Working with Older People

Cheloni, Sara; Tinker, Anthea

2019 Working with Older People

doi: 10.1108/wwop-04-2019-0007

Motivation is central to the ongoing professional development, performance and retention of healthcare workers. Despite the increasing prevalence of people with dementia (PwD) and the associated demand for geriatric nurses, there exists a paradoxical shortage. The purpose of this paper is to explore the motivation and demotivation of healthcare professionals for working with older PwD, challenges faced, factors influencing intention to leave the field of work and methods to enhance staff motivation to continue working with this group.Design/methodology/approachThis grounded-theory study used thematic analysis to synthesise data from 13 semi-structured interviews relating to the motivating and demotivating factors of healthcare professionals (nurses and healthcare assistants) for working with older PwD in a hospital setting.FindingsStaff were motivated by previous personal experiences, personal characteristics and the fulfilment of the carer–patient relationship. Conversely, staff were mostly demotivated by organisational and working environment factors (e.g. poor leadership characteristics, inadequate staffing levels, lack of development opportunities), negatively influencing their intention to remain in employment.Research limitations/implicationsThe generalisability of the results is limited by the size of the sample. Different organisational strategies/interventions (i.e. support, training, recognition and rewards) are necessary to nurture staff motivation, improve retention, create positive working environments and enhance patient care.Originality/valueThis study offers numerous ways in which to address factors contributing to demotivation in working with PwD, thereby helping to improve staff retention and support the needs of a growing population.

Manthorpe, Jill; Bramley, Stephanie

2019 Working with Older People

doi: 10.1108/wwop-02-2019-0004

The purpose of this paper is to review evidence about the role of education in supporting ex-service personnel to move to social care work with older people. Social care has long-standing, well-recognised problems of staff recruitment and retention in many jurisdictions. Within ageing societies, the need for more social care staff is predicted to rise. Therefore, policy makers and employers are exploring if there are untapped sources of potential employees. Some ex-service personnel may be interested in exploring a move to social care work with older people but may need to gain additional qualifications.Design/methodology/approachDatabases and grey literature were searched systematically to provide an overview of the evidence on this topic. Six articles were included in the review.FindingsA narrative analysis revealed two themes: preparing ex-service personnel for enrolment onto health and social care programmes, and supporting ex-service personnel during health and social care programmes.Research limitations/implicationsThis review was confined to English language studies published between 2008 and 2018. Few mentioned specific user or client groups.Originality/valueThis review identified evidence gaps relating to whether the skills, education, training and experience gained in the armed services are transferable to civilian social care work with older people; the types of support which are offered to ex-service personnel who are interested in completing qualifications necessary for social care roles and the views of ex-service personnel about their experiences of completing educational courses to facilitate a transition into social care work with older people.

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

2019 Working with Older People

doi: 10.1108/wwop-01-2019-0003

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/approachData 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.FindingsA 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/implicationsThis paper is based on a relatively small research project in which the participants were self-selecting and therefore not necessarily representative.Practical implicationsThe paper makes some key recommendations for good practice in green dementia care in extra care housing and care homes.Social implicationsOutdoor 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/valueThe paper makes some key recommendations for good practice in green dementia care in extra care housing and care homes.

Moore, Steve

2019 Working with Older People

doi: 10.1108/wwop-06-2019-0014

The purpose of this paper is to present findings from a research project designed to enhance knowledge of the current extent and nature of abuse in contemporary care homes for older people.Design/methodology/approachA self-completion, postal questionnaire was used to elicit both numerical and textual data that were subsequently subjected to both quantitative and qualitative analysis. The questionnaire was distributed to newly appointed care staff in five participating care homes providing care to older people to determine the nature of any abuse they may have witnessed in the homes in which they had previously worked.FindingsA significant proportion of respondents had witnessed numerous occurrences of primarily psychological and physical abuse and neglect, perpetrated against the older people living in the care homes in which they had previously worked.Research limitations/implicationsAlthough the research draws upon the experiences of only 197 anonymous questionnaire respondents, of whom 180 had witnessed abuse, data suggest that abuse continues to occur in some care homes for older people.Originality/valueThe research has revealed staffs’ recent experiences of a range of abusive acts and practices. When combined with two previous studies using the same or a similar methodology, the research also confirms the enduring presence of abuse in care homes. Findings again suggest that changes are required to current methods of external scrutiny and investigation of practices in care homes.

Moriarty, Jo; Norrie, Caroline; Manthorpe, Jill; Lipman, Valerie; Elaswarapu, Rekha

2019 Working with Older People

doi: 10.1108/wwop-05-2019-0010

The purpose of this paper is to investigate the content, purpose and effectiveness of the handover of information between care home staff beginning and completing a shift.Design/methodology/approachThis was an exploratory study drawing on ethnographic methods. A total of 27 interviews with a range of care home staff, including managers, registered nurses, senior care workers and care workers were undertaken in five care homes selected to give a good contrast in terms of size, ownership, shift patterns and type of handover.FindingsMost handovers were short – lasting 15 min or so – and were held in the office or secluded area in which staff could talk privately. They lasted longer in one home in which the incoming and outgoing shifts physically visited each resident’s room and the communal spaces. Staff felt that handovers were important for the efficient running of the home as well as to alert everyone to changes in a resident’s health or important events, such as a hospital appointment. In one home, handheld devices enabled staff to follow a resident’s care plan and update what was happening in real time.Research limitations/implicationsThis was a small scale study based on data from a limited number of care homes.Practical implicationsThe increasing popularity of 12 h shifts means that many homes only hold two short handovers early in the morning and in the evening when the night staff arrive. There appears to be a trend to reduce the number of staff paid to attend handover. Despite this, handovers remain an important component of the routine of a care home. The information contained in handover relates to the running of the care home, as well as residents’ wellbeing, suggesting that, while their content overlaps with written records in the home, they are not superfluous.Originality/valueAlthough the literature on handovers in hospitals is extensive, this appears to be the first published study of handover practices in care homes.

Pedley, Yvonne; McDonald, Paul

2019 Working with Older People

doi: 10.1108/wwop-08-2019-0019

There is often a focus on the negative aspects of residential care for older people. In the UK, there has been increasing media attention on abuse in these and other care settings and this has impacted upon public perceptions and subsequent government policy. Consequently, care staff are “tarred with the same brush”, yet narratives of their views have rarely been investigated. The paper aims to discuss these issues.Design/methodology/approachThis undergraduate, qualitative, single-case study aimed to investigate the views of staff and explore the implications for them and their practice. The views of 15 participants in a residential care home were obtained through interviews and a focus group.FindingsAlthough the findings reveal sensitivities to the negative portrayal of care roles, they also reveal positive responses through a willingness to change practice, a strengthening of care values and a reduction in risks.Originality/valueThis study will be of interest to those multi-disciplinary residential teams who care for older people as it uncovers a striking sense of guardianship amongst residential care staff, and a willingness to reflect on, and change, practice. The study endorses the value of small practitioner-led research as an illustration of how a residential care team consisting of managers and staff can strengthen its resolve against adverse media coverage and negative public perceptions. This study suggests that this will have positive implications for the health and safety of older people living in residential settings.