Category Archives: Older people

Finding unity in diversity within China’s long-term care system

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csm_Maags_pic_f1915bd14eChristina Maags is a Lecturer in Chinese Politics at the School of Oriental and African Studies (SOAS), London, specializing in the politics of demographic change in China. (1,278 words)

Preparing for the growing ageing population is a huge cause for celebration and yet also a key concern in many countries. Yet, in developing countries, which are experiencing a greater speed of population ageing at a time when they are lacking the financial resources and institutions to provide long-term care (LTC) services, finding policy solutions is becoming ever more urgent.

The People’s Republic of China (PRC) is facing these challenges while the decades of one-child policy are exacerbating these trends, as fewer and fewer younger people are left to provide care to their older relatives. Although in China, as in other East Asian countries, the cultural norm of filial piety has been strong, the stark decline in fertility translates into one younger person, mostly female, sometimes having to care for four to eight older relatives or in-laws. In 2016, 213 million, or 16.7% of the Chinese population, were over 60 years old (Cheng, 2017). Among these older people almost 150 million have long-term health conditions, and more than 40 million are living with deteriorating mental or physical health. As an editorial in The Lancet argues, China’s population ageing is ‘a ticking bomb’ (The Lancet, 2016). Continue reading →

Managing dementia where there is challenging behaviour

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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 →

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

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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 →

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

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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

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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 →

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

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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 →

Interactive technologies and games – what relevance do they have for social care?

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John WoolhamJohn Woolham is Senior Research Fellow at the Social Care Workforce Research Unit in the Policy Institute at King’s. (856 words)

There’s a saying, apparently, amongst actors: never work with children or animals. For academics, one might add children, animals and robots—if one of the presentations I recently attended was anything to go by—but I’ll come to that.

The conference, known as I-TAG, (Interactive Technologies and Games) was held in Nottingham and organised by colleagues from Nottingham Trent University. I don’t know anything about robotics or computer technology (in fact, anyone who knows me will attest to my cack-handedness at anything even vaguely IT related). I am, though, very interested in exploring how electronic assistive technologies and telecare can help people who need social care to maintain independence and quality of life; and because I recently became Deputy Editor of the Journal of Assistive Technologies (soon to be re-named the Journal of Enabling Technologies) I went along for one day of this two day conference to find out more about ITAG, and to invite anyone doing interesting work to consider publishing with us. Continue reading →

Let’s Talk – Care Homes and Delayed Discharge

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Bev EvansNorman CrumpBev Evans and Norman Crump, both of Lancaster University Management School, report from a recent meeting where participants discussed the transition from hospital to care home. (913 words)

According to the National Audit Office (2016), between 2013 and 2015, official delayed transfers of care rose 31 per cent and in 2015 accounted for 1.15 million bed days – 85 per cent of patients occupying these beds were aged over 65. Since 2010, waits for beds in nursing homes increased by 63 per cent. Across Morecambe Bay University Hospitals NHS Foundation Trust (MBUHT) waiting for a care home place can be a significant cause of delay.

In early October, Cumbria Registered Social Care Managers’ Network, Kendal Integrated Care Community (ICC) and MBUHT convened a special ‘Let’s Talk’ discussion group which brought together local care home managers, social workers, hospital discharge coordinators, ward staff and nurse practitioners from the community. The aim of the meeting was to explore how the transition from hospital to a care home could be improved. ‘Let’s Talk’ is a specially facilitated session delivered by King’s College London, Lancaster University, Dignity in Dementia and the South Lakes Registered Social Care Managers Network. Meetings are designed to enable participants to see issues from each other’s perspectives and to afford time to critically reflect on a particular ‘wicked issue’. Continue reading →

Rules-of-thumb ~ are they the answer to our decision making dilemmas at the end of life for people with dementia?

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PDFtoJPG.me-01Dr Nathan Davies discusses Rules of Thumb for End of Life Care for People with Dementia. (954 words)

Back in 2011 when I started my PhD and was working on a European study which was examining palliative care services for people with dementia, there was a distinct lack of guidance about how end of life care should be delivered. The only real ‘saving grace’ I guess was the Liverpool Care Pathway. This offered some guidance about what should happen towards the end of life. It was meant to incorporate and describe best practice from hospice care, the ‘gold standard’ of end of life care, and allow it to be translated to other settings such as the acute hospital ward. Although, I say saving grace… really, it wasn’t best suited to people with dementia and it only focused on the last few days of life.

The Liverpool Care Pathway received some shocking criticism, spearheaded mainly by the Daily Mail and ultimately this led to the removal of the pathway by the UK government in 2013. What we saw in the middle of our projects were practitioners losing more and more confidence in providing end of life care generally, let alone for people with dementia.
This led us to think, what can we do to help with practitioners confidence but not develop yet another pathway or guideline? Maybe what we need is something that is short, easy to remember, prompts us to think and leads us to an action. Cue light bulb moment, and we have the idea of developing rules-of-thumb (heuristics). Rules-of-thumb are simple, easy to remember schematic patterns which help with decision making. We were fortunate to gain funding for this research from the Alzheimer’s Society and Marie Curie. Our research team included dementia and end of life care experts, including Prof Steve Iliffe, Dr Kethakie Lamahewa, Prof Jill Manthorpe, Dr Rammya Mathew, and Dr Liz Sampson. Continue reading →

Values, Equalities, Rights and Dementia

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Laura Cole is Senior Research Associate at the Social Care Workforce Research Unit, King’s College London. (929 words)

It is often overlooked that two thirds of people with dementia are women, and caring is often viewed as a woman’s role; both in the family and the workplace. These seemingly obvious points were highlighted at the second* event of the VERDe Network, ‘Venus, Mars and Dementia – Gender perspectives on dementia’ held on 2 June 2016 in central London. Everyone who  attended was keen to explore the equalities dimensions arising from gender differences that affect the services, policies and practitioners that aim to support people with dementia and their carers. Continue reading →