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Welfare Reform on the Web (August 2010): Care of the elderly - UK

Bournemouth, Dorset and Poole Total Place pilot: services and support for older people

T. Bracey

Working with Older People, vol. 14, June 2010, p. 31-37

The Total Place programme was designed to look at how organisations could improve public services at less cost by taking a 'whole area' approach. The approach had two main components. The first, a high level count, was designed to map all public expenditure in an area. The second was a 'deep dive' investigation of an area-specific theme. Because of the mounting demographic challenge in the Bournemouth, Dorset and Poole sub-region, this Total Place pilot focused on the theme of services and support for older people. This paper details how the project worked and some of the findings to date.

Burnham's Labour leadership pitch centres on the reform of elderly care

J. Dunning

Community Care, June 24th 2010, p. 11

Labour Party leadership candidate Andy Burnham wants to create a national care service for older people, with standardised eligibility across the country and provision free at the point of need, funded by a compulsory 10% levy on estates, capped at 50,000. He is the first of the Labour leadership candidates to raise social care as an issue.

Challenges to improving end of life care of people with advanced dementia in the UK

I.C.V. Thune-Boyle and others

Dementia, vol.9, 2010, p. 259-284

This article examines relatives' and health care professionals' understanding of advanced dementia and their attitudes towards end of life treatments and care in the UK. It focused on areas likely to relate to decision making with the aim of recognising the challenges and barriers to the provision of appropriate end of life care. Results showed that dementia was not viewed as a terminal neurodegenerative illness by the majority of participants. Poor understanding of the natural history of dementia influenced both relatives' and health professionals' attitudes towards treatments, expectations and decision making, including the timing of the introduction of palliative care. Families expected life prolonging treatments such as feeding tubes and antibiotics to be used even though they agreed that the patient's quality of life was poor. This suggests that they did not have realistic expectations regarding prognosis.

The impact of the 2005 Mental Capacity Act on social workers' decision making and approaches to the assessment of risk

A. McDonald

British Journal of Social Work, vol. 40, 2010, p. 1229-1246

The study on which this article is based formed part of a programme of research into the early impact of the Mental Capacity Act 2005 on decision making and recording in health and social care. A purposive sample was drawn of field social workers with older people with dementia living in the community. Participants were asked to select a case that was current during the period November 2007 to May 2008 and to compare practice and recording in this case with a similar case concluded before the coming into force of the Act. There was a movement away from a rights based approach to decision making towards an actuarial approach within which risks were quantified in accordance with agency recording procedures. Cases involving interagency responsibilities were more likely to prompt a legalistic approach. Making a defensible decision became an important driver of practice when decision making was structured through case conferences or safeguarding procedures that sought a single right answer to an unclear situation.

An introduction to intergenerational practice

A. Hatton-Yeo

Working with Older People, vol. 14, June 2010, p. 4-11

Intergenerational practice aims to bring people together for purposeful, mutually beneficial activities which promote greater understanding and respect between generations and contribute to building more cohesive communities. This article provides an introduction to the topic, looks at the impact of intergenerational projects, and presents an overview of the policy and practice context.

It's official: Britain is the best place in the world to die

J. Laurance

The Independent, July 15th 2010, p. 19

A report by the Economist Intelligence Units ranks the UK top of the 'Quality of the Death' index. The index ranks 40 countries according to their attitudes to death and treatment of the dying, with the UK topping the ranking thanks to its network of hospices, NHS provision of palliative care and access to pain killing drugs.

Kiss of life for death tax bid

A. Porter

Daily Telegraph, July 21st 2010, p.1 + 2

During the 2010 election campaign Andrew Lansley, health secretary in the coalition government, attacked Labour plans for a compulsory levy of up to 20,000, payable on retirement or death, to cover the costs of care in old age. It has been disclosed that a Commission set up by Lansley to examine options for funding care of the elderly is free to consider the introduction of a compulsory levy.

Notes on the end of life: the social interactions between patients, carers and professionals

D. Briggs

Quality in Ageing and Older Adults, Vol.11, June 2010, p. 35-46

This paper presents the findings from a consultation on end of life care services in one London borough. The findings are indicative of the pressured emotional social interactions between patient, carer and professional: how they develop, why they develop, how they are alleviated and how they are exacerbated. Attention needs to be focused on these issues, given the recent drive for greater consideration for the family carers in the delivery of end of life services. It is suggested that, while there are some encouraging signs of good practice among end of life care agencies and professionals in the borough, greater sensitivity is needed on the part of frontline staff in their day to day interactions with patients and carers.

Positive approaches to the fourth age

B. Bano and S.M. Benbow

Quality in Ageing and Older Adults, vol.11, June 2010, p.29-34

There is a developing consensus that services need to understand and meet the spiritual and transcendence needs old frail older people in care settings. It is argued that it may be insufficient to address these needs purely on an individual basis. It is suggested that several approaches are required in order to understand and meet the spiritual needs of people in the fourth age. While a person-centred approach is essential, much can also be gained from a broader understanding that places the older person in the context of the wider community. Spiritual and other needs may be met by addressing social inclusion.

Self-funders in care homes: should they be offered an annual review of their placement from their local authority?

P. Scourfield

Working with Older People, vol.14, June 2010, p. 17-22

Older care home residents whose places are funded by their local authority are required by law to have their placements reviewed at least annually. Such reviews provide an opportunity for the older person and their relatives to comment on their care. Older people who self-fund do not have this opportunity and this is inequitable.

Tories accused of U-turn on 'death tax' to care for elderly

N. Watt, R.Ramesh and D. Brindle

The Guardian, July 21st 2010, p. 12

Health secretary Andrew Lansley has established a new independent commission to examine compulsory funding of long-term care for the elderly, to be chaired by economist Andrew Dilnot, that will report within a year. It will be free to examine a number of funding options. Andy Burnham, shadow health secretary, accused the Government of abandoning its former position, which was critical of Labour's plans for a tax to fund elderly care.

When will dementia be cured?

V. Pitt

Community Care, July 1st 2010, p. 24-25

Bids for dementia research funding have for some time been low in number and quality. However, the new coalition government has pledged to prioritise funding of dementia research. Costs of care could be reduced by research into the causes of dementia, the mechanics of the disease, the establishment of diagnostic tests, and the development of new therapies.

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