, an insecurity itself the product of a decade of “austerity” policies. Increased unemployment, reduced hours, and enforced self-isolation for multiple vulnerable groups is likely to lead to an increase in UK food insecurity, exacerbating diet-related health inequalities. The social and economic crisis associated with the pandemic has exposed the fragility of the system of food charity which, at present, is a key response to growing poverty. A vulnerable food system, with just-in-time supply chains, has been challenged by stockpiling. Resultant food supply issues at food banks, alongside rapidly increasing demand and reduced volunteer numbers, has undermined many food charities, especially independent food banks. In the light of this analysis, we make a series of recommendations. We call for an immediate end to the five week wait for Universal Credit and cash grants for low income households. We ask central and local government to recognise that many food aid providers are already at capacity and unable to adopt additional responsibilities. The government's – significant – response to the economic crisis associated with COVID-19 has underscored a key principle: it is the government's responsibility to protect population health, to guarantee household incomes, and to safeguard the economy. Millions of households were in poverty before the pandemic, and millions more will be so unless the government continues to protect household incomes through policy change.

This study aims to examine the recent literature on health-promoting behavior, health needs and associated factors among older adults.

An massive search of five databases involving documents in the past decade was commenced.

This review showed a significant relationship between older adults’ demographic characteristics (marital status, income, chronic disease, education level and smoking status) and health-promoting behaviors. This review showed that older adults with a high level of education, high income, chronic diseases and smoker and married older adults are associated with better health-promoting behaviors.

The result of the current review supports the Pender Health Promotion Model that individual personal characteristics can affect the level of engagement in health-promoting behaviors. Assessing the health-promoting behaviors of older adults can help in identifying their health needs.

This paper – the first of three – aims to explore some of the complex physical and mental health needs of those experiencing homelessness. It will act as a leader to the other articles by establishing the nature of the problem and offer a rationale for carrying out a service user needs assessment as part of a review of local service provision in the North West of England against the backdrop of the current COVID-19 epidemic.

There are a number of complex social and health inequalities often experienced by those who are homeless. Effectively tackling these requires a co-ordinated multi-agency response to both prevent and tackle the harms associated with being and becoming homeless.

Partnership working offers the best opportunity to meet the complex needs of those experiencing homelessness. The current delivery model being actioned in the North West of England highlights the importance of the links between statutory and non-statutory services. An ongoing service user needs assessment will further help to highlight contemporary issues faced by those experiencing homelessness and those providing services in the context of the COVID-19 epidemic.

Future papers as part of this series of three will consider the implications of social exclusion and barriers to accessing services faced on a day-to-day basis by those experiencing homelessness.

The opportunity to reflect on established views in relation to the nature and scope of homelessness. It will consider the implications exclusion from society and service provision that this group face on a day-to-day basis. The paper will describe a contemporary approach to tackling current issues faced by those experiencing homelessness in the current context of the COVID-19 epidemic.

Needs change as people get older. Procuring resources to satisfy them can generate anguish and insecurities in consumers due to their financial situation. This study aims to analyze the relationship between age and financial stress among Mexican adults and estimate the age of their maximum financial stress.

This study is based on constructing a financial stress indicator using the confirmatory factor analysis and linear regression models with a quadratic term, employing data from the National Survey on Financial Inclusion 2021.

Results show that the relationship between age and financial stress follows a quadratic pattern, with a maximum level at age 56, which varies according to sex, marital status, number of dependents, education and regions. These findings interest financial product designers and policy developers who aim to improve consumers' well-being.

Longitudinal studies and indicators, such as financial fragility, are needed to facilitate refining models over time.

There is no evidence of studies that have addressed the age of maximum financial stress in Latin America. Doing so is relevant because identifying the stages in life when adults are most vulnerable to financial stress helps assess its causes more precisely, thus mitigating its adverse effects.

Most abuse affecting older adults in the UK, as across Europe, takes place within caring relationships, where one person is disabled and needs care/support. This paper critically appraises two of the key theoretical explanations. First, feminist theories of “intimate partner abuse” tell us that it is mostly men who perpetrate abuse against women. Second, “carer strain”: the stress caused by caring responsibilities, often with inadequate help from services. Neither fully reflects the complex dynamics of “dangerous care” leading to a lack of voice and choice in safeguarding responses. This paper aims to articulate the need for an overarching theoretical framework, informed by a deeper understanding of the intersectional risk factors that create and compound the diverse experiences of harm by disabled people and family carers over the life course.

The critical synthesis of the theoretical approaches informing UK policy and practice presented here arises from a structured literature review and discussions held with three relevant third sector agencies during the development of a research proposal.

No single theory fully explains dangerous care and there are significant gaps in policy, resources and practice across service sectors, highlighting the need for joint training, intersectional working and research across service sectors.

Drawing both on existing literature and on discussions across contrasting policy and practice sectors, this paper raises awareness of some less well-acknowledged complexities of abuse and responses to abuse in later life.