“Healthy Country, Healthy People”: Aboriginal Embodied Knowledge Systems in Human/Nature Interrelationships

The relationships between humans and nature require interdisciplinary perspectives to develop expanded understandings at this crucial time for the planet and its inhabitants. A poignant step towards improving the global ecological situation--which includes human survival and flourishing--is to reconnect our human/nature relationships. From an Australian Aboriginal standpoint, human-nature connectedness is integrally embedded in the relationship to the natural world that is termed Country. This term not only illustrates geographical boundaries but encompasses the harmony and balance of all living things within a cultural and spiritual context. At the interface of this knowledge, ways of thinking, feeling and being include a relatedness to localised knowledge based on the guiding principles of respect, responsibility and reciprocity to place. These principles ensure a sustainable environment that incorporates a ‘whole of life’ approach to human and nature health and wellbeing. In articulating how a sense of place is critical to psychological health within the human psyche, this paper explores Australian Aboriginal eco-therapeutic approaches surrounding the proverb ‘Healthy Country, Healthy People’ that strengthen our social and emotional connections with the natural world. The article advocates for a re-evaluation of self and our embedded perspectives that we draw from nature through being on Country

The challenges of joint working: lessons from the Supporting People Health Pilot evaluation

Purpose: This paper reports the findings of the evaluation of the Supporting People Health Pilots programme which was established to demonstrate the policy links between housing support services and health and social care services by encouraging the development of integrated services. The paper highlights the challenges of working across housing, health and social care boundaries. <br><br> Method: The evaluation of the 6 health pilots rested on two main sources of data collection: Quarterly Project Evaluation Reports collected process data as well as reporting progress against aims and objectives. Semi-structured interviews - conducted across all key professional stakeholder groups and agencies and with people who used services - explored their experiences of these new services. <br><br> Results: The ability of pilots to work across organisational boundaries to achieve their aims and objectives was associated not only with agencies sharing an understanding of the purpose of the joint venture, a history of joint working and clear and efficient governance arrangements but on two other characteristics: the extent and nature of statutory sector participation and, whether or not the service is defined by a history of voluntary sector involvement. In particular the pilots demonstrated how voluntary sector agencies appeared to be less constrained by organisational priorities and professional agenda and more able to respond flexibly to meet the complex needs of individuals. <br><br> Conclusion and discussion: The pilots demonstrate that integrating services to support people with complex needs works best when the service is determined by the characteristics of those who use the service rather than pre-existing organisational structures

Important features of home-based support services for older Australians and their informal carers

This author accepted manuscript (post print) is made available in accordance with the publisher copyright policy following 24 month embargo from the date of publication (8 February 2015) in accordance with publishers copyright policy.In Australia, newly initiated, publicly subsidised ‘Home-Care Packages’ designed to assist older people (≥65 years of age) living in their own home must now be offered on a ‘consumer-directed care’ (CDC) basis by service providers. However, CDC models have largely developed in the absence of evidence on users’ views and preferences. The aim of this study was to determine what features (attributes) of consumer-directed, home-based support services are important to older people and their informal carers to inform the design of a discrete choice experiment (DCE). Semi-structured, face-to-face interviews were conducted in December 2012–November 2013 with 17 older people receiving home-based support services and 10 informal carers from 5 providers located in South Australia and New South Wales. Salient service characteristics important to participants were determined using thematic and constant comparative analysis and formulated into attributes and attribute levels for presentation within a DCE. Initially, eight broad themes were identified: information and knowledge, choice and control, self-managed continuum, effective co-ordination, effective communication, responsiveness and flexibility, continuity and planning. Attributes were formulated for the DCE by combining overlapping themes such as effective communication and co-ordination, and the self-managed continuum and planning into single attributes. Six salient service features that characterise consumer preferences for the provision of home-based support service models were identified: choice of provider, choice of support worker, flexibility in care activities provided, contact with the service co-ordinator, managing the budget and saving unspent funds. Best practice indicates that qualitative research with individuals who represent the population of interest should guide attribute selection for a DCE and this is the first study to employ such methods in aged care service provision. Further development of services could incorporate methods of consumer engagement such as DCEs which facilitate the identification and quantification of users’ views and preferences on alternative models of delivery

The contribution of volunteers in social care services for older people

Faced with unprecedented challenges, the adult social care sector in England has seen increasing attention given to the potential of volunteers to contribute to service provision. This article reports the findings of a qualitative study that explored the contribution made by volunteers to social care services for older people. The article draws attention to the difficulties associated with recruiting and training volunteers to work in the sector, particularly during a period of reduced public expenditure, which is putting the sector under strain. Given the challenges faced, the article considers whether it is appropriate to involve volunteers in care work

‘Extra hands’ or the ‘icing on the cake’?:The boundaries of the volunteer role in formal care settings in England

The adult social care sector in England has been encouraged to increase the role of volunteers in service delivery. To understand the volunteer role in care delivery and its impact upon paid care work, we undertook 94 qualitative interviews in seven care settings for older people in England. While the boundaries between care worker and volunteer were clearly established in some organisations, they were more indistinguishable in others. We discuss how both clear and murky boundary making, especially regarding ‘emotional’ and ‘bodily’ aspects of care, can contribute towards paid care work’s invisibility, lack of recognition and poor remuneration

Exploring the role of volunteers in social care for older adults

Purpose This paper aims to report the findings of a study that explores the contribution volunteers make to social care for older adults, identifying lessons for the social care sector and policymakers. Design/methodology/approach An exploratory multiple case study design was used to capture the perspectives and experiences of managers of services, volunteer co-ordinators, volunteers, paid care staff and older people. Seven diverse social care organisations took part in the study drawn from three locations in the South West of England. Findings This study identified three distinct models of volunteer contribution to social care services for older people. Although the contributions made by volunteers to services are valued, the study drew attention to some of the challenges related to their involvement. Research limitations/implications The organisations taking part in this small-scale study were all based in the South West of England, and the findings are therefore not generalisable but contribute to the growing evidence base related to this important field. Practical implications This study demonstrates the importance of the volunteer co-ordinator role and suggests that it is properly funded and resourced. It also confirms the importance of volunteers receiving appropriate training and support. Originality/value Given the increasing involvement of volunteers in the provision of social care, this paper provides lessons to ensure the role of volunteers in social care enhances rather than diminishes the quality of care provided