Privacy and Dignity in Continence Care Project Phase 2.

This report provides an account of the methods and findings of Phase 2 of the Privacy and Dignity in Continence Care for Older People study funded by the Royal College of Physicians and the British Geriatrics Society. The overall objectives of this two year project were to: • Identify and validate person-centred attributes of dignity in relation to continence; • Develop reflective guidelines for dignified care; • Produce recommendations for best practice

Empowering older people through technology: Academic Review of the iContact Project conducted by Acting Up

It starts with a short discussion of the nature of multimedia profiling, then discusses the development of multimedia profiling within Kingsgate Resource Centre and with KOVE and considers why Acting Up successfully developed in these contexts and not in others. It concludes with a discussion of the outputs of profiling and their impacts

Empowerment and protection

This paper provides a summary of a piece of research that looks at the development of policies and practices in risk assessment and management in community services for adults with learning disabilities. The research was funded through the Foundation for People with Learning Disabilities and was carried out by Andy Alaszewski, Helen Alaszewski and Alison Parker

Risk, Uncertainty and Life Threatening Trauma: Analysing Stroke Survivor's Accounts of Life after Stroke

This paper examines the ways in which stroke survivors identify and manage the risks and uncertainties of their situation. It draws on interview data from a UK study in East Kent of 31 stroke survivors (aged between 38 and 89 years). The interviews created accounts based on the experience of stroke and post stroke recovery. Stroke survivors experienced their stroke as an unanticipated event in which there was a failure of foresight. The stroke undermined their ontological security and increased their awareness of and anxiety about everyday activities both in and outside the home, created awareness of a new danger, that of having another potentially fatal stroke, and could damage their social standing. Survivors used a variety of strategies to manage such uncertainties. They shortened their time horizons, either abandoning longer-term plans or discussing them in very vague and general terms. They concentrated either on the present, "taking each day as it comes" or developed goals to structure the short-term future. These short-term goals involved challenges and there was in some cases the possibility of a harmful outcome. Such voluntary risk-taking provided an opportunity for "centre work" which could re-establish the stroke survivors social standing

Communicating Information to Stroke Survivors. A pilot study

This study explored current approaches to communicating information to stroke survivors and their relatives. The aim of this pilot project was to gain better understanding of information provision about stroke from health professionals by exploring the perspectives of the stroke survivors, their carers and professionals themselves. The study aimed to explore, through qualitative interviews, how such information is provided, what works well in information giving, what the barriers to good information provision are and how these arise. The research provided a step towards developing an information toolkit for service providers, stroke survivors and relatives to engage in effective person-centred communication. The study is based on interviews conducted with health professionals in acute, community and primary care settings in East Kent and with a small sample of stroke survivors and carers. We interviewed 19 stroke survivors, 6 relatives and 23 health professionals (11 individually and 12 in 2 focus groups) involved in their care and support. To protect individual identities, we have changed all names in our report

Communicating Information to Stroke Survivors. Executive Summary.

This study explored current approaches to communicating information to stroke survivors and their relatives. The project’s aim was to gain better understanding of information provision about stroke from health professionals. It explored the perspectives of stroke survivors, their carers and professionals. The study aimed to explore, through qualitative interviews, how information is provided, what works well in information giving, what the barriers to good information provision are and how these arise. The study helped develop an information toolkit for service providers, stroke survivors and relatives to engage in effective person-centred communication. The study is based on interviews conducted with health professionals in acute, community and primary care settings in East Kent and with a small sample of stroke survivors and carers. We interviewed 19 stroke survivors, 6 relatives and 23 health professionals (11 individually and 12 in 2 focus groups) involved in their care and support

Life after stroke: Reconstructing everyday life

Stroke can have a major impact on a person’s life. For example a stroke may leave an individual with residual disabilities such as difficulty with walking or speech that creates considerable challenges to everyday life. While quite a lot of research has been done on how to prevent and treat stroke, comparatively little research has been undertaken on the ways in which individuals respond to strokes and how they reconstruct and manage their everyday lives after a stroke. In this study we seek to understand how individuals identify and manage the challenges and opportunities of every day life and the ways in which professionals can help their development.We are particularly interested in how individuals identify and manage risk, however, our previous research indicated that risk tended to be identified with hazard and danger.We therefore expressed risk as part of everyday life and we provide a general account in this report.We plan to specifically highlight risk in a forthcoming paper

Privacy and Dignity in Continence Care for Older People. Report on Phase 1.

In recent years dignity in care has become a priority and the focus of a number of government reports and policy initiatives. (DH 2003, 2007), (SCIE 2006). The National Service Framework for older people (DH 2001) and its follow up document, (DH 2006a) for example stated that maintaining dignity was pivotal in improving care for older people. However, despite this political support, there continue to be problems in health and social care settings related to preserving the dignity of older people (Levenson 2007). There is a risk therefore that generalised policy statements have little effect on actual practice and care unless they are operational, and supported by detailed guidelines for practice. Alongside policy, there has also been an increase in studies of dignity in health care (Chochinov et al,2002a), (Woolhead et al 2006) particularly focusing on the ways in which dignity is defined and what it means to people. There have, however, been far fewer on the relationship between dignity and personal care particularly when care involves sensitive issues such as incontinence. This report provides an initial analysis of emerging themes and findings from Phase 1 of the study of privacy and dignity in continence care for older people funded by the Royal College of Physicians and the British Geriatrics Society. The overall objectives of this two year project are to: i. develop reflective standards/guidelines for dignified care, ii. produce recommendations for best practice, iii. provide advice with regard to changing practice in the clinical setting

Towards the creative management of risk: Perceptions, practices and policies

The present paper examines the importance of risk when supporting individuals with learning disabilities. It uses data from a small research project designed to examine the perceptions of risk held by users, carers and professionals, as well as the risk policies of agencies. Risk is an important issue in the provision of support. The service users in the present study saw risk primarily in terms of hazards. The carers were concerned about hazards and harm, but recognized the need for risk-taking. The professionals emphasized the importance of reasonable risk-taking. Agencies also recognized the importance of risk management, and most had or were developing risk policies. However, most of these policies are based on a restricted approach to risk which emphasizes hazard assessment, and health and safety issues. There was limited evidence of broader integrated approaches to risk management which had the capacity to link and balance safety and empowerment