Adult family violence coming out of the shadows

© [2023, Emerald Publishing Limited]. This AAM is provided for your own personal use only. It may not be used for resale, reprinting, systematic distribution, emailing, or for any other commercial purpose without the permission of the publisher.We consider what is known regarding the characteristics and context of adult family violence; and what practitioners and organisations in the United Kingdom might learn from the literature. Approach - We review literature on adult family violence and parricide and include illustrative cases from a study of domestic homicide review reports involving older adults. Findings - Adult family violence most often involves mothers killed by their adult sons. Mental health issues, alcohol/ substance misuse, and criminality are common themes for perpetrators. Caregiving responsibilities is a theme for both victims and perpetrators. Our research identified two main categories of adult family homicide: perpetrators with major psychotic illness, and victims-perpetrators in complex relational contexts. Practical implications - We consider how practitioners respond to situations of adult family violence and learning for policy-makers, agencies and practitioners. Originality - This paper summarises what is known, argues that more research is needed, and suggests practical ways forward for policy-makers, relevant agencies and practitioners

A narrative review of literature on the use of health and social care by older trans adults: what can United Kingdom services learn?

This article has been accepted for publication and will appear in a revised form, subsequent to peer review and/or editorial input by Cambridge University Press, in Ageing & Society published by Cambridge University Press. Copyright The Author(s), 2021.We carried out a narrative review and thematic analysis of literature on the physical healthcare, mental healthcare and social care of trans older adults to ascertain what is known about older trans adults’ contacts with and use of health and social care. Thirty papers were found: a majority originated in the United States. Five themes were identified: experience of discrimination/ prejudice and disrespect; health inequalities; socioeconomic inequalities; positive practice; and staff training and education. The first three themes present challenges for providers and service users. Experiences of discrimination/ prejudice and disrespect over the course of their lives powerfully influence how older trans adults engage with care services and practitioners. Health and socio-economic inequalities suggest that older trans adults are likely to have greater need of services and care. The remaining two themes offer opportunities for service improvement. We conclude that more research is needed, that there is a strong argument for taking a life course perspective in a spirit of cultural humility, and that contextual societal factors influence service users and providers. We identify positive trans-inclusive practices which we commend to services. More needs to be done now to make older adult services appropriate and welcoming for trans service users

Exploring the scope for Normalisation Process Theory to help evaluate and understand the processes involved when scaling up integrated models of care: a case study of the scaling up of the Gnosall Memory Service

Purpose: The scaling up of promising, innovative integration projects presents challenges to social and health care systems. Evidence that a new service provides (cost) effective care in a (pilot) locality can often leave us some way from understanding how the innovation worked and what was crucial about the context to achieve the goals evidenced when applied to other localities. Even unpacking the “black box” of the innovation can still leave gaps in understanding with regard to scaling it up. Theory-led approaches are increasingly proposed as a means of helping to address this knowledge gap in understanding implementation. Our particular interest here is exploring the potential use of theory to help with understanding scaling up integration models across sites. The theory under consideration is Normalisation Process Theory (NPT). Design/methodology/approach: The article draws on a natural experiment providing a range of data from two sites working to scale up a well-thought-of, innovative integrated, primary care-based dementia service to other primary care sites. This provided an opportunity to use NPT as a means of framing understanding to explore what the theory adds to considering issues contributing to the success or failure of such a scaling up project. Findings: NPT offers a framework to potentially develop greater consistency in understanding the roll out of models of integrated care. The knowledge gained here and through further application of NPT could be applied to inform evaluation and planning of scaling-up programmes in the future. Research limitations/implications: The research was limited in the data collected from the case study; nevertheless, in the context of an exploration of the use of the theory, the observations provided a practical context in which to begin to examine the usefulness of NPT prior to embarking on its use in more expensive, larger-scale studies. Practical implications: NPT provides a promising framework to better understand the detail of integrated service models from the point of view of what may contribute to their successful scaling up. Social implications: NPT potentially provides a helpful framework to understand and manage efforts to have new integrated service models more widely adopted in practice and to help ensure that models which are effective in the small scale develop effectively when scaled up. Originality/value: This paper examines the use of NPT as a theory to guide understanding of scaling up promising innovative integration service models

Spontaneous concerns about risk and abuse reported by people with dementia and their carers

Purpose To look at concerns about risk/ abuse expressed spontaneously by people with dementia (PwD) and their carers in narratives describing their journeys with dementia. Method Thirty-five narratives were elicited from PwD, carers of PwD and couples where one partner was living with dementia as part of a study on the impact of producing narratives on PwD and their carers. Participants were found to allude to risk/ abuse, or specifically mention thoughts on risk and abuse in their narratives. A secondary analysis of the theme of risk/ abuse is reported here. Findings Concerns about risk/ exploitation were often expressed in the narratives, and covered a range of areas including driving; safety in the home; safety outdoors; falls; finances; risk to PwD from others; risk to others from PwD; potential or actual police incidents; and neglect. Research limitations The narratives were elicited as part of another project and participants were not asked directly about risk: themes reported here were brought up spontaneously by participants. Practical implications In relation to dementia a wide range of risk/ abuse issues is of concern to PwD and their carers, including driving and financial vulnerabilities. PwD and carers are prepared to talk about risk/ abuse when given an opportunity. It is important to investigate and understand experiences and concerns about risk/ abuse if they are to be addressed in health and social care practice. Originality The narratives offer unique insights into the concerns of PwD and family carers

Mobile app: Living and dying well with dementia

This is the peer reviewed version of the following article: Bhattacharyya, S., Benbow, S. M., & Collins, E. (2017). Mobile app: Living and dying well with dementia. Progress in Neurology and Psychiatry, 21(3), 4-5. DOI: 10.1002/pnp.470, which has been published in final form at http://onlinelibrary.wiley.com/doi/10.1002/pnp.470/abstract. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-ArchivingDigital technology is gaining wider use in healthcare. Here the authors consider whether a mobile application (app) they have developed could help promote understanding of dementia, its impact on those affected and to focus formal and family carers on key issues in end of life care

Older adults and violence: An analysis of domestic homicide reviews in England involving adults over 60 years of age

This article has been accepted for publication and will appear in a revised form, subsequent to peer review and/or editorial input by Cambridge University Press, in Ageing and Society published by Cambridge University Press. Copyright Cambridge University Press.Domestic Homicide Reviews (DHRs) are conducted when an individual aged 16 or over appears to have died from violence, abuse or neglect by a person to whom they are related or with whom they are in an intimate relationship or who is a member of the same household. DHRs aim to identify lessons to be learned, to improve service responses to domestic abuse, and to contribute to prevention of domestic abuse/ homicide. We submitted freedom of information requests to English Local Authorities to identify DHRs where victim, perpetrator, or both were aged over 60. Collected Reports and/ or Executive Summaries were thematically analysed. Analysis identified four key themes in the context of the key relationship and caring: major mental illness of the perpetrator; drug and/or alcohol abuse; financial issues; and a history of domestic abuse in key or family relationships. We analysed 14 adult family homicides, 16 intimate partner homicides, and five homicide-suicides. Age per se did not emerge as a significant factor in our analysis. Terminology needs to be standardised, and training/ education regarding risk assessment improved in relation to age, myths around ageing/ dementia, and stresses of caring. Management of mental illness is a key factor. A central repository of DHR Reports accessible for research and subject to regular review would contribute to maximising learning and improving practice

Late life acquired dual-sensory impairment: A systematic review of its impact on everyday competence

The literature on the relationship between late acquired dual-sensory impairment (DSI) in older adults and the ability to remain independent is limited. A systematic search of the literature was conducted to assess the impact that late life acquired DSI in older adults has on their ability to remain independent within their homes. Exclusion and inclusion criteria were applied to the papers identified and eight qualified for inclusion in the review. Each selected paper was assessed using a quality rating scale. Country of origin, population studied, age, vision, and hearing criteria all varied between papers. They provide evidence that DSI affects everyday competence, and this effect is complicated by physical comorbidities, mental health, and social factor

Talking about my experiences ... at times disturbing yet positive': Producing narratives with people living with dementia

Background: This research investigated narrative production and use with families living with dementia. We hypothesised that the process of narrative production would be beneficial to people with dementia and carers, and would elicit important learning for health and social care professionals. Method: Through third sector partners, we recruited community-dwelling people with dementia and carers who consented to develop written, audiotaped or videotaped narratives. Audio-taped narratives were transcribed verbatim and handwritten narratives word-processed. After checking by participants, completed narratives were analysed thematically using qualitative data analysis computer software. A summary of the analysis was circulated to participants, inviting feedback: the analysis was then reviewed. A feedback questionnaire was subsequently circulated to participants, and responses were analysed thematically. Results: Twenty-one carers and 20 people with dementia participated in the project. Four themes of support were identified: ‘relationships’, ‘services’, ‘prior experience of coping’ and having an ‘explanation for the dementia’. Three themes were identified as possible additional stresses: ‘emotions’, ‘physical health’ and ‘identity’. We suggest a model incorporating all these themes, which appeared to contribute to three further themes; ‘experience of dementia’, ‘approaches to coping’ and ‘looking to the future’. In participant feedback, the main themes identified were ‘emotions’, ‘putting things in perspective’, ‘sharing or not sharing the narrative’ and ‘actions resulting’. Conclusions: Producing a narrative is a valuable and engaging experience for people with dementia and carers, and is likely to contribute to the quality of dementia care.Further research is needed to establish how narrative production could be incorporated into routine practice

Doctors and their families

From Crossref journal articles via Jisc Publications RouterHistory: epub 2023-01-18, issued 2023-01-18Publication status: PublishedObjective This article reflects on the relationship between doctors and their families and how it influences a doctor’s health, well-being and practice and the health and well-being of other family members. It uses an established model for conceptualising this recursive relationship, drawing on systemic and communications theory, coordinated management of meaning. The article invites doctors to reflect on relational influences between them and their families across the course of their career and following retirement. Conclusion Families are important to, and influence, the well-being of their doctor-members. Likewise, doctors are important to, and influence, the health and well-being of their families