Clara Ajoke Awoyomi, D. Oliver, R. Forrester-Jones
Context: Dance has been suggested as a way of helping people with advanced dementia, providing meaningful involvement and activity. Objectives: To investigate if individuals with advanced dementia would be able to take part in dancing in a Dance Cafe within a residential home setting and undertake the assessment of nutrition, quality of life, balance and mobility. Methods: A wait-list intervention approach was used, with residents allocated randomly to the intervention or a control group, who received the dance intervention later. A Dance Cafe was held weekly for 8 weeks, and assessments were made of weight, nutrition, balance, mobility and quality of life. Focus groups were held with staff and family members after the intervention period to assess their opinions. Findings: The regular assessments of nutrition, balance and quality of life were obtained for the residents with dementia, and they were able to join in the Dance Cafe. No conclusions could be made from the limited quantitative results; in the qualitative assessment, however, the staff and families all felt the participants had benefitted from the Dance Cafe in terms of improved mobility and positive psychosocial effects. Limitations: The small size of the intervention group prevented any statistical analysis of the quantitative assessments. Implications: It is possible to undertake a Dance Cafe with people with severe dementia, and assessments of nutrition and mobility can be undertaken. Further research with a larger group would be needed to investigate its effectiveness.
{"title":"A Pilot Study of the Acceptability of a Dance Café for People with Severe Dementia","authors":"Clara Ajoke Awoyomi, D. Oliver, R. Forrester-Jones","doi":"10.31389/JLTC.67","DOIUrl":"https://doi.org/10.31389/JLTC.67","url":null,"abstract":"Context: Dance has been suggested as a way of helping people with advanced dementia, providing meaningful involvement and activity. Objectives: To investigate if individuals with advanced dementia would be able to take part in dancing in a Dance Cafe within a residential home setting and undertake the assessment of nutrition, quality of life, balance and mobility. Methods: A wait-list intervention approach was used, with residents allocated randomly to the intervention or a control group, who received the dance intervention later. A Dance Cafe was held weekly for 8 weeks, and assessments were made of weight, nutrition, balance, mobility and quality of life. Focus groups were held with staff and family members after the intervention period to assess their opinions. Findings: The regular assessments of nutrition, balance and quality of life were obtained for the residents with dementia, and they were able to join in the Dance Cafe. No conclusions could be made from the limited quantitative results; in the qualitative assessment, however, the staff and families all felt the participants had benefitted from the Dance Cafe in terms of improved mobility and positive psychosocial effects. Limitations: The small size of the intervention group prevented any statistical analysis of the quantitative assessments. Implications: It is possible to undertake a Dance Cafe with people with severe dementia, and assessments of nutrition and mobility can be undertaken. Further research with a larger group would be needed to investigate its effectiveness.","PeriodicalId":73807,"journal":{"name":"Journal of long-term care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49218682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ramona Backhaus, Inge Jochem, Helga Reijnders-Paffen, J. Meijers
Context: In most countries, registered nurse retention and role development in nursing homes is a challenge. Objective: To obtain insight into factors contributing to successful retention of registered nurses in nursing homes and into how to differentiate the role of vocationally trained registered nurses and baccalaureate-educated registered nurses. Method: A qualitative, descriptive, explorative study. In June 2019, World Cafe was held, a method for hosting group dialogs, in which direct care professionals, managers, human resources employees, and teachers participated. A theme-based content analysis was used to analyze data. Findings: Identified factors expected to contribute to retention were role clarity, role content, role model availability, room for professional development, learning on the job, a match between education and actual work, management and board-level support, adequate salaries, and a positive image of working in nursing homes. Vocationally trained registered nurses were considered to perform a key role resident care by serving as case managers. Baccalaureate-educated registered nurses were considered to focus on indirect care (e.g., coaching staff, stimulating evidence-based practices, implementing innovations). Limitations: Due to the limited sample size and the qualitative, explorative nature of the study, findings can only be generalized with caution. Implications: To refine registered nurse roles in nursing homes, it seems crucial to rethink the current roles and hierarchies. Even though management and human resources departments are considered responsible for contributing to role clarity and the creation of supportive practice environments, the registered nurses themselves are also expected to come up with their role.
{"title":"How to Position, Attract and Retain Registered Nurses in Nursing Homes: A Qualitative, Explorative Study","authors":"Ramona Backhaus, Inge Jochem, Helga Reijnders-Paffen, J. Meijers","doi":"10.31389/jltc.80","DOIUrl":"https://doi.org/10.31389/jltc.80","url":null,"abstract":"Context: In most countries, registered nurse retention and role development in nursing homes is a challenge. Objective: To obtain insight into factors contributing to successful retention of registered nurses in nursing homes and into how to differentiate the role of vocationally trained registered nurses and baccalaureate-educated registered nurses. Method: A qualitative, descriptive, explorative study. In June 2019, World Cafe was held, a method for hosting group dialogs, in which direct care professionals, managers, human resources employees, and teachers participated. A theme-based content analysis was used to analyze data. Findings: Identified factors expected to contribute to retention were role clarity, role content, role model availability, room for professional development, learning on the job, a match between education and actual work, management and board-level support, adequate salaries, and a positive image of working in nursing homes. Vocationally trained registered nurses were considered to perform a key role resident care by serving as case managers. Baccalaureate-educated registered nurses were considered to focus on indirect care (e.g., coaching staff, stimulating evidence-based practices, implementing innovations). Limitations: Due to the limited sample size and the qualitative, explorative nature of the study, findings can only be generalized with caution. Implications: To refine registered nurse roles in nursing homes, it seems crucial to rethink the current roles and hierarchies. Even though management and human resources departments are considered responsible for contributing to role clarity and the creation of supportive practice environments, the registered nurses themselves are also expected to come up with their role.","PeriodicalId":73807,"journal":{"name":"Journal of long-term care","volume":"205 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76066347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Context: Day centres have long traditions in social care in the United Kingdom and internationally. In England, they are provided by a mix of organisations, they are not regulated, and there is no national representative body. Research mainly focuses on centre attenders and carers. Frontline staff and volunteer perspectives are rarely reported. Objective: To highlight the role of day centre work and volunteering for individuals and inform recruitment and workforce development. Methods: Qualitative interview data gathered from seven volunteers and ten staff at four English day centres for older people were thematically analysed. Data are drawn from three-year case study research investigating the role, outcomes, and commissioning of day centres. Findings: Paid or volunteer work in day centres has the potential to make unique contributions to people’s lives. Older volunteers and staff particularly value centres’ group environment and the continuity involved which contribute to person-centred relationships and role satisfaction. These experiences and satisfaction help explain why day centre staff retention is above average in social care. Limitations: Although in diverse settings, this research was small-scale. Only high-quality centres may have participated. Methods may have unintentionally excluded volunteers with learning disabilities. Implications: Within a context of problematic recruitment and retention and policy aspirations for community engagement and building on local assets, findings are relevant to workforce development and local recruitment strategies. Further research might explore what creates the working and volunteering culture within a centre and links between culture and outcomes, with a view to developing a model of day centre culture.
{"title":"Making My Day. Volunteering or Working at a Day Centre for Older People: Findings of Exploratory Research in English Day Centres","authors":"Katharine Orellana, J. Manthorpe, A. Tinker","doi":"10.31389/JLTC.58","DOIUrl":"https://doi.org/10.31389/JLTC.58","url":null,"abstract":"Context: Day centres have long traditions in social care in the United Kingdom and internationally. In England, they are provided by a mix of organisations, they are not regulated, and there is no national representative body. Research mainly focuses on centre attenders and carers. Frontline staff and volunteer perspectives are rarely reported. Objective: To highlight the role of day centre work and volunteering for individuals and inform recruitment and workforce development. Methods: Qualitative interview data gathered from seven volunteers and ten staff at four English day centres for older people were thematically analysed. Data are drawn from three-year case study research investigating the role, outcomes, and commissioning of day centres. Findings: Paid or volunteer work in day centres has the potential to make unique contributions to people’s lives. Older volunteers and staff particularly value centres’ group environment and the continuity involved which contribute to person-centred relationships and role satisfaction. These experiences and satisfaction help explain why day centre staff retention is above average in social care. Limitations: Although in diverse settings, this research was small-scale. Only high-quality centres may have participated. Methods may have unintentionally excluded volunteers with learning disabilities. Implications: Within a context of problematic recruitment and retention and policy aspirations for community engagement and building on local assets, findings are relevant to workforce development and local recruitment strategies. Further research might explore what creates the working and volunteering culture within a centre and links between culture and outcomes, with a view to developing a model of day centre culture.","PeriodicalId":73807,"journal":{"name":"Journal of long-term care","volume":"136 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80256481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Hockley, Trish Hafford-Letchfield, Sarah Noone, B. Mason, L. Jamieson, Rikke Iversholt, K. Musselbrook, George Palattiyil, Dina Sidhva, N. Quinn, Sumeet Jain, L. McKie, D. Tolson
An important part of care home life is the support given to older residents by their families/friends through regular visiting. Social visits to residents by their families ceased in response to the COVID-19 pandemic and residents were confined to their rooms. This paper reports on how care home staff improvised to address this situation during the first wave of the pandemic. It focuses on steps taken to maintain communication between residents and families to support emotional well-being. We undertook in-depth cafe-style interviews with twenty-one staff to explore creative practices that they introduced. It was part of a wider Scottish study examining the effect of lockdown on families whose relative was living/dying in a care home (May–October, 2020). Findings reveal the enormous effort by care staff to maintain family connections and the rapid acclimatisation involved working with a number of different on-line platforms, the pulling together of staff from across the care home, and, the attention to emotional well-being of residents living and dying in the care home. Findings highlight the professionalism and commitment of the leadership and staff involved. Whilst some of the staff accounts need no further comment, we draw on some themes from the care home research literature to make sense of the findings in terms of what we might learn going forward. This in-depth qualitative study emphasises the importance of recognising, fostering and nurturing relational compassionate care within long-term care. There is however little evidence whether health and social care policies recognise the importance of this on-going relationship.
{"title":"COVID, Communication and Care Homes: A Staffs’ Perspective of Supporting the Emotional Needs of Families","authors":"J. Hockley, Trish Hafford-Letchfield, Sarah Noone, B. Mason, L. Jamieson, Rikke Iversholt, K. Musselbrook, George Palattiyil, Dina Sidhva, N. Quinn, Sumeet Jain, L. McKie, D. Tolson","doi":"10.31389/JLTC.74","DOIUrl":"https://doi.org/10.31389/JLTC.74","url":null,"abstract":"An important part of care home life is the support given to older residents by their families/friends through regular visiting. Social visits to residents by their families ceased in response to the COVID-19 pandemic and residents were confined to their rooms. This paper reports on how care home staff improvised to address this situation during the first wave of the pandemic. It focuses on steps taken to maintain communication between residents and families to support emotional well-being. We undertook in-depth cafe-style interviews with twenty-one staff to explore creative practices that they introduced. It was part of a wider Scottish study examining the effect of lockdown on families whose relative was living/dying in a care home (May–October, 2020). Findings reveal the enormous effort by care staff to maintain family connections and the rapid acclimatisation involved working with a number of different on-line platforms, the pulling together of staff from across the care home, and, the attention to emotional well-being of residents living and dying in the care home. Findings highlight the professionalism and commitment of the leadership and staff involved. Whilst some of the staff accounts need no further comment, we draw on some themes from the care home research literature to make sense of the findings in terms of what we might learn going forward. This in-depth qualitative study emphasises the importance of recognising, fostering and nurturing relational compassionate care within long-term care. There is however little evidence whether health and social care policies recognise the importance of this on-going relationship.","PeriodicalId":73807,"journal":{"name":"Journal of long-term care","volume":"364 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80462763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brief Summary: Residents in long-term care facilities in Canada with mental and cognitive disorders have complex care needs. To meet these needs an integrated model of care is recommended. Context: The high prevalence of mental disorders in residents of long-term care (LTC) facilities raises serious concerns for facility operators and staff. These residents have multiple vulnerabilities that facility staff should have the necessary knowledge and skills to properly meet their needs. Objectives: To describe the profile of residents with mental disorders (MD) and Alzheimer’s Disease and Related Dementias (ADRD) in Canadian long-term care (LTC) facilities. Findings: Seventy-six percent of residents had MD (40%) and ADRD (36%). These residents compared to those without such disorders were more likely to be cognitively impaired, manifest aggressive behavior, receive psychotropic drugs, and physically restrained, and less likely to be socially engaged. Strengths and Limitations: The large representative sample was a key strength. The findings add to the knowledge about the profile of LTC residents. The cross-sectional design of the study limits the findings to the population studied. Implications: Residents with MD and ADRD compared to those without such disorders are highly vulnerable because of their double burden of mental and physical comorbidities. Their profile may be of interest to LTC facility operators, clinicians, and policy makers about their complex care needs. Our findings raise awareness of the need for trained LTC facility staff for knowledge and skills in psychogeriatric conditions to assess, plan, and implement appropriate interventions for these residents. Coordinated and integrated models of care with access to psychogeriatric specialists such as psychiatrists or advanced practice nurses will also be of benefit to them.
{"title":"Profile of Residents with Mental Disorders in Canadian Long-Term Care Facilities: A Cross-Sectional Study","authors":"Vahe Kehyayan, Jonathan Chen, J. Hirdes","doi":"10.31389/JLTC.47","DOIUrl":"https://doi.org/10.31389/JLTC.47","url":null,"abstract":"Brief Summary: Residents in long-term care facilities in Canada with mental and cognitive disorders have complex care needs. To meet these needs an integrated model of care is recommended. Context: The high prevalence of mental disorders in residents of long-term care (LTC) facilities raises serious concerns for facility operators and staff. These residents have multiple vulnerabilities that facility staff should have the necessary knowledge and skills to properly meet their needs. Objectives: To describe the profile of residents with mental disorders (MD) and Alzheimer’s Disease and Related Dementias (ADRD) in Canadian long-term care (LTC) facilities. Findings: Seventy-six percent of residents had MD (40%) and ADRD (36%). These residents compared to those without such disorders were more likely to be cognitively impaired, manifest aggressive behavior, receive psychotropic drugs, and physically restrained, and less likely to be socially engaged. Strengths and Limitations: The large representative sample was a key strength. The findings add to the knowledge about the profile of LTC residents. The cross-sectional design of the study limits the findings to the population studied. Implications: Residents with MD and ADRD compared to those without such disorders are highly vulnerable because of their double burden of mental and physical comorbidities. Their profile may be of interest to LTC facility operators, clinicians, and policy makers about their complex care needs. Our findings raise awareness of the need for trained LTC facility staff for knowledge and skills in psychogeriatric conditions to assess, plan, and implement appropriate interventions for these residents. Coordinated and integrated models of care with access to psychogeriatric specialists such as psychiatrists or advanced practice nurses will also be of benefit to them.","PeriodicalId":73807,"journal":{"name":"Journal of long-term care","volume":"61 2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73246137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Context: Unpaid carers are the backbone of long-term care (LTC) systems around the world. The COVID-19 pandemic has further increased the pressure many unpaid carers experience; however, their experience has been largely absent from public reporting. Objective: We aim to map the available evidence of the impacts of COVID-19 on unpaid carers of adults (>18 years) with LTC needs as well as of measures implemented to mitigate these effects and how well they have worked. Method: We conducted a rapid review of the academic and grey literature on unpaid carers of adults with LTC needs during the COVID-19 pandemic, covering the period until November 2020. Findings: We identified six key themes that highlight the impacts of COVID-19 on unpaid carers of people living in the community. These are: care commitment, concerns related to COVID-19, availability of formal and informal support, financial implications, carer health and well-being, and carers’ adaptability. In addition, we captured aspects identified by unpaid carers supporting people in residential care settings under the theme ‘carers of people in residential settings’. Finally, we reported evidence of measures implemented to mitigate the impacts on carers. This included the use of technology and the receipt of financial assistance and support for working carers. Limitations: The evidence reported in this review is based largely on cross-sectional data and some of the data reported relies on convenience samples. Implications: We highlight the financial and health impacts that many unpaid carers experience. Given the vital support carers provide to adults with LTC needs, policy makers should consider supporting unpaid carers to mitigate the negative impacts on their lives.
{"title":"The Impacts of COVID-19 on Unpaid Carers of Adults with Long-Term Care Needs and Measures to Address these Impacts: A Rapid Review of Evidence up to November 2020","authors":"K. Lorenz-Dant, A. Comas-Herrera","doi":"10.31389/JLTC.76","DOIUrl":"https://doi.org/10.31389/JLTC.76","url":null,"abstract":"Context: Unpaid carers are the backbone of long-term care (LTC) systems around the world. The COVID-19 pandemic has further increased the pressure many unpaid carers experience; however, their experience has been largely absent from public reporting. Objective: We aim to map the available evidence of the impacts of COVID-19 on unpaid carers of adults (>18 years) with LTC needs as well as of measures implemented to mitigate these effects and how well they have worked. Method: We conducted a rapid review of the academic and grey literature on unpaid carers of adults with LTC needs during the COVID-19 pandemic, covering the period until November 2020. Findings: We identified six key themes that highlight the impacts of COVID-19 on unpaid carers of people living in the community. These are: care commitment, concerns related to COVID-19, availability of formal and informal support, financial implications, carer health and well-being, and carers’ adaptability. In addition, we captured aspects identified by unpaid carers supporting people in residential care settings under the theme ‘carers of people in residential settings’. Finally, we reported evidence of measures implemented to mitigate the impacts on carers. This included the use of technology and the receipt of financial assistance and support for working carers. Limitations: The evidence reported in this review is based largely on cross-sectional data and some of the data reported relies on convenience samples. Implications: We highlight the financial and health impacts that many unpaid carers experience. Given the vital support carers provide to adults with LTC needs, policy makers should consider supporting unpaid carers to mitigate the negative impacts on their lives.","PeriodicalId":73807,"journal":{"name":"Journal of long-term care","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87659644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Sutcliffe, K. Davies, Saima Ahmed, J. Hughes, D. Challis
Context: Home care agencies are a critical part of the social care system in England, however little is known of how they perceive their role in delivering personalised care or their approach to supporting people with dementia. Objectives: To investigate the perception of home care managers of their capacity and capability to provide care for people living with dementia with a focus on specialist care, and the challenges of delivering personalised support. Methods: A qualitative study employing semi-structured interviews (May-October 2018) of ten independent home care managers in England. Findings: Three themes were identified. First, managers aimed to provide responsive care, assessing individual needs and family circumstances including addressing social and emotional needs in keeping with a model of personalised care. Second, in responding to commissioning processes, managers found prescriptive specifications constrained delivery of responsive home care. Sharing assessment and care planning with commissioning teams helped managers personalise client care but created tensions. Third, workforce preparedness was a priority, with life skills and experience valued above qualifications. Agencies used different service models, with only a few referring to specialist dementia roles or services. However, all were aiming to increase understanding of dementia across their teams as part of their approach to personalisation. Limitations: It was not possible to interview home care workers who may have given alternative viewpoints.
{"title":"Delivering Personalised Home Care for People with Dementia: An Investigation of Care Providers’ Roles and Responsibilities","authors":"C. Sutcliffe, K. Davies, Saima Ahmed, J. Hughes, D. Challis","doi":"10.31389/JLTC.35","DOIUrl":"https://doi.org/10.31389/JLTC.35","url":null,"abstract":"Context: Home care agencies are a critical part of the social care system in England, however little is known of how they perceive their role in delivering personalised care or their approach to supporting people with dementia. \u0000Objectives: To investigate the perception of home care managers of their capacity and capability to provide care for people living with dementia with a focus on specialist care, and the challenges of delivering personalised support. \u0000Methods: A qualitative study employing semi-structured interviews (May-October 2018) of ten independent home care managers in England. \u0000Findings: Three themes were identified. First, managers aimed to provide responsive care, assessing individual needs and family circumstances including addressing social and emotional needs in keeping with a model of personalised care. Second, in responding to commissioning processes, managers found prescriptive specifications constrained delivery of responsive home care. Sharing assessment and care planning with commissioning teams helped managers personalise client care but created tensions. Third, workforce preparedness was a priority, with life skills and experience valued above qualifications. Agencies used different service models, with only a few referring to specialist dementia roles or services. However, all were aiming to increase understanding of dementia across their teams as part of their approach to personalisation. \u0000Limitations: It was not possible to interview home care workers who may have given alternative viewpoints.","PeriodicalId":73807,"journal":{"name":"Journal of long-term care","volume":"118 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79085724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Stewart, J. Hughes, D. Challis, A. Worden, S. Davies, Chengqiu Xie, S. Asthana, Alex Gibson
Context: Traditionally local authorities in England allocated resources in social care following a professional assessment of need and a costed care plan. With the introduction of personal budgets, resource allocation tools have been used to provide service users with an initial indicative budget for their care. This is promoted as being more transparent, equitable and giving people greater control over decisions about their care. Objective: This study examined the different approaches to resource allocation and the content of resource allocation tools used for social care in England. Methods: Information was obtained from local authorities about their resource allocation systems. An analytic framework was developed and applied to the tools to explore: who identified needs; whether informal and formal support were recorded; and whether 17 need indicators covering functional status, mental health, and health and wellbeing were present and in what detail. Findings: Ninety-one per cent of 152 authorities responded and 61 per cent of authorities’ tools were analysed. Three approaches were identified: points-based self-assessment tools; standardised assessment data (FACE); and non-points-based/ready reckoner tools. Most authorities used a points-based self-assessment tool. All tools included the service user’s views and a high proportion included a professional’s view, while fewer covered the carer’s view on need. Coverage and presence of detail for the 17 need indicators showed high variation and was least on points-based self-assessment tools. Limitations: The study is the first to examine a large sample of resource allocation tools and provides a valuable baseline for future work. However, non-points-based/ready reckoner tools were under-represented in the sample. Implications: Further research could build upon this study to examine key properties of the tools used such as reliability, validity, sensitivity and specificity; and explore their impact upon service users and staff in terms of time use, cost, utility and equity.
{"title":"Understanding Resource Allocation Processes in Social Care for Frail Older People: Lessons from a National Survey","authors":"K. Stewart, J. Hughes, D. Challis, A. Worden, S. Davies, Chengqiu Xie, S. Asthana, Alex Gibson","doi":"10.31389/JLTC.21","DOIUrl":"https://doi.org/10.31389/JLTC.21","url":null,"abstract":"Context: Traditionally local authorities in England allocated resources in social care following a professional assessment of need and a costed care plan. With the introduction of personal budgets, resource allocation tools have been used to provide service users with an initial indicative budget for their care. This is promoted as being more transparent, equitable and giving people greater control over decisions about their care. Objective: This study examined the different approaches to resource allocation and the content of resource allocation tools used for social care in England. Methods: Information was obtained from local authorities about their resource allocation systems. An analytic framework was developed and applied to the tools to explore: who identified needs; whether informal and formal support were recorded; and whether 17 need indicators covering functional status, mental health, and health and wellbeing were present and in what detail. Findings: Ninety-one per cent of 152 authorities responded and 61 per cent of authorities’ tools were analysed. Three approaches were identified: points-based self-assessment tools; standardised assessment data (FACE); and non-points-based/ready reckoner tools. Most authorities used a points-based self-assessment tool. All tools included the service user’s views and a high proportion included a professional’s view, while fewer covered the carer’s view on need. Coverage and presence of detail for the 17 need indicators showed high variation and was least on points-based self-assessment tools. Limitations: The study is the first to examine a large sample of resource allocation tools and provides a valuable baseline for future work. However, non-points-based/ready reckoner tools were under-represented in the sample. Implications: Further research could build upon this study to examine key properties of the tools used such as reliability, validity, sensitivity and specificity; and explore their impact upon service users and staff in terms of time use, cost, utility and equity.","PeriodicalId":73807,"journal":{"name":"Journal of long-term care","volume":"67 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78333260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Leichsenring, A. Schmidt, Heidemarie Staflinger
Context: The COVID-19 pandemic highlights limitations of long-term care (LTC) systems in Europe, which continue to be divided between health and social care, and between formal and informal care. Objective: This article focuses on Austria’s LTC sector and its critical features that became visible during the outbreak of the COVID-19 pandemic. Method: The analysis was carried out via desk-research, which covered literature, on-going qualitative analysis of media coverage, and statements and reports by interest organisations and governmental agencies between March and August 2020. Where necessary, useful and feasible, update information on ensuing developments until the end of 2020 was added during a final revision. Findings: In Austria, the number of cases as well as the number and share of deaths in care homes were lower than in other countries until August 2020. Yet, the crisis brought several idiosyncrasies to the fore, most prominently a lack of support for informal caregivers and lack of acknowledgements of the rights of live-in personal (migrant) carers. We find that the COVID-19 crisis has shed light on the fact that existing inequalities are being aggravated by gender and migration issues. Implications: (i) The crisis highlights the need for better communication, integrated care and health information flows between health and social care; (ii) Clear guidelines are required to balance older people’s right to self-determination versus (public) health concerns; (iii) Increasing reliance on migrant carers from Eastern Europe has led to a dualisation of the LTC labour market in the past decades, which needs to be countered by increased quality standards and endeavours to fundamentally change the employment situation of live-in carers; (iv) Informal carers are vulnerable groups that deserve special attention and call for expansion of community services in long-term care.
{"title":"Fractures in the Austrian Model of Long-Term Care: What are the Lessons from the First Wave of the COVID-19 Pandemic?","authors":"K. Leichsenring, A. Schmidt, Heidemarie Staflinger","doi":"10.31389/JLTC.54","DOIUrl":"https://doi.org/10.31389/JLTC.54","url":null,"abstract":"Context: The COVID-19 pandemic highlights limitations of long-term care (LTC) systems in Europe, which continue to be divided between health and social care, and between formal and informal care. Objective: This article focuses on Austria’s LTC sector and its critical features that became visible during the outbreak of the COVID-19 pandemic. Method: The analysis was carried out via desk-research, which covered literature, on-going qualitative analysis of media coverage, and statements and reports by interest organisations and governmental agencies between March and August 2020. Where necessary, useful and feasible, update information on ensuing developments until the end of 2020 was added during a final revision. Findings: In Austria, the number of cases as well as the number and share of deaths in care homes were lower than in other countries until August 2020. Yet, the crisis brought several idiosyncrasies to the fore, most prominently a lack of support for informal caregivers and lack of acknowledgements of the rights of live-in personal (migrant) carers. We find that the COVID-19 crisis has shed light on the fact that existing inequalities are being aggravated by gender and migration issues. Implications: (i) The crisis highlights the need for better communication, integrated care and health information flows between health and social care; (ii) Clear guidelines are required to balance older people’s right to self-determination versus (public) health concerns; (iii) Increasing reliance on migrant carers from Eastern Europe has led to a dualisation of the LTC labour market in the past decades, which needs to be countered by increased quality standards and endeavours to fundamentally change the employment situation of live-in carers; (iv) Informal carers are vulnerable groups that deserve special attention and call for expansion of community services in long-term care.","PeriodicalId":73807,"journal":{"name":"Journal of long-term care","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78289116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Helen Chester, J. Hughes, I. Bowns, M. Abendstern, S. Davies, D. Challis
Context: A longstanding concern, both in the UK and internationally, is that multiple health and social care professionals undertake assessments of adults and older people with complex needs, but that information is not shared. Electronic information sharing within assessment and support planning has been identified as a means of promoting integrated care for adults with complex health and social care needs. Objective: To evaluate the implementation of a shared electronic record between nursing and adult social care practitioners in separate agencies and locations to inform the assessment of need for adults and older people with complex needs. Methods: The design of the study reflected the incremental implementation of the shared electronic record between 2010 and 2012 in one geographical area within England. It was a mixed-methods case study employing data from three sources: audit of patient case files; survey of nurse practitioners’ time use, well-being and job satisfaction; and manager interviews post-implementation providing further insights into the implementation process. Findings: Electronic information sharing facilitated greater involvement of adult social care practitioners in the continuing healthcare assessment process and contributed to a more streamlined service. No adverse effects of the intervention on the well-being and job satisfaction of nursing practitioners’ were reported. Limitations: This research was undertaken in a single setting. Implications: Continuing healthcare services are a universal service that uses a standardised assessment process, offering the potential for this to be replicated elsewhere. Thus, findings are of value to policy makers and practitioners and offer the potential to inform wider roll-out.
{"title":"Electronic Information Sharing Between Nursing and Adult Social Care Practitioners in Separate Locations: A Mixed-Methods Case Study","authors":"Helen Chester, J. Hughes, I. Bowns, M. Abendstern, S. Davies, D. Challis","doi":"10.31389/JLTC.16","DOIUrl":"https://doi.org/10.31389/JLTC.16","url":null,"abstract":"Context: A longstanding concern, both in the UK and internationally, is that multiple health and social care professionals undertake assessments of adults and older people with complex needs, but that information is not shared. Electronic information sharing within assessment and support planning has been identified as a means of promoting integrated care for adults with complex health and social care needs. Objective: To evaluate the implementation of a shared electronic record between nursing and adult social care practitioners in separate agencies and locations to inform the assessment of need for adults and older people with complex needs. Methods: The design of the study reflected the incremental implementation of the shared electronic record between 2010 and 2012 in one geographical area within England. It was a mixed-methods case study employing data from three sources: audit of patient case files; survey of nurse practitioners’ time use, well-being and job satisfaction; and manager interviews post-implementation providing further insights into the implementation process. Findings: Electronic information sharing facilitated greater involvement of adult social care practitioners in the continuing healthcare assessment process and contributed to a more streamlined service. No adverse effects of the intervention on the well-being and job satisfaction of nursing practitioners’ were reported. Limitations: This research was undertaken in a single setting. Implications: Continuing healthcare services are a universal service that uses a standardised assessment process, offering the potential for this to be replicated elsewhere. Thus, findings are of value to policy makers and practitioners and offer the potential to inform wider roll-out.","PeriodicalId":73807,"journal":{"name":"Journal of long-term care","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88005794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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