The Ethical Implications of Spirituality in Residential Care for Older People (ETHoS Project)

Demographic changes, political, social, and migration trends are changing the care demand in the United Kingdom. This is reflected in residential care for older people, especially regarding the spiritual needs of residents. Attention to spiritual and religious diversity is limited in residential care for older people and the implementation of diverse spiritual care is under-explored. Furthermore, knowledge and education regarding spirituality is limited among staff members in residential care. This study aimed to understand the ethical implications of ‘spirituality’ in residential care for older people. Qualitative research with an ethnographic approach was conducted in four care homes each with a different cultural or spiritual background. This comprised participant observation, semi-structured interviews with residents with capacity and focus groups with staff. Prior to the interviews, residents were asked to bring an artefact which had to give or represent a sense of wellbeing. It functioned as a conversation starter and gave insight into older people's ideas of spirituality. Finally, an e-Delphi process was conducted with an expert panel to explore knowledge and advice relating to spirituality in residential care for older people.Spiritual needs are the needs that resonate to someone's 'core being'. Barriers to good spiritual care were assumptions made by care home staff regarding residents' spiritual needs, moral dissonance relating to fears of taking risks, and a lack of advocacy for residents. Spiritual wellbeing was enhanced by creating a care home culture of intimacy, hospitality and intersectional awareness. This study raises awareness of the importance and diversity of spiritual needs of older people in residential care. The findings of this study inform care home managements, care home staff, nursing students and policy makers on how to improve spiritual care for older people in residential care. A reflective toolkit was produced to help care home staff think about the space for spirituality in their care home. This is the first of its kind and has the potential to help support care home staff and management to reflect upon how spirituality can be best incorporated into the care home culture through enhancing connectedness and understanding individual residents

Dementia Research Ethics Resources

This resource was developed following a DemComm Winter Residential School session in November 2023, titled ‘Navigating the Ethical Maze’, which built on a webinar delivered in August 2023 on ‘Ethics and dementia research’. DemComm is a 2-year programme funded by the National Institute of Health and Care Research and the Alzheimer's Society. There are over 50 research fellows in the programme. At the Winter School, DemComm fellows commented on a list of challenges, compiled during the webinar, and discussed potential solutions to these both in small groups and during an open discussion. The challenges and the solutions were mapped across the research cycle: - Idea generation and proposal - Recruitment (including consent and capacity assessment) - Data collection/data access - Data analysis - Dissemination and engagement - Patient and public involvement This is a 'living document' and we are happy to receive ideas on what to add or change in the current version. As it is a short document, the list of resources is not exhaustive

‘I wasn’t on the front line per se, but I was part of health care’:Contributions and experiences of ancillary staff in care homes in England during the COVID-19 pandemic

Objectives: Ancillary staff – cleaning, catering, housekeeping and laundry workers – play a crucial role in care homes, by promoting infection control, food preparation and hygiene, and contributing to the care home environment. This study sought to understand the experiences of ancillary staff working in English care homes during the COVID-19 pandemic. The results will inform policy makers, employers, care home managers and others, both in England and overseas, as how to best support the ancillary workforce. Methods: Between March and August 2021, video and telephone interviews were conducted with those working or living in care homes in England. Participants comprised ancillary staff (n = 38), care home managers (n = 8), care home residents’ family members and friends (n = 7), human resource managers (n = 5) and care home residents (n = 5). Results: Ancillary staff often had increased responsibilities and contributed to pandemic efforts by changing working practices, routines and job roles with the aim of supporting residents and other staff. Teamwork, underpinned by strong leadership, helped ancillary staff feel supported. Conclusions: Ancillary staff should be better recognised as being central to care home care. They are essential workers helping to keep residents safe and well.</p

Supplemental Material - ‘I wasn’t on the front line <i>per se</i>, but I was part of health care’: Contributions and experiences of ancillary staff in care homes in England during the COVID-19 pandemic

Supplemental Material for ‘I wasn’t on the front line per se, but I was part of health care’: Contributions and experiences of ancillary staff in care homes in England during the COVID-19 pandemic by Olivia Luijnenburg, Kritika Samsi, Ian Kessler, Caroline Norrie, Stephen Martineau and Jill Manthorpe in Journal of Health Services Research & Policy.</p