Search

The marketisation of European home care has given rise to significant private for-profit providers growth. However, little research has focused directly on commercial companies to examine the mechanisms through which they emerge, grow and shape long-term care policy – this is this paper's task. Drawing on the literature on business power, the recent concept of "institutional business power" is introduced, defined as the power flowing from the entrenched position of business actors in the provision of public social services. The paper identifies the mechanisms through which private providers have grown and assesses the extent of their institutional power by examining their influence on policy and the support they obtain from relevant home care stakeholders. The limits of providers' institutional power are also discussed. The paper relies on semi-structured interviews with representatives of public, private and non-profit home care providers. [ABSTRACT FROM AUTHOR]

This paper examines the influence of the Troika on the retrenchment and reform of social security in Ireland during its bailout between 2010 and 2013. To do this, it draws on data from in-depth interviews with senior civil servants and civil society organisation staff who met with the Troika as part of their quarterly missions to Ireland during this period. The key themes which emerged from these interviews include the largely domestic origins of social security retrenchment and reform; the surprising, and distinctive, positions adopted by the European Commission and the International Monetary Fund (IMF); the extent of the Irish government's room for manoeuvre in this area, and the ways in which the Irish government defended social security against proposals for additional cuts put forward by the Troika. The paper concludes by arguing that the scope for domestic decision-making was heavily constrained, yet non-trivial, and that the Troika's influence comprised not only ‘powering’ but also ‘persuasion’. [ABSTRACT FROM PUBLISHER]

This paper explores the impact of legal rights to housing for homeless people, focusing on the capacity of such rights to ‘empower’ those experiencing homelessness. Lukes’ (2005) three-dimensional view of power, complemented by Bourdieu's (1972) concept of ‘habitus’, is used to distinguish between conceptualisations of empowerment. A distinction is drawn between ‘traditional’ understandings of empowerment, which focus on people's capacity to realise their ‘subjective interests’, and on understandings that foreground ‘real interests’. These latter ‘radical’ perspectives direct attention to people's ‘habitus’ – their internalised dispositions to perceive situations and act in particular ways. Empirically, the paper draws on a qualitative comparison of approaches to homelessness in Scotland and Ireland. Whereas in Scotland virtually all those who are homeless now have a legal right to settled accommodation, Ireland has rejected such a ‘legalistic’ approach, pursuing a consensus driven ‘social partnership’ model. Based on primary research with national experts, service providers and homeless single men in both countries, it is argued that legal rights can effectively empower homeless people. These findings call into question popular and political understandings of the relationship between legal welfare rights and self-reliance. [ABSTRACT FROM PUBLISHER]

Migrant care workers make a substantial contribution to older adult care in Ireland and the United Kingdom (UK). However, little is known about the relational aspects of care involving migrant care workers and older people. Given that the care relationship is closely linked to quality of care, and that the Irish and UK sectors are increasingly restricted by economic austerity measures, this lack of information is a concern for care practice and policy. Our paper explores the relationship between migrant care workers and older people in Ireland and the UK and draws on data collected in both countries, including focus groups with older people (N = 41), interviews with migrant care workers (N = 90) and data from a survey of and interviews with employers. The findings illustrate the complexity of the migrant care worker–older person relationship; the prevalence of need orientated, friendship and familial-like, reciprocal, and discriminatory interlinking themes; and the role of individual, structural and temporal factors in shaping these relationships. [ABSTRACT FROM PUBLISHER]

This paper examines life-long singlehood and its ramifications in old age among women and men in Ireland. During the life-time of the 26 research participants, Ireland shifted from the Western European marriage pattern, characterised by high rates of singlehood, late marriage and high fertility, to declining prevalence of singlehood, higher marriage rates and lower fertility. In-depth interviews were analysed with the help of narrative analysis and grounded theory methods. We identified two main pathways into singlehood that had a long-term impact on the participants' lives. The women and men who had chosen singlehood associated this status with independence, self-fulfilment and autonomy throughout their lifecourse, including in old age. In contrast, older adults who had been constrained in their choice of marital status due to poverty, care work, family roles and cultural norms, expressed regret and dissatisfaction with their single status. In the latter group, the ramifications of the inability to actualise the roles of a spouse, parent and grandparent were particularly apposite in later life when many felt the absence of close ties and expressed loneliness. For some of the older adults who had been constrained in their choice of marital status in earlier life, the possibility of entering into a romantic relationship seemed more feasible in later life. How older adults interpret their pathway into the single status in earlier life impacts on relationship formation and life satisfaction in older age. [ABSTRACT FROM PUBLISHER]

Personhood has been a key influence on the development of person-centred care models in dementia. However, there is ambiguity around the concept and interpretation of personhood, and what it means in practical terms for the delivery of care to people with dementia. This study examines the conceptualisation of personhood within the formal care system for people with dementia in Ireland. A multiple perspective study design examines the experiences of personhood in dementia from the perspectives of people with dementia, family carers and a range of formal carers. Semi-structured interviews with participants were conducted in both community and long-term care settings. Interpretative phenomenological analysis is used to examine the data. A total of 31 participants were interviewed: eight people with dementia, eight family carers and 15 formal carers. There is general consensus on the core elements of personhood among all participants: interests and preferences; lifecourse experiences; social interaction; family; and place. However, there is ambiguity among family carers and formal carers in the interpretation of changes to personhood as the disease progresses. Interpersonal and structural barriers to supporting personhood are identified by all participants. The findings provide guidance on the traits of personhood-enhancing care, including effective communication skills, and the potential of health and social care reform to support the core elements of personhood among people with dementia. [ABSTRACT FROM AUTHOR]

The social needs of frail or isolated older people are sometimes aided by referrals to day centres in the United Kingdom. Since the late 1940s, day centres have had a role to play promoting socialisation in later life. Additionally, attendance at day centres is often open ended, with participants only leaving due to moving to a nursing home or dying. In this study, the views of those attending time-limited day centre programmes in seven day centres in Northern Ireland have been sought in relation to their thoughts about the service as well as how they feel when it ends. Seventeen participants completed diaries for the programme duration and/or engaged in an interview process. Participants reflected on the social and educational benefits of attending but also recognised impositions in the centres that impinged upon individual choices and also the length of time they could remain. This study reveals that, in order to maintain socialisation, time-limited programmes must have clear follow-on strategies for participants. Additionally, respondents' experiences reflect that a paternalistic model of care delivery remains in place that, whilst restrictive, reveals that access to the service is more specialised and not universal. Nevertheless, should day centres wish to remain relevant, it is important that service users are fully consulted about their desires and choices within the setting. [ABSTRACT FROM AUTHOR]

Breast-feeding initiation and continuation rates in the UK and Ireland are low relative to many European countries. As a core outcome of the prospective Cork Nutrition and Development Maternal-Infant Cohort (COMBINE) study (Cork, Ireland), we aimed to describe infant milk feeding practices in detail and examine the prevalence and impact of combination feeding of breast milk and infant formula on breast-feeding duration. COMBINE recruited 456 nulliparous mothers (2015–2017) for maternal–infant follow-up via interview at hospital discharge (median 3 (interquartile range (IQR) 2, 4) d (n 453)), 1 (n 418), 2 (n 392), 4 (n 366), 6 (n 362) and 9 (n 345) months of age. Median maternal age was 32 (IQR 29, 34) years, 97 % of mothers were of white ethnicity, 79 % were Irish-born and 75 % were college-educated. Overall, 75 % breastfed to any extent at discharge and 44 % breastfed solely. At 1, 2, 4, 6 and 9 months, respectively, 40, 36, 33, 24 and 19 % breastfed solely. Combination feeding of breast milk and infant formula was common at discharge (31 %) and 1 month (20 %). Reasons for combination feeding at 1 month included perceived/actual hunger (30 %), healthcare professional advice (31 %) and breast-feeding difficulties (13 %). Of mothers who breastfed to any extent at discharge, 45 % stopped within 4 months. Mothers who combination fed were more likely to cease breast-feeding than those who breastfed solely (relative risk 2·3 by 1 month and 12·0 by 2 months). These granular data provide valuable insight to early milk feeding practices and indicate that supporting early breast-feeding without formula use may be key to the successful continuation of breast-feeding. [ABSTRACT FROM AUTHOR]

Policies to extend working life (EWL) assume homogeneous workers face similar choices about working longer: this may be difficult for women, workers in physically onerous jobs or in low-paid precarious employment. Work-life trajectories are gendered; women interrupt employment and pension-building to provide care. There is occupational variation in capacities to prolong working lives: physically demanding jobs cause work-related health deficits. The precariously employed cannot contribute regularly to pensions and may face age discrimination. This research provides an inter-occupational and cross-national dimension to EWL research, comparing women teachers and health-care workers in the United States of America (USA) and Republic of Ireland. It documents intra-cohort distinctions that emerge among women when considering educational opportunities and occupational tracks expressed in lifecourse trajectories and accumulated capacities for extended work. Analysis draws on interview data from ten teachers and ten health-care workers in each country, comparing the implications of EWL policies for women workers: in precarious versus secure occupations and occupations with different physical demands. It reveals work-life trajectories leading to poorer financial and health outcomes for older health-care workers, especially in the USA. Most women (regardless of occupation or country) opposed extending working life, with concerns ranging from health status and ability to work to the desire to have healthy years in retirement. The most important distinctions are between the occupational categories considered, rather than cross-national differences. Implications for national and work-place policy and research are considered. [ABSTRACT FROM AUTHOR]