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Purpose: Demand for care at home is growing because of the increase in life expectancy, an ageing population and the chronic conditions that often accompany longevity. Daytime care at home services have been widely reported on, but less is known about overnight care at home. This paper aims to gather evidence about overnight social care for older adults in their homes. Design/methodology/approach: Recent studies were identified through searches in three electronic databases. Studies published in English between January 2016 and June 2022 exploring overnight care at home for older adults were eligible for inclusion. An additional Google search identified home care services within the UK currently providing overnight support. Findings: The review retrieved five relevant papers, highlighting the paucity of research in this area. A narrative review of the literature identified common themes that suggested domiciliary night care staff play an integral role in meeting the overnight care and support needs of older adults who wish to be cared for at home. Despite the limited evidence base in this area, the Google search for UK domiciliary services who provide overnight support identified several active programmes. Originality/value: To the best of our knowledge, this is the first scoping review exploring the provision of overnight social care to older adults in their own homes. The review highlights the need for further research to inform commissioning and practice development. [ABSTRACT FROM AUTHOR]

This paper investigates the planning of virtual ward (VW) capacity including the remote monitoring of frail and elderly patients. The main objective is to optimize VW hub locations across a region in the United Kingdom. Furthermore, assigning the optimal number of clinicians to different regions needs to be considered. We develop a mathematical model that minimizes the setup and travel costs of VW hubs and staff. Our experimental analysis evaluates different levels of demand considering postcode areas within different Trusts, also known as Health Boards, in the National Health Service (NHS). Furthermore, our experiments provide insights into how many hub locations should be deployed and staffed. This can be used to individually find the number of remote monitors and clinicians for each facility as well as the system overall. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to highlight current finding issues relating to the provision of hospice care services which are largely provided by the independent sector and heavily reliant on charitable fund raising. The primary focus is on the UK, but it is an issue of relevance to many other countries around the world. Design/methodology/approach: The paper is an opinion piece informed by contemporary reports, official publications and research findings, as well as the author's own work within the hospice sector. Findings: As with many other countries around the world, the bulk of hospice funding in the UK comes from charitable donations of various kinds. However, the impact of COVID-19 highlighted both the fragility of this funding model and the precarious nature of hospice sector finances currently. Practical implications: This is an issue of growing importance that affects older people and their families not only in the UK but in all countries with ageing populations. Hospices play an important role in providing end-of-life care and, with demand for services steadily rising due to demographic trends, there are important questions about the sustainability of the current hospice funding model. Social implications: Issues of funding require a much higher level of engagement from policymakers if hospice care is going to continue to play a significant part in achieving a good death for people from all sections of society. Originality/value: Although hotly debated within the hospice sector and in official reports, this issue has yet to be properly examined within academic circles. [ABSTRACT FROM AUTHOR]

This paper reports on an innovative interprofessional education (IPE) initiative conducted in three care homes across Greater Manchester in the United Kingdom (UK). Students from a variety of professions including nursing, physiotherapy, social work, podiatry, counseling, and sports rehabilitation worked collaboratively in the homes to address the residents' individual goals. We found that care homes provided students with many opportunities for interprofessional working and learning. Through better understanding the dimensions of different perspectives and approaches, students improved their education and transformed their perceptions of aged care. Having a diverse range of professionals allowed staff to gain insight into the latest evidence-based practice and address the multiple needs of the residents more holistically. Residents gained an enriched sense of meaning and purpose in their daily life by engaging in fulfilling and meaningful activities. The complexities of undertaking an IPE initiative in this setting are also considered and we conclude by proposing important avenues for future research. [ABSTRACT FROM AUTHOR]

Extra-care housing (ECH) has been hailed as a potential solution to some of the problems associated with traditional forms of social care, since it allows older people to live independently, while also having access to care and support if required. However, little longitudinal research has focused on the experiences of residents living in ECH, particularly in recent years. This paper reports on a longitudinal study of four ECH schemes in the United Kingdom. Older residents living in ECH were interviewed four times over a two-year period to examine how changes in their care needs were encountered and negotiated by care workers, managers and residents themselves. This paper focuses on how residents managed their own changing care needs within the context of ECH. Drawing upon theories of the third and fourth age, the paper makes two arguments. First, that transitions across the boundary between the third and fourth age are not always straightforward or irreversible and, moreover, can sometimes be resisted, planned-for and managed by older people. Second, that operational practices within ECH schemes can function to facilitate or impede residents' attempts to manage this boundary. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to highlight some of the work with/for/about older people being undertaken by museums during the coronavirus disease (COVID-19) pandemic, thinking of museums as caregivers. Design/methodology/approach: This paper reviews the responses from museums which work with older adults, in times of pandemic. It reviews how museums have addressed older people during the COVID-19 outbreak in the UK and Portugal. Two Portuguese maritime museums which have older adults as strategic audiences are selected and their Facebook webpage during the lockdown is analyzed. Findings: Museums were committed to delivering online the work they have been doing offline, not without limitations. The digital turn in times of pandemic draw attention to inequalities regarding visitors who has access and literacy to engage with the digital museum as well as museums themselves. Unlike in the UK, in the two maritime museums, there were no specific programmes targeting older people – except for COVID-19 messages. However, older adults are presented online as active and as experts on maritime issues, representing empowering versions of ageing, either online or offline. Originality/value: This paper reviewed and illustrated with empirical examples from the UK and Portugal how museums are addressing older adults during the COVID-19 pandemic, contributing to the wider debate on the role of arts, culture and cultural heritage for the well-being of older adults. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to report on a scoping review of the advantages and challenges of extra care housing (ECH) provision in the UK for people living with dementia. Access to suitable housing is a fundamental right for people living with dementia and can enable people to live as well as possible (Twyford and Porteus, 2021). Understanding the advantages and disadvantages of different models of housing with care has been identified as a research priority by people living with dementia (Barrett et al., 2016) but "there is no current consensus on the best model of specialist housing for people with dementia" (Twyford and Porteus, 2021, p. 29). Design/methodology/approach: This scoping review identifies the advantages and disadvantages of living in ECH for people with dementia. It is the preliminary stage of a study that seeks to develop knowledge about different models of ECH for people living with dementia (Atkinson et al., 2021). Findings: Advantages include the promotion of independence, flexible staffing, safety and security, social inclusion, physical design and integrated service provision. Disadvantages include barriers to entry, tensions between independence and support, managing advanced dementia, resourcing flexible care, managing social exclusion, loneliness and stigma and a disabling environment. Research limitations/implications: The scoping review reinforces the need for further research into different models of ECH provision in the UK for people living with dementia. The review provides insight that is of benefit to all stakeholders involved in ECH and contributes to the development of evidence-based provision called for in the recent All Party Parliamentary Group inquiry (Twyford and Porteus, 2021). Originality/value: This scoping review summarises the current position for people living with dementia in ECH. [ABSTRACT FROM AUTHOR]

Increasing longevity has led to a rising number of adult children who are at higher ages when they provide care for their parents. Drawing on the lifecourse approach and exchange theory, the paper addresses similarities and differences in parent care between late middle-aged and older adult children. The study uses the UK Household Longitudinal Study, restricting the analysis sample to individuals aged 50 and older with a living parent or parent-in-law. It presents multivariate models to examine differences between late middle-aged (aged 50–64) and older (aged 65+) children in being a parent carer, providing intensive care, the duration of parent care and providing selected types of help to parents. The involvement in parent care increases among women up to the end of their seventh decade of life and for men up to their eighth decade of life. At higher ages, the proportion of parent carers decreases more strongly for women than men. Older carers have shorter care-giving episodes than younger carers, but there is no significant difference in the type of care provided. Even past retirement age, parent care remains classed and gendered, with women from lower social classes having the highest likelihood of providing intensive parent care in old age. Having dependent children or living in a non-marital union depress the likelihood of caring for a parent even past retirement age. [ABSTRACT FROM AUTHOR]

The care of older people is being radically reformulated by placing the individual at the centre of care process through the introduction of individual care plans. This marks a significant transition for the care of older people away from acute responsive clinical care towards a greater emphasis on co‐produced preventative health and social care and relations of care "with" older people. Geographies of volunteerism are yet to consider the effect of co‐production as a dominant rhetoric in UK health and social care. In this paper we show that the Health and Social Care Act (2012) and the Care Act (2014) has the potential to fundamentally alter discourses of care by introducing new spatialities to older people's care. New spatialities of care will not only rely on the reciprocity and interdependence of care between individuals and organisations but also the mobilisation of a voluntary care‐force to be attentive to individuals. Spatialising co‐production reveals the institutional and professional boundaries that prevent the type of open partnership that sits at the heart of the rhetoric. Our ethnographic and qualitative methodology was developed to understand how our case study of Living Well (Cornwall, UK), as a philosophy of care, is realised in practice and to consider the main collaborators' views of different methods of co‐production involving volunteers. We discuss two principal spaces of co‐production, highlighting the opportunities provided for, and barriers to, co‐production expressed by volunteers and other partners by attending to the relations of care that are recognised through: (1) formal meetings and coffee mornings, which provide spaces for volunteers to contribute, and (2) multi‐disciplinary team (MDT) meetings, in which volunteers are largely absent. The care of older people is being radically reformulated by placing the individual at the centre of care process through the introduction of individual care plans. In this paper we show that the Health and Social Care Act (2012) and the Care Act (2014) has the potential to fundamentally alter discourses of care by introducing new spatialities to older people's care. Our ethnographic and qualitative methodology was developed to understand how our case study of Living Well (Cornwall, UK), as a philosophy of care, is realised in practice and to consider the main collaborators' views of different methods of co‐production involving volunteers. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to explore the terms used in the Macmillan Dictionary and the Oxford English Dictionary to identify the people who are paid to provide care to the elderly and check their presence in a corpus – professional home care (PHC) – of three UK-based specialised websites. Design/methodology/approach: This study is based on the frameworks and methods of corpus-assisted Discourse Analysis (Baker, 2006). The terms were extracted from a corpus of British websites of companies providing PHC services. Findings: This study highlights that in the PHC corpus, the words "caregiver" and "carer" are used as synonyms at the level of popular communication, whereas "care assistant" and "care worker" are used for intra-specialistic communication. The analysis also points out the variations in terminology observed in the corpora that are intended for different communication contexts, e.g. how professionals define themselves compared to how external actors identify them. Originality/value: This paper provides insight into the terminological aspects of caregiving in the professional field through a corpus-based study on specialised terminology integrating lexicographic considerations. This methodological framework can capture the sociolinguistic attitudes of speakers. [ABSTRACT FROM AUTHOR]

Despite the growth of cultural gerontology this century, relatively few gerontologists have interrogated their own experiences of ageing through a critical reflexive lens. This paper seeks to address this lack of attention by discussing some findings of the Ageing of British Gerontology project: a two-year (2015–2017) Leverhulme-funded study focused on identifying key developments and changes in gerontological research, theory, policy and practice in Britain since the founding of the British Society of Social and Behavioural Gerontology (now the British Society of Gerontology) in 1971. As part of our mixed-method study, we undertook 50 in-depth biographical interviews with 'senior' or retired individuals who have played a key role in the creation and development of gerontology in Britain. As well as focusing more widely on gerontological developments, we asked participants about the relationship between their professional insights into ageing and their personal experiences of ageing – both their own and that of loved ones. In this paper, we discuss the findings in relation to five key themes: health, illness and mortality; close personal relationships; work relationships; challenging ageism; and ageing selves. We found evidence that participants often drew upon their personal experiences of ageing in a range of contexts, including teaching and research. There were also numerous examples of professional insights informing personal decision-making, especially in relation to care of loved ones, though the emotionally challenging aspects of this emphasised the limitations of professional insights. Ultimately, we argue that the distinction between the personal and the professional is something of a false dichotomy, and there is often a complex interplay between the two aspects. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to promote discussion about, and the development of the evidence-base underpinning integrated working for intergenerational working. It discusses perspectives on intergenerational work in general and specifically draws on case experiences of the use of intergenerational reminiscence based on sporting memories to highlight issues pertaining to integrated working.Design/methodology/approach The paper presents a general discussion of issues of intergenerational projects and integrated working, with case discussions of the use of sporting memories as an intervention for focusing intergenerational contact.Findings It is concluded that intergenerational work has much to offer but that it is far from clear how best to organise integrated working for this type of work. There are interesting lessons to be drawn for intergenerational interventions and integrated working from the case study discussions.Research limitations/implications Although case studies can provide crucial in-depth knowledge they can be limited in developing evidence we can be sure is more generalisable across contexts. Hence, further research is required into the impact of intergenerational projects, and how best to maximise this through effective integrated working.Practical implications The discussion and case study materials suggest there is much potential in using intergenerational projects to achieve a range of possible outcomes but it is not clear how integrated working is best operationalised in such work. Care is required about clarity concerning the aims of specific projects, but practitioners and others should be encouraged to carefully explore this area of work.Social implications The challenges of an ageing society are significant, as is the need to maintain intergenerational contact, mutuality and the implicit social contract across generations. Specifically developing opportunities for such contact may help achieve this and a range of other positive outcomes.Originality/value This paper brings together a discussion of intergenerational projects with consideration of the challenges of integrated working, and adds specific case study lessons from the use of sports-based reminiscence. [ABSTRACT FROM AUTHOR]

Asset-based thinking is increasingly prevalent in health policy and is to be found also in discourses on social care. This article explores and critiques the applicability of asset-based approaches to social care for older people, using Carol Bacchi's analytical framework to consider developments in the United Kingdom especially. The problem construction, assumptions and suggested solutions underpinning an asset-based approach are considered in turn. The paper draws two major conclusions. The first is that, while it has potential application to the field, the key assumptions and objectives of the asset-based approach do not hold well for social care and therefore adopting the approach carries risks. The paper concludes, secondly, that an asset-based approach is ‘over-promised’ in the sense of being insufficiently theorised and lacking empirical evidence. A number of suggestions are made for greater critical interrogation, improved empirical evidence and closer scrutiny of the policy ‘solutions’ associated with assets-related thinking. [ABSTRACT FROM AUTHOR]

Malnutrition in hospitalized patients remains a significant problem. Protected Mealtimes is a complex, inter-professional ward-based intervention that was first introduced in the United Kingdom to address this issue. Now implemented internationally, the approach still remains in key policy documents including the National Health Service Essence of Care. This review aims to synthesize the nutrition, satisfaction and quality of life patient/resident outcomes that arise from the implementation of Protected Mealtimes in hospitals and residential aged care facilities and to consider fidelity issues that have been reported in previous research. A defined search strategy was implemented in seven databases to identify full text papers of original research that evaluated Protected Mealtimes implementation. After screening, data were extracted from eight studies (7 quantitative and 1 qualitative study) that were conducted in hospitals. There was no research identified from the aged care sector. There were few positive outcomes that resulted from Protected Mealtimes implementation, many fidelity issues with the intervention were reported. It is apparent that Protected Mealtimes provide few, if any, benefits for hospitalized patients. It is a complex, multi-pronged initiative that has limited fidelity and limited outcomes. As such, we recommend that disinvestment by policy makers for hospitals should be considered, with the implementation of other evidence based mealtime initiatives. We provide no recommendation for disinvestment in the aged care sector, since the approach has not been evaluated against any of the eligible outcomes of this review. [ABSTRACT FROM AUTHOR]

Background Given the globally ageing population, care homes have an important role in delivering palliative and end-of-life care. Advance care planning (ACP) is promoted to improve the quality of end-of-life care in this setting. While many professionals can be involved in ACP, little is known about what influences multi-professional involvement and how multi-professional working impacts the ACP process in the UK. This study investigated multi-professional practice in relation to ACP in nursing homes. Design and methods An ethnography was undertaken in two UK nursing homes using multiple methods of data collection: observations, interviews and document review. Participants included the following: nursing home residents (n  = 6), relatives (n  = 4), nursing home staff (n  = 19), and visiting health and social care professionals (n  = 7). Analysis integrated thematic analysis, mapping of resident ACP trajectories and documentary analysis. Findings This paper suggests that multi-professional and relatives' involvement in ACP was disjointed. Continuity and coordination were disrupted by misalignment of visiting professional and nursing home organisational structures. Findings show a 'knotworking' approach to teamwork and power imbalance between nursing home staff and visiting professionals, such as general practitioners. While residents wished their relatives to be involved in their ACP, this was not formally recognised, and limited support existed to facilitate their involvement. Conclusion The structure and organisation of multi-professional and relatives' involvement in ACP led to fragmentation of the process. This marginalised the voice of both the resident and nursing home staff, thereby limiting ACP as a tool to enhance quality of end-of-life care. [ABSTRACT FROM AUTHOR]

Tensions between religious freedoms and lesbian, gay, bisexual, trans and queer (LGBTQ) rights have evolved from debates about sinful deviance to competing equality claims. There is a growing debate, originally in the US, but emerging in the UK, about whether religious social workers, particularly those holding fundamentalist Christian beliefs, can deliver affirmative, anti-oppressive services to LGBTQ people. This is important because over two-fifths of social workers identify as Christian and almost a quarter of UK charities, including those running community and residential care services for older people, are religious organisations. These concerns have been highlighted in a recent judicial review involving a social work student, Felix Ngole, who was expelled by the University of Sheffield for making homophobic comments on his Facebook page. The Court of Appeal ruled the University's decision was procedurally flawed and had conflated religious prejudice with discrimination. This paper considers 70 online responses to a Community Care article written by Ngole, which highlight divided opinions within the social work profession. It critically interrogates, within regulatory contexts, whether it is possible to be both deeply opposed to LGBTQ people's lives and yet work affirmatively and anti-oppressively with them. An urgent research agenda is proposed. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to present findings from face-to-face interviews with three former care staff who were proven to have abused some of the older people living in the care and nursing homes in which they had once worked. The research sought to explore the intra-personal dynamics, personal characteristics and work experiences that led these staff to perpetrate abuse. Design/methodology/approach: Semi-structured interviews were undertaken with three former care and nursing home staff who had committed abusive acts and the data secured subjected to thematic narrative analysis. Findings: None of the three people interviewed had intended to become care staff and reported that the interview and induction processes they experienced did little to establish their suitability for the work they would be undertaking or to prepare them for its demands. Participants expressed their generally negative perceptions of older people, particularly those living with dementia, and told of how they also felt that they were under pressure to conform with the often abusive care home regimes that they had entered. They also recounted some specific abusive practices developed to allow them to manage the constant tension between the time available to complete all of the tasks required when "caring" for older people, and revealed their perceptions of external scrutiny of care home conduct and the behaviours developed to deflect the effectiveness of this oversight. Two interview participants also revealed their unfavourable attitudes to some of the people they were employed to care for that were based upon perceptions of ethnic differences, and of how this had contributed to the abuse they perpetrated. Research limitations/implications: Though the research draws upon the experiences of only three former care staff, the data reveal some of the intra-personal dimensions of individual staff who have engaged in abusive acts, and illuminates how the care home environment with which they interact can engender conditions under which abuse is more likely to occur. Originality/value: Unusually, the paper explores the characteristics, perceptions and experiences of care staff who have actually committed abusive acts against those entrusted to their care. [ABSTRACT FROM AUTHOR]

Purpose In most European countries there is a range of quality control system mechanisms, however, poor quality and institutional violence can be found in the residential sector. Taking Portugal as an example of a country that uses an inspection-only approach, this paper focuses on the monitoring system for controlling the quality of care in nursing homes. The purpose of this paper is to analyse how mistreatment of older people is identified and dealt with by the national social security services. In particular it looks at what the indicators are with which to assess poor quality care and mistreatment (how it is perceived and defined), which factors affect mistreatment of older people and intervention outputs (i.e. what are the sanctions to prevent and combat this).Design/methodology/approach An exploratory approach was based on a mixed method, using a database of 3,685 complaints reported to the social security inspection services. To understand the context of the complaints and the assessment of institutional violence, focus groups were carried out with inspectors from the National Inspection Service.Findings The focus groups identified severe situations of poor care, mistreatment of older people and loss of human rights and dignity. Some indicators were found in key areas of care and the factors associated with this were based on Kamavarapu's typology (2017): physical conditions of facilities; closed organisational models; difficult working conditions; and perceived concerns of residents. Monitoring and inspection systems are still based on minimum standards focusing on structural and process quality, devoting little attention to the human rights situation of older persons and clinical issues.Research limitations/implications The number of participants in the focus groups was limited in size but the uniqueness of this exploratory method draws a dark picture of non-licensed nursing homes in Portugal.Originality/value An exploratory analysis was useful to identify institutional violence and discuss potential implications, in terms of effectiveness of quality care control, which calls for special attention by policy makers and researchers when monitoring the human rights of older persons. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to examine and explicate the concept of poor care by exploring what it is and what contributes to its occurrence in practice with a particular focus on the care of older people.Design/methodology/approach The results of systematically searched published literature were analysed using an inductive, descriptive, thematic approach as part of Rodgers' evolutionary concept analysis method.Findings The concept of poor care is understood in the context of the antecedents of vulnerability, use of healthcare services and interaction with healthcare personnel. Its defining characteristics involve individual's personal traits, interpersonal dynamics, an endangered self, misconceptions or organisational constraints.Research limitations/implications Further research is needed to explore the recognition of poor care and reporting thresholds. In addition, the role of the "zone of tolerance" of expectations in the delivery and receipt of interpersonal care and attention for older people needs to be better understood.Originality/value Understanding the continuum and mapping the structures of poor care in contemporary UK healthcare practice can help sensitise practitioners to the widespread range and potential for instances of poor care. This concept analysis uniquely demonstrates consequences not only for the patient but also for healthcare staff and other individuals. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to describe the development of a digital tool in an English county striving towards a vision of integrated information that is used to underpin an increasingly integrated future of health and social care delivery.Design/methodology/approach It discusses the policy context nationally, the origins and implementation of the initiative, the authors’ experiences and viewpoint highlighting key challenges and learning, as well as examples of new work undertaken.Findings In all, 12 health and care organisations have participated in this project. The ability for local commissioners and providers of services to now understand “flow” both between and within services at a granular level is unique. Costs are modest, and the opportunities for refining and better targeting as well as validating services are significant, thus demonstrating a return on investment. Key learning includes how organisational development was equally as important as the implementation of innovative new software, that change management from grass roots to strategic leaders is vital, and that the whole system is greater than the sum of its otherwise in-silo parts.Practical implications Data linkage initiatives, whether local, regional or national in scale, need to be programme managed. A robust governance and accountability framework must be in place to realise the benefits of such as a solution, and IT infrastructure is paramount.Social implications Organisational development, collaborative as well as distributed leadership, and managing a change in culture towards health and care information is critical in order to create a supportive environment that fosters learning across organisational boundaries.Originality/value This paper draws on the recent experience of achieving large-scale data integration across the boundaries of health and social care, to help plan and commission services more effectively. This rich, multi-agency intelligence has already begun to change the way in which the system considers service planning, and learning from this county’s approach may assist others considering similar initiatives. [ABSTRACT FROM AUTHOR]

Purpose – Approximately 100,000 people in the UK aged 75 and over have concurrent dementia and sight loss, but current understanding of their experiences, needs and preferences is limited. The purpose of this paper is to report on a research project that explored the provision of social care and support for older people with both conditions. Design/methodology/approach – The project was a collaboration between the universities of York, Worcester, Bournemouth and Cambridge, supported by the Thomas Pocklington Trust and the Housing and Dementia Research Consortium. Data for this paper were drawn from focus groups held in 2013 involving 47 professionals across the dementia, sight loss and housing sectors. Findings – Thematic analysis identified five main barriers to providing high-quality, cost-effective social care and support: time constraints; financial limitations; insufficient professional knowledge; a lack of joint working; and inconsistency of services. The requirements of dementia and sight loss often conflict, which can limit the usefulness of equipment, aids and adaptations. Support and information needs to address individual needs and preferences. Research limitations/implications – Unless professionals consider dementia and sight loss together, they are unlikely to think about the impact of both conditions and the potential of their own services to provide effective support for individuals and their informal carers. Failing to consider both conditions together can also limit the availability and accessibility of social care and support services. This paper is based on input from a small sample of self-selecting professionals across three geographical regions of England. More research is needed in this area. Practical implications – There are growing numbers of people living with concurrent dementia and sight loss, many of whom wish to remain living in their own homes. There is limited awareness of the experiences and needs of this group and limited provision of appropriate services aids/adaptations. A range of measures should be implemented in order to support independence and well-being for people living with both conditions and their family carers. These include increased awareness, improved assessment, more training and greater joint working. Social implications – People living with dementia or sight loss are at high risk of social isolation, increasingly so for those with both conditions. Services that take an inclusive approach to both conditions can provide crucial opportunities for social interaction. Extra care housing has the potential to provide a supportive, community-based environment that can help residents to maintain social contact. Originality/value – This paper adds much-needed evidence to the limited existing literature, and reflects the views of diverse professionals across housing, health and social care. [ABSTRACT FROM AUTHOR]

Recent years have seen a growth in research on retirement/lifestyle migration to Spain, however this has tended to focus on the reasons for moving, as well as the lifestyles adopted as part of a healthy and active retirement. However, ageing in Spain can bring challenges as a person's resources for independent living diminish. This paper draws on narrative interviews with vulnerable older British people in Spain, focusing on those who have encountered a severe decline in health, are frail and in need of care. It looks at the formal and informal networks and agencies that support these individuals, in particular the resources and strategies they employ to access care. Drawing on a framework of care provision developed by Glucksmann and Lyons, four broad modes of provision for old age care used by older British people in Spain are identified: state/public, family/community, voluntary/not-for-profit and market/for-profit. The paper argues that there are language, cultural, spatial and financial barriers when accessing care in Spain as an older British citizen. It is concluded that there are some frail, vulnerable people that may fall through a support gap, whereby they are no longer the responsibility of UK welfare services, yet not fully recognised in their new country of residence, and asks if more should be done to support this population. [ABSTRACT FROM PUBLISHER]

Understanding patterns of intergenerational support is critical within the context of demographic change, such as changing family structures and population ageing. Existing research has focused on intergenerational support at a given time in the individuals' lifecourse, e.g. from adult children towards older parents and vice versa; however, few studies have focused on the dynamic nature of such support. Analysing data from the 1958 National Child Development Study, this paper investigates the extent to which the receipt of parental help earlier in the lifecourse affects the chances of adult children reciprocating with support towards their parents later in life. The findings show that three-quarters of mid-life adults had received some support from their parents earlier in life, and at age 50 more than half were providing care to their parents. Patterns of support received and provided across the lifecourse differ markedly by gender, with sons being more likely to have received help with finances earlier in the lifecourse, and daughters with child care. The results highlight that care provision towards parents was associated with support receipt earlier in life. However, the degree of reciprocity varies according to the type of care provided by children. Such findings have implications for informal care provision by adult children towards future cohorts of older people, and by extension, the organisation of social care. [ABSTRACT FROM AUTHOR]

Frailty has recently emerged as a dominant concept against a backdrop of media and governmental narratives that frame the growing ageing population as an economic threat to the current configuration of health care in the United Kingdom (UK). Despite frailty's popularity amongst geriatricians and policy makers, the concept faces resistance from other health-care professionals and older people themselves. This paper draws on the Foucauldian idea of biopower; by suggesting that the contemporary emergence and utilisation of frailty represents a biopolitical practice a number or critical observations are made. First, despite biomedical experts acknowledging ambiguities in the definition of frailty, the concept is presented as a truth discourse. This is driven by the ability of frailty measurements to predict risk of costly adverse outcomes; the capability of frailty scores to enumerate complex needs; and the scientific legitimacy frailty affords to geriatric medicine. Consequently, frailty has become pervasive, knowable and measurable. Second, the routine delineation between frail and robust objectifies older people, and can be said to benefit those making the diagnosis over those being labelled frail, with the latter becoming disempowered. Last, studies show that frailty is associated with increasing wealth inequalities in the UK; however, experts' suggested management of frailty shifts the focus of responsibility away from ideologically driven structural inequalities towards the frail older person, attempting to encourage individuals to modify lifestyle choices. This neglects the association between lifestyle opportunities and socio-economic deprivation, and the impact of long-term poverty on health. These observations, set against the contemporary political climate of economic austerity, cuts to public services and rationalisation of health resources, bring the urgency of a critical consideration of frailty to the fore. [ABSTRACT FROM AUTHOR]

Many people living with dementia have difficulties at mealtimes, which can result in serious complications for physical and mental health, leading to hospital admissions and even death. However, current training in mealtime care for staff working with this population has been found to be poorly reported, with variable effectiveness. It is essential that care home staff are able to provide good care at mealtimes. This study used ethnography to explore current practice in mealtime care for this population, identify good practice, and understand the factors influencing mealtime care. Approximately 28 h of mealtime observations were conducted in two UK care homes with diverse characteristics. Observations focused on interactions between care staff and residents living with dementia. Twenty-five semi-structured interviews were carried out with care home staff, family carers, and visiting health and social care professionals, to explore mealtime care from their perspectives. A constant comparative approach was taken, to probe emergent findings and explore topics in greater depth. Key thematic categories were identified, including: tensions in mealtime care; the symbolic nature of mealtime care; navigating tensions via a person-centred approach; contextual constraints on mealtime care; and teamwork in mealtime care. The findings indicated that a person-centred approach helps carers to find the right balance between apparently competing priorities, and teamwork is instrumental in overcoming contextual constraints. This evidence has contributed to development of a training intervention for care home staff. Future research should investigate the feasibility of mealtime care training in care homes. [ABSTRACT FROM AUTHOR]

This paper explores the challenges that female elder carers in the United Kingdom face in combining paid work with elder care, and the implications of this care for their current and future working lives. In-depth interviews with 11 working women from a large organisation were conducted, and five of the women were re-interviewed after a period of one year to examine any changes in their situation. The interviews revealed the precarious nature of their daily schedules, which required constant effort to maintain, the intrusion of elder care into their working lives, and the impact it had upon their career development and future aspirations. The findings provide insight into the reasons why carers, especially women, are more likely to reduce their working hours, do not take advantage of training opportunities and retire early. The findings are discussed in relation to the expectation of an extended working age and gender equality. [ABSTRACT FROM AUTHOR]

Many countries are adopting policies to create greater coordination and integration between acute and long-term care services. This policy is predicated on the assumption that these service areas have interdependent outcomes for patients. In this paper, we study the interdependencies between the long-term (home care) services and consultations with a primary care doctor, as used by people over 75 years. Starting with a model of individual's demand for doctor consultations, given supply, we formalize the hypothesis that exogenous increases to home care supply will reduce the number of consultations where these services are technical substitutes. Furthermore, greater coordination of public service planning and use of pooled budgets could lead to better outcomes because planners can account for these externalities. We test our main hypothesis using data from the British Household Panel Study for 1991-2009. To address potential concerns about endogeneity, we use a set of instrumental variables for home care motivated by institutional features of the social care system. We find that there is a statistically significant substitution effect between home care and doctor visits, which is robust across a range of specifications. This result has implications for policies that consider increased coordination between health care and social care systems. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to describe how NHS Sutton Clinical Commissioning Group (Sutton CCG) is working with nursing homes, residential homes and other health and social care organisations in Sutton to improve the quality of provision for residents in nursing and residential homes “care homes”. Design/methodology/approach – The paper explains how Sutton CCG engaged with care homes initially to seek their views on whether they wanted support and what support they would value. It describes what arrangements Sutton CCG put in place for managers and staff in local care homes to provide support face-to-face. The paper outlines the key areas for improvement that Sutton CCG and the care homes are focusing on. It includes examples of work carried out jointly by the care homes and Sutton CCG to improve the quality of care for residents. It goes on to describe joint-working arrangements between the CCG, London Borough of Sutton and other health and social care organisations to ensure the overall quality of care homes in Sutton. Findings – The paper outlines feedback from care home managers and staff who were invited to share their views about what support they wanted from Sutton CCG. It includes early feedback from care homes about the support put in place and the areas where they have found it most useful. Practical implications – In the UK many older people live in care homes. Britain has an ageing population so the need for residential and nursing homes and the numbers of people living in care homes is only likely to increase. Our ageing population also places additional demands on the NHS, with residents in care homes often spending time in A&E and lengthy spells in hospital. This paper highlights how CCGs and other health and social care organisations can work with care homes to improve the health and wellbeing of older residents in care homes and reduce pressures on other health services. Originality/value – Sutton CCG has put in place new arrangements for working with care homes that aim to support carers to improve the lives of their older residents. The paper shares practical examples of support that the CCG has provided which has successfully improved care and decision making in care homes; early indications show this has reduced 999 calls and conveyances to hospital. Sutton CCG, London Borough of Sutton and other statutory organisations with responsibility for care homes in Sutton have also set up a joint intelligence group to gain an overall picture of the quality of the borough’s care homes. [ABSTRACT FROM AUTHOR]

Aim and Objective: To generate content for a new questionnaire, based on the 10 Principles of Dignity in Care. Background: Older people in hospital are vulnerable and at risk of harm, including indignity. The 10 Principles of Dignity in Care, which undergird the United Kingdom's Dignity in Care Campaign, have been used to promote dignified care for older people in hospital. A 2006 recommendation of the campaign was to survey people on their experiences of dignity in care. To undertake such a survey, a questionnaire based on the 10 Principles of Dignity is required. Design: Qualitative methods based on a modified Delphi technique, assessed against the CREDES checklist. Methods: A Delphi panel of experts was convened that included: consumers, carers, clinicians, academics, policy experts and representatives from the National Dignity Council in the UK, Aboriginal people and people from culturally and linguistically diverse backgrounds. Results: Fifty‐seven experts consented to participate, over the three rounds of Delphi panel deliberations (response rate: R1 n = 49, R2 n = 47 and R3 n = 44). The Delphi panellists were asked to rank, rewrite, relocate or remove items and suggest additional items, under each of the 10 Principles of Dignity in Care. The initial list of 93 items, generated from a review of the literature, existing questionnaires and drafted by the authors, was reduced to 87 items in Round 2 and 69 items in Round 3. Conclusions: A panel of experts were able to determine, based on their own judgement, and through consensus, the 69‐items and response categories to be included in the patient and carer versions of the Dignity in Care questionnaire, to progress to a pilot study. [ABSTRACT FROM AUTHOR]

Abstract: Demographic trends with extended life expectancy are placing increasing pressures on the UK state‐funded healthcare budgets. eHealth innovations are expected to facilitate new avenues for cost‐effective and safe methods of care, for enabling elderly people to live independently at their own homes and for assisting governments to cope with the demographic challenges. However, despite heavy investment in these innovations, large‐scale deployment of eHealth continues to face significant obstacles, and lack of sustainable business models (BMs) is widely regarded as part of the greatest barriers. Through various empirical methods that include facilitated workshops, case studies of relevant organizations, and user groups, this paper investigates the reasons the private market of eHealth innovations has proved difficult to establish, and therefore it develops a framework for sustainable BMs that could elimiesnate barriers of eHealth innovation commercialization. Results of the study suggest that to achieve sustainable commercialization, BM frameworks and innovation diffusion characteristics should be considered complements but not substitutes. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic and the lockdown measures imposed as a result affected the lives of people in all parts of society across the world. In 2020, during the first UK national lockdown, older adults (aged 70 years and over) were told to 'shield' within their homes, as they were regarded as being at higher risk of serious COVID-19 infection compared to other age groups. This paper explores older adults' experiences of COVID-19 lockdown measures whilst living in housing with care schemes for older people. The purpose is to examine the impact of the lockdown measures on scheme life including social connections amongst residents and their general everyday wellbeing during this time. We present qualitative findings based on interviews with 72 residents who took part in longitudinal and cross-sectional interviews across 26 housing with care schemes. Data were analysed using a thematic framework approach to examine specifically their experiences of living in housing with care schemes during the 2020 UK lockdown. The paper highlights that COVID-19 restrictions had a detrimental impact on the social connections and interactions of older residents living in housing with care schemes, as well as on their feelings of autonomy and independence. Despite this, residents adapted and coped with self-isolation restrictions and sought out positive ways to maintain social contact with others inside and outside to the scheme. We further highlight the tensions that providers of housing for older adults faced in promoting residents' autonomy and connectedness whilst also trying to provide a safe living environment and protect residents from risk of COVID-19 infection. Our findings apply not only to a pandemic situation but to the broader understanding of how housing with care for older adults must navigate between autonomy and support. • COVID-19 lockdowns challenged the independence and autonomy of older residents of housing with care in the UK. • Older adults in housing with care exercised autonomy through employing practices to maintain social connections. • Housing staff bolstered residents' autonomy, facilitated social interactions, and supported residents' wellbeing. • Housing staff faced challenges in maintaining the independent ethos of housing schemes whilst also protecting residents. [ABSTRACT FROM AUTHOR]

Geriatric medicine is the clinical specialty that focuses upon the care of older people—especially those with frailty (a state of increased vulnerability). In hospital, older people living with frailty are at high risk of developing a range of unpleasant outcomes such as delirium, falls, fractures, pressure sores and death. Comprehensive geriatric assessment is a form of holistic care that incorporates a specific set of clinical competencies that are able to reduce these adverse outcomes. Over the years, geriatric medicine has moved from being more of a community-based service towards a more acute specialty—encroaching now upon emergency department care. The challenge now is to work out how best to deliver geriatric care across the whole hospital (older people with frailty are not just cared for in geriatric wards!). The themed collection published on the Age & Ageing journal website outlines key articles that are attempting to develop solutions to this challenging conundrum. We hope that you enjoy reading them. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to investigate the influence that volunteering before medical school with older people in a care home has on the perceptions of older people. Design/methodology/approach: Eight medical students answered an anonymous questionnaire relating to their experiences of volunteering in a care home before medical school. This was combined with an analysis of the relevant literature. Findings: All the students had initially volunteered to enhance their CV for medical school. After volunteering, they had a greater realisation of the variety of older people. They also gained a number of transferable skills related to communicating with older people, especially those with cognitive impairment. The greatest learning experience was around the issues to do with dementia. Research limitations/implications: The research is based on eight students although they were from different areas. Practical implications: It would be beneficial if care homes could be more proactive in encouraging prospective medical students to volunteer. Medical schools could also provide clearer advice or take a more active stance such as encouraging prospective students to volunteer with older people. Further research should be with a larger sample to gain insight into varying perspectives. It would also be useful to conduct research into older adults' attitudes towards the contribution of potential medical students to their own lives and to the home. Social implications: Volunteering before medical school should be encouraged as it will enhance the chances of getting a place as well as being an eye opening experience and equip them with lifelong skills. Originality/value: Original. [ABSTRACT FROM AUTHOR]

Introduction: Many older people live with both multiple long‐term conditions and frailty; thus, they manage complex medicines regimens and are at heightened risk of the consequences of medicines errors. Research to enhance how people manage medicines has focused on adherence to regimens rather than on the wider skills necessary to safely manage medicines, and the older population living with frailty and managing multiple medicines at home has been under‐explored. This study, therefore, examines in depth how older people with mild to moderate frailty manage their polypharmacy regimens at home. Methods: Between June 2021 and February 2022, 32 patients aged 65 years or older with mild or moderate frailty and taking five or more medicines were recruited from 10 medical practices in the North of England, United Kingdom, and the CARE 75+ research cohort. Semi‐structured interviews were conducted face to face, by telephone or online. The interviews were recorded, transcribed verbatim and analysed using reflexive thematic analysis. Findings: Five themes were developed: (1) Managing many medicines is a skilled job I didn't apply for; (2) Medicines keep me going, but what happened to my life?; (3) Managing medicines in an unclear system; (4) Support with medicines that makes my work easier; and (5) My medicines are familiar to me—there is nothing else I need (or want) to know. While navigating fragmented care, patients were expected to fit new medicines routines into their lives and keep on top of their medicines supply. Sometimes, they felt let down by a system that created new obstacles instead of supporting their complex daily work. Conclusion: Frail older patients, who are at heightened risk of the impact of medicines errors, are expected to perform complex work to safely self‐manage multiple medicines at home. Such a workload needs to be acknowledged, and more needs to be done to prepare people in order to avoid harm from medicines. Patient and Public Involvement: An older person managing multiple medicines at home was a core member of the research team. An advisory group of older patients and family members advised the study and was involved in the first stages of data analysis. This influenced how data were coded and themes shaped. [ABSTRACT FROM AUTHOR]

The General Medical Council (GMC) provides a core curriculum for all medical degrees in the UK. However, these guidelines do not provide in-depth, specific learning outcomes for the various medical specialties. Recognising our ageing population, the British Geriatrics Society in 2013 published their own supplementary guidelines to encourage and further direct teaching on Gerontology and Geriatric Medicine in medical school curricula. Although teaching on Geriatric Medicine, a sub-discipline of Gerontology, has reassuringly increased in UK medical schools, there are convincing arguments for greater emphasis to be placed on the teaching of another sub-discipline: Social Gerontology. Considering the skills and knowledge likely to be gained from the teaching of Social Gerontology, in this paper we argue for the greater universal adoption of its teaching. This would help ensure that the doctors of tomorrow are better equipped to manage more successfully and holistically the growing cohort of older patients. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to review the coalition's policy on ageing. Design/methodology/approach - A detailed review of recent government policy towards ageing. Findings - Localism has become increasing important, with reforms to health, planning and care emphasising the importance of localised action. The "nudge" of auto-enrolment will increase the number of people saving for old age. Originality/value - This policy analysis incorporates a detailed review of recent government policy on ageing. [ABSTRACT FROM AUTHOR]

The article examines the funding challenges facing the adult social care system in Great Britain and their implications for the general election in 2019. It describes the failure of the government to address the issue of the funding of social care. It also discusses the promises made by the Labour party, the Liberal Democrats and the Conservatives regarding health and social care budgets.

What happens when caring for the ageing population is so devalued that robots are deployed to care for our elders? We examine the growing employment of companion robots in elder care as one response to a critical labour shortage and loneliness epidemic shared across the Global North. Reflecting on interviews conducted with robot engineers, researchers, NGO care providers and local government, we examine five robots under development or in use in the UK and the USA. We ask if machines providing emotional and social care signal a diminishment of what it means to be human or if robots and automation present a promising solution to our elder care crisis. We do not evaluate the efficacy of robotic technology but identify and question assumptions concerning what it means to be human in modernity and examine companion or social robots at a moment of crisis and the substantive reorganisation of social reproduction wrought by neoliberal austerity. We end by calling for a reimagining of elder care, in which the care of our elders is radically revalued and where robots assist and support workers in their difficult and skilled labour of care. [ABSTRACT FROM AUTHOR]

The UK has a significant and growing population of older adults with frailty and complex healthcare needs, necessitating innovative care solutions. This study aimed to explore patients' and carers' experiences of a novel integrated service that was set up to address the increasing healthcare needs of older people living with frailty. A qualitative study that combined free-text survey questions with in-depth interviews. This study is part of a larger non-randomized trial of the service, with evaluation of wellbeing and quality of life at baseline, 2 to 4 weeks, and 10 to 14 weeks. Patients (aged 65 and above) with an electronic Frailty Index in the severe range and their informal family carers participated in this study. Data were collected between April 2019 and March 2020. Free text survey responses and interview data were subjected to reflexive thematic analyses. Four themes were generated: the overall experience of the service; interactions within the service; treatment and interventions; and outcomes due to the service. Most participants wanted further follow-up and more extensive integration with other services. Most participants described their overall experience positively, especially the available time to address their full range of concerns, but opportunities to integrate the service more fully and to extend follow-up remain. [ABSTRACT FROM AUTHOR]

Time is a key organising principle in the formal provision of care to older people in their own homes. It is used when delivering homecare services, calculating fees and care staff's pay entitlement. Research in the UK highlights how the predominant service model of compartmentalising care into pre‐defined tasks, delivered in strictly scheduled time‐based units, offers poor quality jobs, characterised by low pay, insecure and tightly controlled work. Our case study research of 'new models' of homecare however, found variation in the way time measures were operationalised. Drawing from Thompson's (1967, Past & Present, 38, 56–97) conceptualisation of clock‐time (where care work is controlled by external measures of time) and nature's time (where care work is performed through internal notions of time) as a lens, we examine how service delivery models and job quality are temporally connected through homecare work. Through our analysis, we exemplify how the use of strict time‐based measures can limit care work according to nature's time. We also consider the potential of ambitemporality—the accommodation of clock and nature's time—in organising service delivery as a means of enriching job quality. Finally, we discuss the pertinent implications of conceiving job quality in homecare work through a temporal lens. [ABSTRACT FROM AUTHOR]

Following the Cabinet reshuffle in January, the Department of Health was rebranded as the Department of Health and Social Care, with Jeremy Hunt MP still at the helm. [ABSTRACT FROM AUTHOR]

With the focus of care shifting from the hospital to the community, supportive nutritional care to old people is to become an important issue to address in the community, since undernutrition has serious consequences, both for the quality of life and for the health care costs. Several modifiable nutritional risk factors relate to undernutrition. Unfortunately, the problem with (risk of) undernutrition is aggravated due to a lack of alertness among e.g. health care staff, leading to insufficient attention for systemic screening and nutritional care. Only a few of the existing screening tools have been validated among old people receiving support at home. Few studies have assessed the beneficial effect of nutritional support among old people in their own home, and recently, it was concluded that such have shown limited effects. One reason may be that the nutritional interventions performed have not taken the multiple nutritional risk factors afore-mentioned into consideration when formulating the action/treatment plan and hence not used a multidisciplinary approach. Another reason may be that the intervention studies have not used validated screening tools to identify those old people most likely to benefit from the nutritional support. However, three recent studies have used a multidisciplinary approach and two have proven a beneficial effect on the quality of life of the old people and the health care costs. These findings suggest that when planning nutritional intervention studies for old people receiving support at home, modifiable nutritional risk factors should be taken into consideration, and a multidisciplinary approach considered. [ABSTRACT FROM AUTHOR]

Background: With an ageing population, older adults will have more complex health and social care needs and many of these older adults will be living in care homes. Despite the growth in care home populations, care home residents are often excluded from research that could potentially benefit their care. The purpose of this scoping review is to explore resident-related barriers and facilitators to including older people living in UK care homes in research and to identify potential approaches to modify such barriers. Method: The 6-stage scoping review methodology framework proposed by Arksey and O'Malley guided this review. Five electronic databases (MedLine, PsychINFO, Scopus, Web of Science, CINAHL) and grey literature were searched. Identified articles went through two levels of screening, and those deemed relevant were collated, summarised and reported using a thematic analysis approach. Results: 90 reports were eligible for inclusion and were synthesised into 7 themes and related subthemes: (1) research design; (2) understanding and beliefs about research (resident and care home staff); (3) communication; (4) relationships; (5) eligibility criteria (resident and care home); (6) preference-based decisions; and (7) care home staff and environment. Given the complex interplay of the factors identified, both direct and indirect factors were included. Conclusions: A number of recurring barriers and facilitators to the inclusion of care home residents in research are reported. However, isolating resident-related barriers was complex as both direct and indirect factors must be considered as influential. Understanding the barriers and facilitators to inclusion will enable these factors to be addressed and increase the evidence-base for care provided to older people living in care homes. [ABSTRACT FROM AUTHOR]

Background: Chronic subdural haematoma (CSDH) is increasingly common. Although treatment is triaged and provided by neurosurgery, the role of non-operative care, alongside observed peri-operative morbidity and patient complexity, suggests that optimum care requires a multi-disciplinary approach. A UK consortium (Improving Care in Elderly Neurosurgery Initiative [ICENI]) has been formed to develop the first comprehensive clinical practice guideline. This starts by identifying critical questions to ask of the literature. The aim of this review was to consider whether existing systematic reviews had suitably addressed these questions. Methods: Critical research questions to inform CSDH care were identified using multi-stakeholder workshops, including patient and public representation. A CSDH umbrella review of full-text systematic reviews and meta-analysis was conducted in accordance with the PRISMA statement (CRD42022328562). Four databases were searched from inception up to 30 April 2022. Review quality was assessed using AMSTAR-2 criteria, mapped to critical research questions. Results: Forty-four critical research questions were identified, across 12 themes. Seventy-three articles were included in the umbrella review, comprising 206,369 patients. Most reviews (86.3%, n=63) assessed complications and recurrence after surgery. ICENI themes were not addressed in current literature, and duplication of reviews was common (54.8%, n=40). AMSTAR-2 confidence rating was high in 7 (9.6%) reviews, moderate in 8 (11.0%), low in 10 (13.7%) and critically low in 48 (65.8%). Conclusions: The ICENI themes have yet to be examined in existing secondary CSDH literature, and a series of new reviews is now required to address these questions for a clinical practice guideline. There is a need to broaden and redirect research efforts to meet the organisation of services and clinical needs of individual patients. [ABSTRACT FROM AUTHOR]

This article presents an exploration of the changing experiences of six chaplains employed by a large care provider (LCP) during the COVID-19 pandemic. Semistructured interviews carried out over a ten-month period with six chaplains during the pandemic highlighted three key themes relating to their experiences in care homes during the crisis: (i) adapting work practices; (ii) mental health and well-being; (iii) giving and receiving support. In the context of a worldwide pandemic, this study highlights the issues experienced by chaplains in residential and aged care homes at the epicentre of COVID-19-related deaths in the United Kingdom. [ABSTRACT FROM AUTHOR]

Cera, a homecare provider, uses digital care plans (DCP), to streamline the provision of home care. DCP rollout is part of a larger digitization initiative, including carer visit reports collected through a mobile app and branch actions recorded in a web application supported by a secure central database. This retrospective cohort study aimed to assess the association of a DCP rollout with service user hospitalization rates. his study utilized retrospective data from 2 groups of service users, those for whom their first 30 days of Cera membership occurred prior to DCP rollout (pre-DCP group) versus those whose first 30 days of Cera membership occurred after DCP rollout (post-DCP group). The 30-day hospitalization rate was the primary outcome measure and was determined through a combination of carer reports, reporting from service users or their families, and branch staff follow-up. There were 55 hospitalizations among 392 users in the pre-DCP group in the 30 days after joining Cera (14.0% hospitalization rate), compared to 23 hospitalizations among 297 users in the post-DCP group (7.7% hospitalization rate). This represented a significant reduction in hospitalizations in the post-DCP group (6.3% absolute difference in hospitalization rate; 45% relative reduction; P <.001). This result was robust to multiple sensitivity analyses. The implementation of a DCP was associated with a 45% relative reduction in the 30-day hospitalization rate for new service users when compared to pre-DCP enrollment. These benefits could be further amplified by combining the DCP with additional initiatives aimed at the prediction and prevention of avoidable hospitalizations. [ABSTRACT FROM AUTHOR]

Background. The increased comorbidities among older people are related to the longer life expectancy and the way a condition is defined. People who live longer and remain healthy express different needs from older people of previous decades. Objective. This study aims to present the profile of the older person in contemporary society and the careworkers' humanistic training needs. Methodology. The focus group methodology was selected. Twelve focus groups consisted of 69 participants over 60 years old in total and six focus groups of 41 careworkers in total, from Italy, Portugal, Finland, Romania, UK, and Cyprus, were conducted. A content analysis was used. Results. A profile of the older person living in the above stated countries was revealed with the "New Old" being financially independent, active with a healthy lifestyle, more informed and educated in relation to the past, liking social interactions, open-minded to new relationships, volunteering for non-for-profit associations, using technology, or wanting to learn how to use. However, older people in these countries were still experiencing ageism (discrimination, ignorance, and social exclusion) and lack of respect. Care workers also expressed their views in relation to the training needs that meets this new profile of older people including basic nursing skills, daily living activities, humanistic, person-centered care, social skills, and ICT competence. Conclusions. This multicenter focus group discussions study promoted the concept of the older person in contemporary society and the importance of humanistic care. A new definition of the older person and an adaptation of the training curricula for careworkers Job certification including the person-centered approach is required. [ABSTRACT FROM AUTHOR]

This article presents a review of publications of the author as related to technology supporting Ageing-in-Place for older people to prevent or delay residential care. In four decades, the focus developed from the increasing number of assistive technologies both in the UK and elsewhere that started to reshape home care, towards the views of older people themselves, their perceived needs and the technologies they considered acceptable. It was followed by improving the availability of information for older persons. Influencing (inter)national policies formed the last step. [ABSTRACT FROM AUTHOR]

Context: Care homes in the UK were hit badly by the COVID-19 pandemic, with numerous outbreaks and deaths of residents and staff. Objectives: To capture the impact of the pandemic on care home staff well-being and share insights and learning about how to optimise support for the workforce. Methods: Fifteen senior care staff from care homes looking after older people in England were interviewed between December 2020 and March 2021, when the sector was still under strict restriction measures. The topic guide was developed in consultation with care home staff. Interviews were transcribed and analysed using a reflexive thematic analysis approach to identify themes and sub-themes of the impact on staff well-being. Findings: The impact of the pandemic was overwhelmingly negative, with those interviewed reporting both mental and physical health implications. We identified three themes: emotional exhaustion (upset and trauma, increased responsibility and workload, feelings of guilt); frustration (feeling misunderstood, undervalued, unrecognised, abandoned); and relationships (the importance of supportive working relationships within the care home and with external agencies). Limitations: Staff interviewed were managers or in other senior roles; it would be beneficial to synthesise this research with studies involving other care home staff and residents and their relatives. Given the disparate nature of the care home sector, a larger sample may have identified additional insights. Implications: This study provides insight into the resilience of care home staff during the pandemic and challenges to this; this could help to inform future efforts as to support of the workforce and sector. [ABSTRACT FROM AUTHOR]

The wellbeing of care home staff and the need to support them at work was highlighted with devastating clarity by the COVID pandemic. This small study explores what online and at work wellbeing resources were available to frontline care home workers during the first wave of the pandemic. A mixed methods study was undertaken May and July 2020. A multi-disciplinary team undertook a rapid review of online wellbeing information and resources relevant specifically to the care home sector and its non-nurse staff. Qualitative data comprised of digital recordings of semi-structured interviews with six care home managers of five care homes, and an online survey sent to 55 Scottish care homes with a response rate of 18%. Five overarching lessons were identified from the data. The first two ('managing information overload' and 'medium not appropriate for the message') relate to the awareness and use of the online wellbeing resources by frontline care workers. Three others ('visible and supportive leadership', 'building team camaraderie' and 'maintaining a focus on wellbeing beyond a crisis response') highlight the in-house, practice-based issues of supporting the wellbeing of staff. Although small, the findings from this study are of relevance and use by those in the UK and beyond working develop and sustain more effective ways to support and retain of this vital workforce. [ABSTRACT FROM AUTHOR]