Creative ageing

A series of reports taking a critical look at ageing, and applying gerontological thinking to current debates in services for people over the age of 65

Solution Focused Therapy for Trauma Survivors: A Review of the Outcome Literature

Directly confronting and processing past trauma can be distressing for clients and may contribute to the high dropout rates among leading trauma treatments. Solution-focused therapy (SFT) primarily focuses on the present and future and has been proposed as a strengths-based alternative for treating trauma survivors. This review systematically evaluated the existing outcome literature for the effectiveness of SFT for trauma survivors. Multiple databases were searched using search terms to identify results for solution-focused therapy as a treatment for trauma survivors. Eligible studies included experimental, quasi-experimental, or pre-post designs that reported outcome measures following SFT-based treatment. A total of five studies met inclusion criteria and were evaluated and summarized. Four out of the five studies included data on within-subjects changes in the SFT treatment group, reporting statistically significant improvements on trauma symptoms, recovery, self-esteem, and parenting, with moderate to large effect sizes. Three studies compared SFT with treatment-as- usual (TAU) or no treatment and found mixed results. Compared to control groups, SFT showed statistically significant improvements with large effect sizes on post-traumatic growth and sleep issues, but effect sizes for trauma symptoms were small and not statistically significant or varied greatly between different reporters. The existing literature provides initial evidence of overall improvement for trauma survivors who received SFT, but the effectiveness of SFT at addressing trauma symptoms requires further investigation. More high quality, controlled studies are needed to evaluate SFT as a trauma treatment

Chapter 11 Understanding the Social Care Crisis in England Through Older People’s Lived Experiences

The chapter’s focus is social care in England where responsibility for the organisation and funding of care has shifted from the state to the individual. It draws on a qualitative research project about the experiences of older people who are paying for their social car

Developing a Programme Theory of Integrated Care: the effectiveness of Lincolnshire’s multidisciplinary Neighbourhood Teams in supporting older people with multi-morbidity’ (ProTICare) [summary report]

It is a well-rehearsed conversation that an ageing population places a significant ‘burden’ on the healthcare system where this narrative has become arguably more prevalent during a time of unprecedented economic restraint. A key approach to ensuring cost-effective service delivery through the integration of health and social care services aims to ensure a ‘seamless’ care pathway from early preventative interventions, planned care for complex needs, and a reduction in unscheduled hospital admissions and inappropriate service use. Ultimately it is acknowledged that integrated care will lead to the improvement of older people’s quality of life (Curry and Ham, 2010). An innovative concept developed from this discourse is the ‘Neighbourhood Teams’, a multidisciplinary team, comprising healthcare professionals and voluntary sector services with the underlying focus of providing streamlined case managing of care for individuals with multiple long term conditions. It is evident that multimorbidity is an increasing concern for the healthcare system, recognisable amongst individuals over 65 years of age, especially those defined as the 'oldest old'. Echoing current policy, an additional but essential role of the Neighbourhood Teams is encouraging individuals to self-manage their conditions. This research will report on the effectiveness of four Lincolnshire Neighbourhood Teams in supporting older people with multimorbidities. Furthermore drawing upon existing literature and qualitative interviews with healthcare and voluntary sector staff, the development of a programme theory of integrated care derived from various elements of the project will reflect upon the perceived outcomes of the Neighbourhood Teams and their successes in achieving their stated aims

Acute hepatitis with nontyphoidal salmonella and hepatitis E virus coinfection

SummaryA 65-year-old Taiwanese man presented with dark urine for 5 days before admission to hospital and with fever on the 2nd day of admission to hospital. Laboratory studies showed acute hepatitis with hyperbilirubinemia. Acute hepatitis with nontyphoidal salmonella and hepatitis E virus coinfection was diagnosed. The fever subsided after treatment with ceftriaxone and cefepime. His serum bilirubin reached its peak value on the 3rd week after admission to hospital and then gradually returned to the normal range. To the best of our knowledge, acute hepatitis E coinfection with nontyphoidal salmonella has not been reported previously

When it comes to carers, you've got to be grateful that you've got a carer coming in: Older people's narratives of self funded care in England

The number of older self-funders in England is growing in the context of tight eligibility criteria and fixed financial thresholds to access statutory adult social care. Older people who self-fund their social care fall largely under the radar of statutory services and of research. Our study aimed to listen closely to the stories that older people tell about finding, managing and paying for their care. We interviewed 65 older people living in the community who were funding all or some of their social care. This paper focus on narrative analysis of selected transcripts from these interviews. It sheds light on how older people represent their experiences of self-funding and what underpins these constructions. A key finding is that the disjunctions within older people’s accounts between the care they want and the care they receive reflects wider political and structural tensions in the funding and delivery of care. Older self-funders temper their expectations in light of their experience of shortfalls in the system. This enables them to adjust to the deficiencies but obscures and perpetuates poor care. The discussion considers the findings in relation to: the fundamental disjunction between body labour and commodified care; the shared precarity of older people and care workers; and the individualisation of risks that makes older people and their carers responsible for making a failing care system ‘work’. Our analysis adds to the case for major reform of adult social care, including a revaluing of the status and employment conditions of front-line care workers