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

"COUNCILS PUSHING PATIENTS THROUGH HOSPITALS' REVOLVING DOORS"

C. Kenny

Community Care, Oct.28th-Nov.3rd 2004, p.18-19

The system of fining councils for delayed discharges has successfully unblocked hospital beds, but may also be leading to a rise in readmission rates for older patients. There is also evidence that councils are using residential care as a quick fix to avoid fines in cases where patients could have been supported at home.

HOME TRUTHS

M. Warner and D. Cohen

Health Service Journal, Vol. 114, Nov. 4th 2004, p.28-29

The study assessed whether a greater number of older people would avoid institutional care if current assistive technologies were fully utilised. A number of people were found to benefit from different technology bundles which cost less than institutional care. For this approach to succeed, high application of comprehensive geriatric assessment would be needed.

LEAVING HOSPITAL: THE PRICE OF DELAYS

Commission for Social Care Inspection

London: 2004

The report looks at older people's experience of the hospital discharge system in seven areas across the country. It focuses on individuals' experiences of the impact of the government's scheme for fining councils for delayed discharges. Found wide variations in practice across the country, but worrying evidence of older people being put into residential care for the convenience of the local authority, with a short-term approach that fails to give them choices about their future care. On the other hand, the amount of extra time people had to spend in hospital because their council hadn't arranged care almost halved between October 2003 and January 2004.

"MAKING THE MOVE": RELATIVES' EXPERIENCES OF THE TRANSITION TO A CARE HOME

S. Davies and M. Nolan

Health and Social Care in the Community, vol.12, 2004, p.517-526

Data were collected in 37 semi-structured interviews involving 48 people who had assisted a close relative to move to a nursing home. Findings suggest that health and social care professionals have enormous potential to influence relatives' experiences of nursing home entry. Experiences are enhanced if family carers are able to work in partnership with care staff to ease the transition for the older person.

PROVIDING FOR THATCHER'S CHILDREN

K. Stevens

Community Care, Nov.4th-10th 2004, p.38-39

Older people are now more likely than in the past to be home owners. This means that they can sell their houses and use the proceeds to pay for residential care. This causes problems for the state later on when savings run out and the local authority has to foot the residential care bill. If the older person is paying above the local going rate for institutional care, the council may move them to less plush surroundings. Author calls for better advice for home owners when they commission care.

REARRANGING THE DECKCHAIRS ON THE TITANIC OF LONG-TERM CARE - IS ORGANISATIONAL INTEGRATION THE ANSWER?

C. Glendinning and R. Means

Critical Social Policy, Vol. 24, 2004, p.435-457

Improving the integration of health and social services for older people has been on the political agenda for a number of years, with limited success. The article examines the government's latest solution to the problem: single and multi-purpose legal bodies called Care Trusts to commission and be responsible for all local health and social care. It looks at the problems that have prevented integration over the past fifty years, in particular the changing role of health services in the provision of long-term support for older people and the constant redefinition of the boundaries between health and social services without the funding to support the changes, and argues that unless these continuing problems are addressed integration will only be possible at a superficial level.

RISKY BUSINESS: DIRECT PAYMENTS AND LONE WORKERS

L. Bell

Caring Times, Nov. 2004, p.22 + 24

Government is encouraging greater use of direct payments by older people so that they can commission their own home care services. This puts them at risk of abuse in their own homes by unsupervised lone care workers.

SHORT AND SWEET

P. Hare

Community Care, Nov.18th-24th 2004, p.40-41

Reports on the results of a consultation on what constitutes an effective short break for carers of people with dementia. Carers said that the effectiveness of a respite break is increased by accurate needs assessment, consideration of individual needs of the carer and care recipient, and perceived affordability of the service.

SMALL CHANGES, BIG DIFFERENCE

Anon

Mental Health Today, July/Aug . 2004, p.16-17

The Dementia Services Collaborative is a 22-month project in North East England jointly funded by participating primary care trusts, social services departments and mental health trusts. The collaborative has focused on four key areas of dementia care: early detection, communication, person centred care, and care coordination.

A THEORY OF AGE EXCLUSION THROUGH CLOSURE: "CHRONOLOGICAL AGE" TO "CLINICAL NEED"

M. Simms

Journal of Ageing Studies, Vol. 18, 2004, p.445-465

The article documents the exclusion of older people from labour force participation and continuing care within hospitals. It reviews the history of workforce exclusion, and explores how the poor law "therapy"/ "succour" divide was recast in the Welfare State "health"/ "social care" divide. Socio-economic changes such as the rising cost of healthcare, demographic change, the development of geriatric medicine, and economic restructuring , have served to ration access to continuing care on the basis of clinical need. Concludes that these processes have resulted in age being welded to clinical need to become a force of exclusion, creating a "process of subordination" within welfare state capitalism.

TOWARDS QUALITY CARE: OUTCOMES FOR OLDER PEOPLE IN CARE HOMES

C. Mozley and others

Aldershot: Ashgate, 2004

This evaluation of the outcomes of residential and nursing home care for older people identifies the factors determining the quality of life of those who have moved into care homes. It examines the relationship between older people's psychological well-being and the kinds of care they receive in residential homes. The volume draws on a study of UK care homes, in which new entrants were interviewed soon after admission and then on two further occasions, to ascertain their experiences of care and their quality of life.

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