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Care options for older people are important to individuals and to society, and currently, there is a crisis in this care. The chapter presents a research base projection onto the situation in England in 2045, using Office for National Statistics (ONS) modelling based on current population reaching the age of 85-years plus. We take three The Archers characters and fantasise about their lives in 2045, Shula and Kenton Archer and Hazel Woolley. Through them, we illustrate three options for care, namely, cared for by family members, buying in care in own home and moving into a care home. The financial aspects of these choices are explored.

The perspectives of people with dementia and their care partners regarding “extra care” housing are currently unknown. The purpose of this paper is to report findings of a consultation study exploring the perceived barriers and facilitators of a relocation to extra care housing, from the perspective of people living with dementia, and their care partners.

Fieldwork consisted of paired or 1-1 interviews and small focus groups with potential users of an alternative model of extra care support for people living with dementia in the South of England. The consultation took place between June and August 2013. The interviews and focus groups were audio recorded, transcribed verbatim. The transcripts were analysed thematically.

Benefits of extra care were identified as the opportunity for couples to remain living together for longer, creating a supportive, dementia-friendly community, and a reduction in the strain experienced by the care partners. Barriers centred on a sense of loss, stress and uncertainty. Living and caring at home was perceived as preferable to shared care.

The findings presented here have limited generalisability for two reasons. First, the shared care approach consulted on was very specific. Second, the participants form a purposive sample and as such are not representative of a wider population. Despite best intentions, the voice of people with dementia, are underreported in this consultation. Only one person with early on-set dementia was interviewed and the remaining two people with dementia were interviewed alongside their care partner.

The findings cast doubt on the viability of extra care facilities, designed for couples living with dementia, if extra care continues to be conceptualised and marketed as a preventative lifestyle choice. The findings indicate the value of consulting with people with dementia, and their care partners, when designing new forms of housing with care specifically for people living with dementia.

The findings of this consultation exemplify the wish of couples living with dementia to remain together, in what they perceive to be “home”, for as long as possible. Couples living with dementia are therefore unlikely to wish to move into an extra care facility as a lifestyle choice option, early into their journey with dementia. This raises questions about the suitability of extra care, as a form of housing with care, for couples living with dementia.

This paper contributes to the body of literature, exploring the feasibility of new and innovative alternative care and housing options, for people with dementia. This paper is one of the first to explore extra care as a housing and social care option for couples with dementia.

This paper analyses the value of information and advice for older people in making decisions about housing and care, drawing on an evaluation of FirstStop, a new national information and advice service. The paper discusses the housing problems often faced in older age, and the pressures on public finances of housing an ageing population. The Government is trying to engender a shift to early preparation, prevention and self‐help, so that older people make changes to their housing and care arrangements before encountering a crisis. The paper considers how older people can resolve their housing issues in more satisfactory and empowering ways, and at lower cost to the state, after receiving appropriate and timely information and advice. It also discusses the problems of funding this type of initiative, given the need to ‘prove’ the value for money of publicly funded services in quantitative terms, when the benefits of information and advice are difficult to monetarise.

The research reported here aims to explore the problems facing individuals searching for information about available options in choosing care services.

It presents data drawn from an on‐line survey, follow‐up telephone calls and a focus group, which reveals the preferences people have in searching for information about care services and the difficulties encountered.

It finds that people need information but find it complicated, unwieldy and inaccessible. In addition to using on‐line sources, they value person‐to‐person contact and information tailored to meet their specific needs.

This study is original in raising issues and presenting findings that open up the topic of information in care decision‐making. While it relies on a self‐reporting survey and the direct participation of a small number of subjects, future research based on random sampling and a larger sample of subjects would enable these findings to be tested more thoroughly.

High quality, accurate information is an essential element in enabling individuals to make appropriate choices about the care they seek for themselves or their loved ones. Service providers, councils and commercial undertakings each have a part to play in facilitating that choice.

This research highlights issues that confront both information searcher and provider, making recommendations about overcoming them. The concept of individual choice is a cornerstone of social policy but findings reveal the complexity facing individuals, providers and practitioners in making this a reality.

The importance of information in making decisions about care is under‐researched; this study raises issues and presents findings which open the topic for further exploration.

Unassisted childbirth, also known as “freebirth,” is when a person intentionally gives birth at home with no professional birth attendant. The limited research on unassisted birth in the United States focuses on women’s reasons for making this choice. Studies suggest women are committed to birthing without a professional and that this choice is rooted in religious or natural-family belief systems. These studies do not adequately account for the ways a framework of “choice” obscures the role structural barriers play in decision-making processes. International research on unassisted childbirth finds that it is not always a first choice and may be a last resort for women who have had negative experiences with maternity care. More research on unassisted birth in the United States is needed to better understand if people face similar structural barriers. In this paper I examine how structural limitations of the US healthcare system intersect with values in decision-making processes about childbirth. Drawing on in-depth interviews with nine women who gave birth unassisted in the United States, I examine the women’s shared ideological commitments, negative experiences with health care, and barriers faced seeking care. I discovered that unassisted birth may not be a first, or even positive choice, but rather a compromise informed by ideological commitments and constrained choices. Structural barriers in the US healthcare system prevented women from having a professional birth attendant who they felt was acceptable, available, and accessible. I conclude by discussing the implications of these findings for debates about birth justice and health policy.

This chapter will review the evaluations of the newly developed elderly care system in Japan, Long Term Care Insurance, and its social implications with the focus on demographic change.

By reviewing literature, this chapter will examine how demographic and social change over the years has impacted the features of caregivers. Then, how this policy change has demedicalized the aging process will be described. Finally, this chapter will evaluate whether this insurance has shifted the responsibility for elderly care from the family to society as the governmental slogan advertised.

The new insurance has offered more options in different services and established a new norm of self-reliance and determination for one’s own aging however it is doubtful if this new insurance has shifted the responsibility from family to society.

Applying the implications of policy reforms for elderly care in Japan to the United States, one can assume the traditional U.S. norms and values can facilitate effective utilization of the elderly care system. However, since each nation faces different problems with its specific condition, continuous studies and observations on the relationship between elderly care, immigration issues, and demographic changes will be necessary in order to offer more specific suggestions for each aging nation.

As Japan’s new insurance scheme for the elderly has been studied by many aging nations, recommendations for more comprehensive plans are suggested including building a community-based support system into the Long Term Care Insurance scheme to prevent social isolation and respond to emergency situations for the elderly.

Assesses the extent to which corporate organizations in the US have responded to the working mothers and child care issue. Illustrates, through case studies and examples, how organizations have sponsored or offered financial benefits or provisions to workers; to ease the burden of the financial cost of child care and in so doing maintain a competitive edge by retaining skilled workers. The financial and social implications of the corporate organization as “family caretaker” are also raised for the present as well as for the next century.

Individuals with intellectual disability(ies) are living longer contributing to an overall increase in the average age of caregivers. The purpose of this paper is to review the literature on the physical, social and psychological needs of ageing carers of individuals with intellectual disability(ies) in the UK.

A scoping review framework was used to identify literature from eleven databases, the grey literature and the references lists of relevant studies. Only primary research studies that discussed the needs of non-professional carers, aged 65+ years old, of individuals with intellectual disability(ies) in the UK were included. No date restrictions were applied. Thematic analysis was used to narratively synthesise findings.

Six studies were included. Five key themes were identified: Living with fear, lack of information, rebuilding trust, proactive professional involvement and being ignored. Housing and support information is not communicated well to carers. Professionals require more training on carer needs and trust must be rebuilt between carers and professionals. Proactive approaches would help identify carer needs, reduce marginalisation, help carers feel heard and reduce the risk of care crisis. Greater recognition of mutual caring relationships is needed.

This review highlighted the needs of older caregivers for individuals with intellectual disability(ies) as well as the need for more high-quality research in this field. The information presented in this review may be considered by primary care providers and funding bodies when planning future support for this growing population of carers.

The importance of rehabilitation in promoting independence is recognised in current policy directives on the provision of care to older and disabled people, but has not been widely established within the spectrum of services provided by local authorities. AWorcestershire‐based re‐ablement service presents an effective model of joint working to provide comprehensive multidisciplinary assessments and a therapeutic intervention service aimed at reducing dependency and promoting service users' choice and control over their care programmes.