Managing dementia where there is challenging behaviour

Esme Moniz-Cook and Jill Manthorpe summarise the findings from a study on the management of dementia. (609 words)

  • Help for family carers supporting people with dementia who are distressed is much needed but services struggle to provide effective responses
  • Both families and care home staff need more support to help them to care for people with dementia – especially when the ‘going gets tough’

Bookshelf_NBK447072-page-001The findings from a large research study on the Management of Dementia with clinically significant challenging behaviour at home and in care homes led by the University of Hull and Humber NHS FT are published today (11 August 2017). The research was funded by the National Institute for Health Research (NIHR), Programme Grants for Applied Research (PGfAR). The study examined the records of over 5,300 older people and their families who were referred for specialist help to NHS mental health services across England. Nearly two thirds (61%) of those with dementia and distressing behaviour had a mild dementia rather than severe dementia. Practitioners did not always recognise that people at this stage were experiencing problems such as agitation, aggression and distress; and over a six month period, they did not manage to reduce the difficulties faced by these families. Families bore most of the care costs, and many were untouched by the evidence, guidelines and scope that services should provide them with timely individually-tailored effective responses to their challenging circumstances. Continue reading

Who wants to be an Approved Mental Health Professional?

Stephen MartineauAs the Unit embarks on a new piece of Department of Health commissioned research examining the role of the Approved Mental Health Professional (AMHP), Stephen Martineau and colleagues report from the AMHP Leads Network conference, held in London last week (10 July), and map out some of the background to the study. (977 words)

AMHPs carry out a variety of tasks when it comes to the use of compulsion under the Mental Health Act 1983 (MHA). Chief among these is coordinating the assessment under the MHA of individuals whose mental disorder is such that it fulfils the statutory criteria; the application for a formal admission to a hospital must be ‘founded’ on medical recommendation, as the pink form for a detention under the MHA has it, but the AMHP takes the decision.[1]

Form A2 Section 2 appl by AMHP for admiss for assess-page-001

Form A2. Section 2 MHA: application by an approved mental health professional for admission for assessment (photo links to pdf)

Of course, this is only the very barest description of what is involved in the job: last week, someone who had been the subject of a MHA assessment by an AMHP wrote vividly of the experience in Community Care. Elsewhere, the Masked AMHP has asked, and answered, the question: What is an AMHP?

In making a MHA assessment of a person, AMHPs bring to bear a ‘social perspective’. And it is social workers—initially under the MHA, Approved Social Workers (ASWs)—who have been historically associated with the role. But in 2008 ASWs became AMHPs, and with the change in designation came a loosening of the ties to the social work profession: it was now also possible for certain kinds of nurses, occupational therapists and psychologists to take up the role. Continue reading

Researching in care homes – what was learnt from a study of handovers?

Caroline NorrieCaroline Norrie is Research Fellow at the Social Care Workforce Research Unit, King’s College London (330 words)

What can researchers of care services learn from our recent handover study?  We asked ourselves this question and discussed this at the annual conference of the British Society of Gerontology held in Swansea last week (pictured below is the new beach side campus) at the start of July. Our paper summarised the findings of our unique exploration into handovers in care homes and then we paused to ask what could be relevant to other researchers studying care home practice and systems. Continue reading

Notes from the inaugural conference of the Italian Society of Social Work Research

Gaia CetranoGaia Cetrano is a Research Associate at the Social Care Workforce Research Unit, King’s College London. (1,100 words)

In May this year I was proud to take part in the first conference organized by the new Italian Society of Social Work Research (SOCISS) in Turin, Italy.

The origins of SOCISS date back to 1983 when a group of teachers of social work founded the Italian Association of Teachers of Social Work (AIDOSS). AIDOSS assiduously worked over 30 years to develop common thinking on theories of social work, as well as on the organization of university curricula, and the role of training and research. Then what happened? The Association committee reunited in 2016 and approved a new constitution outlining its new objectives, which included strengthening the dialogue between theory and practice in social work and promoting social work research in Italy and internationally. I think it is very important that the status of the association has now changed to that of a scientific society as this will hopefully help professionals, researchers and academics to acquire a stronger voice and also be in a better position to communicate and negotiate with other disciplines. Continue reading

Providing Support and Care from a Distance

Caroline White of the University of Hull is seeking participants in a new study. (462 words)

Family members and friends often provide support, help and care to others, instead or in addition to paid sources of care and support. These people (often referred to as carers, although this term is not embraced by all) are collectively estimated to save the UK economy £132 billion per year (according to figures from Carers UK in 2015) and have been the subject of much research and policy development. The majority of existing research about carers concerns those who support someone who lives with or near to them. However, as we become an increasingly geographically mobile population many parents, adult children, siblings, other relatives and friends find themselves living at a distance from those they care for and about. A new research project at the University of Hull is working to find out more about the experiences of those who provide help, care and support to a relative or friend who lives at a distance from them (we are meaning that they have to travel for one hour or more to visit them). Continue reading

Mental Health Workers – We need your help for our research

Tasneem ClarkeTasneem Clarke, Research Officer at the Money and Mental Health Policy Institute, based at King’s College London, discusses the Institute’s latest research, which asks: what can mental health practitioners do to support people in financial difficulty? Please take this two minute quiz to register your interest and help her come up with pragmatic solutions to this difficult issue. (736 words)

Money and mental health – a toxic relationship

As practitioners in mental health services know, life can be messy. The people we work with are rarely only facing one issue; from relationship breakdown to past traumas, economic disadvantage or long-term physical and mental health problems – issues interweave and make each other worse. Continue reading

Bringing it all together – re-valuing older people by combining research, training and practice

Valerie LipmanValerie Lipman is a Postdoc Intern at the Social Care Workforce Research Unit in the Policy Institute at King’s College London.

Here’s a challenge for learning institutes in the UK: how can they deliver on-site direct services for the vulnerable groups whom they’re studying and promoting? I talked to Dr Indrani Chakravarty, the founder and Director, of the Calcutta Metropolitan Institute of Gerontology (CMIG) about her experience of doing just this and how she marries research with real practice. Continue reading

Older People & Human Rights

Dr Joan RapaportJoan Rapaport reports from the 9th Annual Joint Conference of Age UK London, the Social Care Workforce Research Unit and Making Research Count. (1,789 words)

The conference, held on the Guy’s Campus of King’s College London, was chaired by Jo Moriarty, Deputy Director of the Social Care Workforce Research Unit, and attracted a capacity audience. Speakers’ presentations are available on the SCWRU conference webpage.

Human Rights Act: overview of current changes: Caroline Green, PhD student, Social Care Workforce Research Unit

Whilst human rights have been around for hundreds of years both globally and in Britain, Caroline acknowledged that our understanding mostly relates to post World War II developments. The European Convention on Human Rights, drafted in 1950, contains numbered ‘Articles’ each of which protects a basic human right. The European Court of Human Rights, based in Strasbourg, rules on cases brought under convention from the 47 signatories. Continue reading

Adult Social Care – where’s the evidence?

Jo Moriarty Nov 2014bJo Moriarty and Martin Stevens are Senior Research Fellows at the Social Care Workforce Research Unit. (1,192 words)

People often talk about the absence of a social care evidence base, but ‘patchy’ is a far better description. Until we arMartin Stevense more explicit about this, it will be difficult to make progress in achieving evidence based policy and practice. We took part in two Meet the Researcher sessions at an event jointly organised by Research in Practice for Adults (RIPfA), the British Association of Social Workers (BASW) and the Association of Directors of Adult Social Services (ADASS). They were part of a day-long seminar designed to bring Directors and Assistant Directors of Adult Social Care and researchers together to discuss current and future adult social care research. Continue reading

Which people with dementia receive less medical attention; what can social care do to promote equality?

Open Access from Age and AgeingClaudia Cooper and Jill Manthorpe introduce their new article, which is open access in Age and Ageing. (726 words)

Women with dementia make fewer visits to the GP, receive less health monitoring and take more potentially harmful medication than men with dementia, our new research has found.

The study, published in Age and Ageing in early December, was funded by Dunhill Medical Trust. We found that only half of all people with dementia had a documented annual review even though GPs are offered financial incentives to carry these out. Women were at particular risk of staying on antipsychotic or sedative medication for longer. This might be because they have fewer GP appointments where their treatment can be reviewed. Continue reading