Working with Older People

Stephen Gethin‐Jones

2012 Working with Older People

doi: 10.1108/13663661211231774

Purpose – This paper aims to follow up on a previous quantitative research project which established that outcome‐focussed care appeared to be associated with an increase in the individuals' subjective well‐being. The purpose of this paper is to establish why the intervention enabled this. Design/methodology/approach – The study utilised a qualitative approach to gather the subjective experience of the individual service users. The sample consisted of 20 service users, who were subject of two semi‐structured interviews; one interview at the start of the intervention and one at the six month stage. The data were then analysed under core themes raised by the service user in these interviews. The sample was divided into two, with one group receiving the outcome‐focussed model of care and the other group receiving the traditional time focussed care. Findings – The research established that service users' subjective well‐being improved due to the ability of outcome‐focussed care to provide consistency, flexibility and most importantly the ability of the service user to form a relationship with the homecare workers providing their care. Practical implications – This paper will assist professionals to understand why outcome‐focus care has a profound impact upon service users' subjective well‐being as opposed to the existing task focussed care. Originality/value – This and the previous paper provide an insight into how different processes and models of intervention impact upon the subjective well‐being of socially isolated older people.

Patricia Duff OBE; Rosemary Hurtley

2012 Working with Older People

doi: 10.1108/13663661211231800

Purpose – This paper aims to highlight the benefits of the 360 SF diagnostic audit for assessing person centeredness of a domiciliary agency and to highlight the challenges they face with some suggested actions. These are exemplars of what is raised in policy and recent reports relating to personalisation, dignity and integration of health and social care and have wider implications for all agencies as they strive to resolve issues for the client. Design/methodology/approach – The approach is a case study describing results of the audit in relation to challenges that include practice development needs, inter agency co‐ordination, collaboration and co‐operation for the achievement of relationship based person centered outcomes in quality improvement work. The pilot study involved data gathered from the clients, relatives and staff, which were analyzed resulting in findings, conclusions and suggestions for ongoing improvement from which action plans were devised and implemented. Findings – The audit results provide examples of the primary interface relationship and co‐ordination challenges, highlighting leaning needs for staff delivering person centred care in domiciliary settings. Practical implications – This paper raises important practice development issues both inside and outside the agency's responsibility. Use of the tool would support cultural and interface relationship issues affecting the client experience and highlight ways to assist the achievement of collaborative ways of working needed for the integration of health and social care. Social implications – The 360 SF (DS) can help organisations provide evidence to CQC and the public for their performance and identify the close interface relationships and their effectiveness in delivering co‐ordinated and integrated health and social care. Originality/value – The 360 SF DOM has highlighted with evidence the challenges of the systemic culture at the interface, in particular the nature and quality of collaboration, communication and practice development needs across the organisational divide to deliver person centred care and support.

Elaine Argyle

2012 Working with Older People

doi: 10.1108/13663661211231828

Purpose – Dementia care is an issue of increasing policy focus, with person centred approaches becoming synonymous with quality provision in this area. However, the implementation and efficacy of this approach is difficult to measure and there are still huge variations in working practices, with task centred approaches traditionally predominating over more holistic forms of care. In order to address these issues the procedure of dementia care mapping has been developed, which aims to assess the wellbeing of people with dementia and other vulnerable groups through the observation of communal activities. This article aims to critically assess the implementation of a person centred approach. Design/methodology/approach – With the use of dementia care mapping, this article assesses the implementation of a person centred approach with a group of care home residents. All were female, their ages ranged from 77 to 92. Findings – It is shown that while participants potentially experienced many benefits from person centred approaches and the social engagement and integration that derived from this, its efficacy and impact was undermined by contextual factors such as staff shortages. Originality/value – In order that contextual factors are recognised and addressed, practice should transcend its focus on the promotion of individual wellbeing and address the wider group and social contexts which can facilitate or prevent its fulfilment.

Mervyn Eastman

2012 Working with Older People

doi: 10.1108/13663661211231837

Purpose – This paper aims to examine the role that the co‐operative sector can play in responding to the needs and aspirations of older people. In addition, through recounting the Change AGEnts co‐operative journey, it seeks to demonstrate that co‐operative principles have the potential to reconfigure services and change the existing negative narrative on which much public sector commissioning and provision is based. Design/methodology/approach – Change AGEnts is the legacy organisation that came out of the Better Government for Older People's Programme (BGOP), 1998‐2009. The journey from a government sponsored initiative (Cabinet Office) to an independent co‐operative illustrates the opportunities and challenges inherent in taking forward the coalition's present policy intentions of promoting co‐ownership of services, localism and building co‐operative communities. Findings – Co‐operative approaches empower both professional and older people, through common ownership and mutuality. The experience of forming a co‐operative and becoming part of the co‐operative movement, has the potential to completely change the relationship between older people and the state. Originality/value – The paper illustrates that deliberation and dialogue has a powerful part to play within the co‐operative movement, through increasing the control of older people in policy and practice outcomes.

Guojun Wang; Xing Su; Alan Hatton‐Yeo

2012 Working with Older People

doi: 10.1108/13663661211231846

Purpose – The article's aim is to provide an overview of how care will be financed in the future in China as a consequence of changes in society. Design/methodology/approach – The article is a descriptive review describing the responses and systems of funding that are being developed in China to address changes in care support structures and systems particularly in response to the single child policy and the impact of the increased financial aspirations of young Chinese people. Findings – Traditional systems of support for elders have been weakened by changes in social structure and there is a need to develop new models of care and methods to finance this through both the state and insurance schemes. One consequence of change has been increasing numbers of elders living by themselves. Social implications – The one child policy has not only reduced the capacity of families to support their elders but has also caused an imbalance in the ratio of male to female children. It has now become essential to develop models of non‐familial support for elders to complement traditional systems. Originality/value – The article provides an insight into the challenges facing China around elder care as a consequence of social policy change and increased economic mobility.