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Welfare Reform on the Web (September 2011): Care of the elderly - UK

Age old questions

P. Toynbee and D. Walker

Public Finance, Aug. 2011, p. 24-29

This article presents a critique of the report of the Dilnot Commission on funding long term care. It argues that the report is crafted for maximum agreement and dodges the crunch issue that, if we are to have sufficient care of acceptable quality for the UK’s ageing population, we collectively are going to have to pay much more. The authors argue that the state will have eventually to take the unpopular step of forcing people to use their housing wealth to pay for their care, in spite of the protests of families deprived of their inheritance.

The Campaign to End Loneliness

L. Ferguson

Working with Older People, vol. 15, no.2, 2011, p. 66-70

This article gives an update on the issue of loneliness in older age, and presents some projects being delivered to alleviate the problem under the umbrella of the recently launched Campaign to End Loneliness. It also presents anecdotal evidence from local groups linking reductions in services to increased loneliness in old age.

Care homes cash in on residents’ deaths

A. Ralph

The Times, August 1st 2011, p. 3

Care homes are making tens of thousands of pounds each year from the deaths of residents. Council records show that care providers are taking up to six months to inform their local authority that a resident has died, meaning that they continue to receive taxpayers’ money to fund that resident’s care.

Care homes jeopardised by private equity firms


Labour Research, Aug. 2011, p. 9-11

Research by unions following the demise of Southern Cross has revealed that the entire private residential care home sector may be on the brink of financial collapse. Companies have borrowed too heavily, despite their financial performance being too poor to repay the debts on agreed terms. It is concluded that the public cannot depend on privatised services to provide residential care for vulnerable older people.

Dementia care: a positive future

A. Milne and P. Hibberd (editors) Quality in Ageing and Older Adults, vol. 12, no.2, 2011, p. 61-120

The papers in this special issue are drawn from a two day conference on dementia care held in May 2010. The articles cover: research evidence on the experiences of people with dementia in care homes; the potential to develop person-centred care for people with dementia in acute hospital settings; the role and aims of the Admiral Nurse Academy; the experiences of family carers of people with dementia; and a specialist mental health intermediate care service for people with dementia.

Development and implementation of a dual diagnosis strategy for older people in South East London

R. Rao and A. Shanks

Advances in Dual Diagnosis, vol. 4, no.1, 2011, p. 28-35

There is a growing population of older people with co-morbid mental health and substance misuse issues in the UK. This paper examines the background, development and implementation of a dual diagnosis strategy designed to address the growing problem of substance misuse among older people in an inner city area in London. A needs assessment highlighted workforce training needs which led to the commissioning of an innovative staff education programme. Pathways were created to allow seamless transition between mental health and substance misuse services, enabling older people with dual diagnosis to receive the care they required.

'Early days': knowledge and use of the Mental Capacity Act 2005 by care home managers and staff

J. Manthorpe and others

Dementia, vol. 10, 2011, p. 283-298

This article reports findings from 32 exploratory interviews with care home managers and staff regarding their knowledge and use of the Mental Capacity Act 2005 (MCA), implemented in England and Wales in 2007. The interviews revealed that, regardless of their knowledge of the MCA, the daily working ethos of staff appeared to be within the remit of the Act. Training could therefore build on these principles. However, considerable variation in understanding terms and principles of the MCA was found. Few participants were aware of specific legislative points, and offered common sense explanations for their actions and decision-making. This level of knowledge may not meet regulators’ requirements or the needs of residents.

How can older people’s mental health services in the UK respond to the escalating prevalence of alcohol misuse among older adults?

M. Rakshi and others

Advances in Dual Diagnosis, vol. 4, no.1, 2011, p. 17-27

Current evidence suggests that the prevalence of alcohol misuse among older people is increasing and likely to rise further as the baby boomer generation enters retirement. Alcohol misuse among older people increases their vulnerability to mental health problems, cognitive impairment, relapse and social exclusion. This article explores how older people’s mental health services and alcohol treatment services can support increasing numbers of service users with co-existing mental health problems and alcohol misuse. It is necessary for older people’s mental health services to routinely screen patients for alcohol misuse as part of a core mental health assessment. Patients who misuse alcohol need to be supported by a standardised care pathway and clear treatment options. This is concordant with current government policy to reduce alcohol related harm.

A new model for care and support: sharing lives and taking charge

A. Fox

Working with Older people, vol. 15, no.2, 2011, p.58-63

There are a range of interventions aimed at vulnerable older people, some long-running but little known, and others struggling to become established, which differ from traditional services in two ways. First, they have a focus on real relationships rather than the highly boundaried, paid-by-the-hour professional/client transaction. Second, they give people of all ages and abilities many more chances to be a contributor as well as a recipient of support. This paper looks at various examples of such services: Shared Lives, ASA Lincolnshire’s At Home Day Resource for people with dementia, Homeshare, KeyRing and microenterprises.

Promoting involvement of older people in shaping policy and practice

C. Wood and M. Wright

Working with Older People, vol.15, no.2, 2011, p. 80-86

Older people face exclusion from participation and are manipulated as a result of stereotyping, poverty and discrimination. Unwelcome stereotypes arise from the social construction of older people, poverty impacts on their participation, and power is used to discriminate against them. This article presents case studies of two different models of promoting participation by older people. The first case study highlights the EngAge Countywide Network in County Durham, which proactively reaches out to marginalised older people to ensure their voices are heard. The second focuses on Kilburn Older Voices Exchange, a neighbourhood renewal project in London which combines collective action with partnership working.

Promoting self-directed support for people living with dementia: overcoming the challenges

D. Moore and K. Jones

Social Care and Neurodisability, vol. 2, no.2, 2011, p. 66-70

This paper looks at how West Sussex County Council has promoted the use of self-directed support to give people with dementia more control over their lives. It describes the challenges involved in making self-directed support a reality for people with dementia, including the paperwork involved and the time spent setting up a service. It is concluded that for services to be truly transformed, there needs to be a fundamental shift in how social workers view people with dementia. Staff need to see the person with dementia as an individual who has the ability to take control of their life despite the difficulties they face.

Talking Mats help involve people with dementia and their carers in decision making

J. Murphy, T.M. Oliver and S. Cox

Joseph Rowntree Foundation, 2010

Government guidelines have emphasised the importance of ensuring that people with dementia and their carers have their voices heard when discussing care needs. This research aimed to explore whether Talking Mats can enable people with dementia and their family carers to feel more involved when making decisions about their daily lives. The study, from April 2008 to June 2009, involved 18 couples and showed that Talking Mats are a highly efficient and successful way of supporting people with dementia to meaningfully participate in discussions about their daily care.

(For a review see Community Care, July 7th 2011, p. 32-33)


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