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Welfare Reform on the Web (February 2004): Care of the Elderly - UK

DOUBLE JEOPARDY? NEEDS AND SERVICES FOR OLDER PEOPLE WHO HAVE LEARNING DISABILITIES

R. Bland and others

Journal of Learning Disabilities, Vol. 7, 2003 p.323-344

Health service providers are facing increased challenges as people with learning disabilities are living longer. The article examines the health problems of people with learning difficulties over the age of 65 and the sources and types of community support received. Care staff were surveyed regarding these services and were generally satisfied with the health support given. However, the study revealed some alarming gaps in care; fewer than 30% had had a hearing test in the past five years and cervical, breast and testicular examinations were rare. The article concludes that there is currently, and will be more so in the future, a great need to develop health supports for older people with learning disabilities.

HOME AND AWAY: HOME FROM HOSPITAL AND THE BRITISH RED CROSS: PROGRESS AND PROSPECTS

London: British Red Cross, 2003

The Home from Hospital Service provides emotional and practical help to (mainly older) people by linking trained volunteers with individuals and developing flexible support packages following discharge from hospital. The service has proved extremely popular, and has grown considerably over the past few years.

HOSPITAL DISCHARGE AND CITIZENSHIP RIGHTS OF OLDER PEOPLE: WILL THE UK BECOME A TEST-BED FOR EASTERN EUROPE?

D. Ford and P. Stepney

European Journal of Social Work, vol.6, 2003, p.257-272

Reforms to community care in the UK have created a tension between aspirations to empower users and enhance choice and the need to contain costs. The desire to contain costs has been accorded a higher priority than the resolve to empower service users. Authors argue that the civil, and even the human, rights of older people may be endangered by the overriding need to meet efficiency targets. These developments provide a warning to Eastern Europe against importing managerial and market principles into the field of care of older people.

IMPROVING OLDER PEOPLE'S SERVICES: AN OVERVIEW OF PERFORMANCE

Social Services Inspectorate, 2003

The report highlights key achievements by councils and their partners in planning and delivery of services for older people. These include:

  • more integration of health and social care;
  • greater consultation with older people;
  • expansion of intermediate care and extra care housing;
  • development of services to promote independence.

However, this process has not yet had a sufficiently widespread impact on the quality of frontline services.

INTERMEDIATE CARE: FROM INNOVATION TO POST-MORTEM?

K.V. Wilson

Journal of Integrated Care, vol.11, Dec.2003, p.4-6

Presents a critique of the creation and implementation of the national policy for intermediate care.

INTERMEDIATE CARE: ITS PLACE IN A WHOLE-SYSTEMS APPROACH

S. Asthana and J. Halliday

Journal of Integrated Care, vol.11, Dec.2003, p.15-24

Paper draws on an independent evaluation undertaken in 2002 of intermediate care services in Cornwall to examine how a whole-systems approach to rehabilitation works in practice. It describes the central role of intermediate care co-ordination in developing and providing oversight of the whole system. Next, the example of residential rehabilitation is used to examine how an individual service relates to the system as a whole. Finally, points out that those seeking to replicate the Cornish experience must appreciate the need to build strong inter-agency partnerships and consider the opportunities and constraints presented by the wider organisational and geographical context.

INTERMEDIATE CARE OR INTEGRATED CARE: THE SCOTTISH PERSPECTIVE ON SUPPORT PROVISION FOR OLDER PEOPLE

A. Petch

Journal of Integrated Care, vol.11, Dec.2003, p.7-14

Intermediate care has featured strongly in evolving strategy for support provision for older people in England. In Scotland, the concept has been rejected in favour of provision of rehabilitation in a client's own home. This apparent divergence is explored in the context of policy divergence post-devolution and against aspirations for a whole-systems approach.

LOCATION OR DIS-LOCATION? TOWARDS A CONCEPTUALZATION OF PEOPLE AND PLACE IN THE CARE-GIVING EXPERIENCE

C. Milligan

Social & Cultural Geography, Vol. 4 2003, p.455-470

The article considers the spatial nature of care and care-giving for frail older people. It examines trans-national approaches to care-giving, as well as care in rural communities before going on to look at the UK experience, where the line between formal and informal care has become increasing blurred. The benefits of home care are explored, but the article also looks at the problems that occur when control is lost as health professionals invade the house and the home is no longer a haven but an extension of a care zone, taking on the features of a hospital ward. Finally, the article examines the difficulties of moving from home care to residential care, for both patient and carer.

PROMOTING FLEXIBILITY IN THE INTERMEDIATE CARE WORKFORCE

S. Nancarrow

Journal of Integrated Care, vol.11, Dec.2003, p.25-30

Paper discusses pressures on intermediate care services that encourage a flexible approach to staffing, including winter crises, different service remits and a constantly changing policy context. Suggests that managers can address the issue of flexibility through adoption of flexible team structures, flexible worker roles and flexible employment structures.

THE PROVISION OF INFORMATION AND ADVICE FOR OLDER PEOPLE: WHAT MORE DO THEY WANT?

N. Raynes and others

Quality in Ageing, vol.4, Nov. 2003, p.23-29

Study critically examined current practice in the provision of information and advice for older people through a literature review, an analysis of the web sites of three major providers, and focus groups. Research showed that the involvement of older people in the design, production, dissemination and monitoring of information was necessary, and that they valued face-to-face contact in the provision of advice.

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