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Purpose: Most abuse affecting older adults in the UK, as across Europe, takes place within caring relationships, where one person is disabled and needs care/support. This paper critically appraises two of the key theoretical explanations. First, feminist theories of "intimate partner abuse" tell us that it is mostly men who perpetrate abuse against women. Second, "carer strain": the stress caused by caring responsibilities, often with inadequate help from services. Neither fully reflects the complex dynamics of "dangerous care" leading to a lack of voice and choice in safeguarding responses. This paper aims to articulate the need for an overarching theoretical framework, informed by a deeper understanding of the intersectional risk factors that create and compound the diverse experiences of harm by disabled people and family carers over the life course. Design/methodology/approach: The critical synthesis of the theoretical approaches informing UK policy and practice presented here arises from a structured literature review and discussions held with three relevant third sector agencies during the development of a research proposal. Findings: No single theory fully explains dangerous care and there are significant gaps in policy, resources and practice across service sectors, highlighting the need for joint training, intersectional working and research across service sectors. Originality/value: Drawing both on existing literature and on discussions across contrasting policy and practice sectors, this paper raises awareness of some less well-acknowledged complexities of abuse and responses to abuse in later life. [ABSTRACT FROM AUTHOR]

Purpose: A systematic review of the literature was completed to examine the needs of those who provide care to people with intellectual disability and dementia. The purpose of this paper was to develop an understanding of the complexities, challenges and support available to meet the needs of an ageing population. Design/methodology/approach: A qualitative evidence synthesis was used to appraise 12 studies. An evidence synthesis approach was used to better understand the challenges caregivers experience in caring for a person with intellectual disability and dementia. Aggregating and integrating findings from multiple studies allowed to identify inconsistencies, quality, relationships and trends to enhance the awareness of gaps in care provision. Findings: There were six main domains identified from the available literature which included: gaps in knowledge and skills, early identification of dementia and associated difficulties, managing behaviour, coping, burden of care and Impact on confidence. Originality/value: To the best of the authors' knowledge, this is the first paper to use qualitative evidence synthesis to understand the challenges of caring for a person with intellectual disability and dementia. [ABSTRACT FROM AUTHOR]

Purpose: The study of theoretical models explaining elder abuse has been one of the main gaps in the literature of the field. The extent of support of each theory is not clear. This study aims to conduct a systematic review to examine research supporting or opposing six theories of elder abuse: caregiver stress theory, social exchange theory, social learning theory, bidirectional theory, dyadic discord theory and the psychopathology of the caregiver. Design/methodology/approach: This study conducts a systematic review of the literature. Seven databases were searched six times using different keywords about each theory. Findings: This paper finds 26,229 references and then organised and analysed these references using pre-established criteria. In total, 89 papers were selected, which contained 117 results of interest; these papers were summarised and assessed for conceptual, methodological and evidence quality. The results showed evidence in favour of all the explored theories, except for social learning theory, whose results indicate multiple interpretations of the theory. This study finishes this paper by proposing that each of these theories might explain different facets of elder abuse and that more research is necessary to understand how the predictions of these different theories interact. Originality/value: This paper presents an extensive review of the literature on theoretical explanations of elder abuse. The findings can be of value for selecting theories for prevention programmes or providing a summary of the evidence for researchers and practitioners interested in the theoretical explanation of elder abuse. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to provide a commentary on the article by Rachel Forrester-Jones on the experiences of older carers of people with learning disabilities. Design/methodology/approach: The commentary reflects on the themes identified in the original article, comparing its findings to the lived experiences of those taking part in older carers' projects in Oxfordshire, England. Findings: Similar broad themes were identified in both samples. Given these findings, the extent to which matters have changed, since the Valuing People work on older carers is considered. Originality/value: The paper discusses policy and practice implications to improve the quality of life of older carers and their families and explores how the voice of older carers can be strengthened to enable them to shape practice and policy. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this commentary is to explore some of the research on family carers of people who have a learning disability and/or are autistic. Design/methodology/approach: The approach is a narrative commentary. Findings: Family carers of people who have a learning disability and/or are autistic may have needs related to mental health and well-being; however, formal systems of support and resources are limited. Originality/value: The commentary explores and integrates perspectives from international research findings to provide a context/background of broader literature in which the paper by Blackman et al., is situated. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to provide an evidence assessment and narrative synthesis of literature regarding the key characteristics of older people living in service-integrated housing (SIH) facilities and their "accommodation journey". Design/methodology/approach: A rapid evidence assessment was conducted: 22 research publications met the inclusion criteria and were analysed using narrative synthesis. Findings: The quality of studies in this area is low, but consistency across components of the results of studies included in the review is apparent. Results suggest key characteristics of older people that drive moves into SIH are a decline in health, increased dependency, increased health service use and carer burden. Suggested key characteristics of SIH residents are high levels of health problems, dependency and health service use, but high self-reported health and well-being. Results indicate that the key driver for older people leaving SIH is a lack of workforce competency to manage further declines in health and dependency status. Research limitations/implications: Current policy may not realise or account for the complex health and care needs of SIH residents. Investment into integrated care, robust community health services and workforce development to facilitate a comprehensive assessment approach may be required to support residents to remain in SIH and live well. Further longitudinal studies are required to map the progression of SIH residents' health status in detail over time to provide an understanding of preventative and enablement support, development of care pathways and workforce planning and development requirements. Originality/value: This evidence assessment is the first to consider the accommodation journey of older people residing in SIH. [ABSTRACT FROM AUTHOR]

Purpose: There is little evidence regarding how to best support the emotional well-being of children in foster care. This paper aims to present the evaluation of an adaptation of the reflective fostering programme, a group-based programme to support foster carers. This study aimed to explore whether a version of the programme, co-delivered by a social work professional and an experienced foster carer, was acceptable and relevant to foster carers and to gather data on programme effectiveness. Design/methodology/approach: In total, 38 foster carers attended the programme and took part in this study. Data was collected regarding carer- and child-focused outcomes at pre-intervention, post-intervention and four-month follow-up. Focus interviews were also conducted to further assess acceptability and relevance for foster carers. Findings: Analysis of quantitative outcome showed statistically significant improvements in all outcomes considered including foster carers stress and carer-defined problems, as well as carer-reported measures of child difficulties. Focus group interviews with foster carers suggested that the programme as co-delivered by a foster carer and a social worker was felt to be relevant and helpful to foster carers. Originality/value: These results provide a unique contribution to limited understandings of what works for supporting foster carers and the children in their care. Promising evidence is provided for the acceptability and relevance of the revised version of this novel support programme and its effectiveness in terms of carer- and child-related outcome measures. This work paves the way for further necessary impact evaluation. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to examine elder abuse (EA) tendency in the context of social integration and caregiver stress (CGS). Afterward, the attempt has been made to examine the role of mens rea or intention in the incidence of EA. Design/methodology/approach: For examining the opinion on EA through the perspective of the elderly and caregiver, a questionnaire was developed using exploratory factor analysis and confirmatory factor analysis. Afterward, a z-test was used for analyzing the results obtained from the elderly and caregivers. Findings: The results showed that in the context of EA, the opinion of caregivers differs from the elderly. This finding was attributed to the theory of ignorance. Based on this, the legal action for every incidence of EA was discouraged by seeking endorsement from the attachment theory especially for the EA incidences arising due to factors such as social isolation or CGS. Research limitations/implications: This research addresses the presence and non-presence of mens rea or intention in the incidence of EA. Future studies may be conducted by taking a sample from two more developed and developing economies. Moreover, based on the findings the recommended framework can be empirically examined by future researchers. Practical implications: Understanding the study through the perspective of the caregiver may facilitate the academicians and practitioners in keeping the fabric of relationships stronger among the elderly and caregiver. Originality/value: Based on the results obtained from the elderly and caregiver, this study proposes a conceptual framework for examining the EA through the lens of mens rea/intention of the caregiver. It is recommended that initiating legal action for every incidence of EA must be discouraged. However, the incidences such as physical abuse (assault), financial abuse, sexual abuse and alike for which the law itself assumes the presence of intention must not be exempted. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to explore the role of culture in shaping the caregiving experiences of British South Asian families caring for a child with developmental disabilities in the UK. In particular it explores how the coexistence of two distinct cultures (British/South Asian) impacts upon these caregiving experiences. Design/methodology/approach – A qualitative design using in-depth interviews and interpretative phenomenological analysis was used with seven parents identifying as British South Asian who had been born in the UK or had moved to the UK as young people. Findings – Three master themes emerged: living with loss, uncertainty and overwhelming responsibility; learning about disability and facing stigma; and having to cope. Research limitations/implications – Using a relatively homogeneous sample of carers this study provides an insight into how exposure to two different cultures shapes the understanding and adaptations of British South Asian carers in the UK. Social implications – Issues in the acculturation of these parents emerge which demonstrate the tensions they face in relating to both South Asian and Western cultural influences. The study makes recommendations for how services can work with such families in order to help them make sense of their children’s disability, access culturally appropriate support and cope with the numerous demands of being a caregiver. Originality/value – This paper contributes to a growing literature on the experience of South Asian parents who care for children with intellectual disabilities. It has important messages for workers about how to support these individuals most effectively. [ABSTRACT FROM AUTHOR]

Purpose – This paper describes an ongoing process of engagement with carers of people with intellectual disabilities currently being monitored by an out of area service for both carers of people placed both in area and out of area within a local Mental Health Learning Disabilities team in South London. Design/methodology/approach – Using a series of consultation events, carers were asked to participate in a free dialogue which focussed on everyday issues for carers. This included financial implications of caring, knowledge of care pathways/systems in care, carer's needs and expectations and the support they currently receive. Findings – This paper highlighted a number of issues and concerns that carers face in their daily lives when supporting one or more people. These include lack of recognition, financial difficulties, lack of training and support. Originality/value – This project offered a valuable insight into current carer perceptions and will help develop further discussion and promote greater engagement by services and mutual understanding with this often neglected group. [ABSTRACT FROM AUTHOR]

Purpose Carers of people with eating disorders (EDs) experience high levels of burden which can lead to clinical levels of depression and anxiety, high levels of expressed emotion and can lead to a non-conducive environment to support recovery. The Maudsley Method skills-based workshops can empower carers to support people with ED to move towards recovery, reduce carer burden and high levels of distress. The paper aims to discuss these issues.Design/methodology/approach Adaptations have been made to the Maudsley Method skills based workshops to include evidence based approaches from cognitive remediation therapy; mindfulness and acceptance commitment therapy. The adapted workshops were assessed via a pilot study with ten carers of people with ED using a mixed method design. The Experience of Caregiving Inventory and SF-36 were used to assess aspects of caregiving and carer wellbeing, respectively pre and post intervention. Thematic analysis was used to evaluate carers’ views on the intervention.Findings Results indicated that carers reduced their level of burden particularly in their experience of stigma, dependency and loss. Furthermore, positive aspects of the relationship with the person with the ED improved. Thematic analysis was used to obtain feedback from carers of the workshops. Qualitative data identified that carers improved their self-awareness, understanding of ED and the techniques they could use, and increased their social support.Research limitations/implications Further research is required to compare the original workshops with this adapted intervention.Originality/value Although this is a pilot study, the results suggest that further evidence based interventions could be added to the Maudsley Method approach to support carers. [ABSTRACT FROM AUTHOR]

Purpose - This paper seeks to reconcile society's need to apply strong sanctions to parents who are responsible for the murder of a disabled adult while also recognising the stresses present in their lives. Design/methodology/approach - The paper reviews six cases in which seven disabled adults were killed by a parent in the UK between 1999 and 2009. Findings - The review found that these were no ordinary crimes and nor were they motivated by malice, but occurred against a backdrop of significant mental illness and distress. In addition, two of the parents killed themselves as well as their adult child and another attempted suicide. The explanations offered in court to account for the murders included a combination of caregiver stress and mercy killing and the courts struggled to find a consistent approach. Research limitations/implications - The review is limited to cases reported in the press and only considers information in the public domain. The portrayal of the issues in the media is integral to the study. The cases reported in this paper are a sub-set of a larger sample of children and adults murdered by caregivers during this period. Originality/value - The paper compares and contrasts some features of these high-profile cases, commenting on the way they were addressed in the courts and making recommendations as to how the backdrop of significant mental ill-health could be taken into account in the way families are offered support with a view to preventing further tragedies. [ABSTRACT FROM AUTHOR]

Purpose – How resources for social care are allocated to individual service users has long been a concern. There are debates regarding the priority given to certain needs in Resource Allocation Systems (RASs). The purpose of this paper is to compare the views of adults with a learning disability and Directors of Adult Social Care regarding their priorities for resource allocation with priorities arising from observed resource allocation decisions. Design/methodology/approach – In a consultation workshop, 12 adults with learning disabilities were asked to rank the perceived importance of eight needs-related outcomes. Directors of Adult Social Care completed an online questionnaire concerning the distribution of resources across the same eight outcomes. Actual resource allocation data from 11 local authorities were also modelled against these outcomes. A variable importance metric (the percentage contribution of each outcome to predicting costs) was used to rank the importance of these outcomes in terms of determining actual resource allocation. Findings from these data collections were compared. Findings – There were discrepancies between the views of adults with a learning disability, the perspectives of Directors and actual resource allocation data. Whereas adults with a learning disability perceived psychological well-being as most important, Directors and actual resource allocation data stressed the importance of activities of daily living and carer burden. Originality/value – This analysis will prove useful in understanding the concerns of adults with a learning disability and whether these are adequately addressed by current RASs. [ABSTRACT FROM AUTHOR]

Purpose – Around 50 per cent of carers of people with eating disorders (EDs) experience mental health difficulties. The purpose of this paper is to investigate well-being of carers of people with ED and carers of people with severe and enduring eating disorders (SEEDs). Design/methodology/approach – Carers (n=104) were recruited from UK support groups and stratified using duration of the care recipient’s ED (0-2, 2-6, >6 years), with the >6 years category classified as SEED. Data were compared with existing carer well-being studies of other patient groups. Findings – Carers of people with SEED were not significantly different on reported well-being to carers of people with ED. However, carers of people with ED reported significantly less well-being than community norms, carers of people with brain injury and of people with dementia. Specifically, poorer social functioning was reported. Research limitations/implications – Further research on carers of people with SEED is warranted as carers of people with SEED were not equally balanced in gender. It would be beneficial if support groups and skill-based workshops were more available for carers. Originality/value – This is the first known study to compare carer well-being of people with SEED with carers of other clinical populations. Further research is required to identify the needs of carers. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to explore US Chinese older adults' views regarding elder abuse interventions in order to understand barriers and facilitators of help-seeking behaviors. Design/methodology/approach -- The study design was qualitative, using a grounded theory approach to data collection and analysis. Community-based participatory research approach was implemented to partner with the Chicago Chinese community. A total of 37 community-dwelling Chinese older adults (age 60+) participated in focus group discussions. Findings -- Participants viewed many benefits of intervention programs. Perceived barriers were categorized under cultural, social, and structural barriers. Facilitators to implement interventions included increasing education and public health awareness, integrating social support with existing community social services, as well as setting an interdisciplinary team. Perpetrators intervention strategies were also discussed. Originality/value -- This study has wide policy and practice implications for designing and deploying interventions with respect to elder abuse outcome. Modifying the cultural, social, and structural barriers that affect health behavior of Chinese older adults contribute to the salience of elder abuse interventions in this under-served. [ABSTRACT FROM AUTHOR]