Health and social work practitioners’ experiences of working with risk and older people

The purpose of this paper is to explore interprofessional and multidisciplinary working between health and social care practitioners providing services to older people through the prism of how risk is assessed and managed. It proposes that whilst interprofessional and multidisciplinary working is a broad and commonly researched topic, there is a relative paucity of evidence specifically regarding how health and social care practitioners work together across structural, cultural and ideological divides. The study aims to expand the domain of integrated health and social care by including perceptions, understanding and use of the concept of risk by professionals from different disciplines.Design/methodology/approachThis paper is based upon an exploratory study using an interpretivist phenomenological perspective, including 23 semi-structured individual interviews with health and social care practitioners and 2 non-participant observations of multidisciplinary team meetings.FindingsThe paper provides empirical insights around the complex dynamics of interprofessional and multidisciplinary working between health and social care practitioners, in particular the saliency of the interconnectedness of individual practitioner Personalities with the Process of interprofessional and multidisciplinary working under the auspices of relevant Policy drivers.Research limitations/implicationsThe research was conducted in Wales and, due to the increasingly divergent policy context within the UK, the research results may lack generalisability from a wider UK or international perspective. Therefore, researchers are encouraged to test the propositions of this research further.Practical implicationsThe paper includes implications for both interprofessional and multidisciplinary policy and practice with older people. With new models of integrated care being sought, the findings of this study may offer a timely and valuable contribution, particularly from the inclusion of a social care perspective and in better understanding the interconnectedness of practitioner personalities with process and policy.Originality/valueThis paper fulfils an identified need to study the complex dynamics and interconnectedness between health and social care practitioners who work together to provide services to older people

Using psychological mechanisms to reduce intergenerational ageism via intergroup contact.

Positive social interaction between members of opposing social groups (intergroup contact) is an effective method of prejudice reduction (Allport, 1954; Pettigrew & Tropp, 2006). This thesis explores how intergroup contact theory can be applied to age groups to reduce ageism towards older adults. Chapters 1 to 3 form the theoretical chapters of the thesis. Chapter 1 defines psychological processes underpinning ageism, provides details of its prevalence, outlines its consequences in society, and gives a justification for its reduction. Chapter 2 introduces the psychological processes underpinning intergroup contact theory and its different formations. This is followed by a literature review of intergenerational contact research, which identifies research gaps in the field and research questions addressed in this thesis. Four empirical chapters then present findings from eight studies. In Chapter 4, Study 1 provides initial correlational evidence of the relationships between direct intergenerational contact, ageism and related psychological processes. Chapter 5 addresses the research question of whether extended contact can be successfully applied to age groups. Studies 2, 3 and 4 provide novel evidence that extended intergenerational contact reduces ageism and is effective via reduced intergroup anxiety, ageing anxiety and ingroup norms. These studies also support prior research demonstrating that direct contact reduces ageism via intergroup and ageing anxieties. Chapter 6 presents two studies that extend the focus of the thesis to include age stereotypes. Secondary analysis of national survey data in Study 5 explores the perception of older adults' competence across the lifespan and friendships with older adults. The degree to which young and middle-aged adults perceive that competence declines with age is attenuated by having as little as one older friend. Building on these findings, Study 6 explores the relationships between direct and extended intergenerational contact, ageist attitudes and warmth and competence stereotypes. Corroborating Chapter 4, both direct and extended contact predicted reduced ageism and are effective via increased competence stereotypes and increased warmth stereotypes. In the final empirical chapter in the thesis Chapter 7 presents two studies that explore intergenerational contact theory in applied contexts. Using an experimental design, Study 7 evaluated an intergenerational programme in which students had conversations with older adults about their technology use. Compared to a control group, the experimental group rated older adults as warmer yet more incompetent. However, only warmth and not incompetence stereotypes formed indirect pathways to subsequent attitudes towards older adults more widely. Study 8 examined care workers positively and negatively experienced intergenerational contact with care home residents. Although care workers experienced more positive than negative contact, negative (but not positive) contact was associated with their attitudes towards care home residents and it generalised to older adults more widely. This indirect effect of negative contact to older adults was effective only for subtle and not blatant ageist attitudes. Overall, the thesis provides a range of evidence suggesting that intergroup contact theory can be successfully applied to the reduction of ageism. It presents a detailed overview of current knowledge, corroborates existing evidence and presents novel findings for extended contact and mediators of both direct and indirect intergenerational contact

Making it real of sustaining a fantasy? Personal budgets for older people

The restructuring of English social care services in the last three decades, as services are provided through a shifting collage of state, for-profit and non-profit organisations, exemplifies many of the themes of governance (Bevir, 2013). As well as institutional changes, there have been a new set of elite narratives about citizen behaviours and contributions, undergirded by modernist social science insights into the wellbeing benefits of ‘self-management’ (Mol, 2008). In this article, we particularly focus on the ways in which a narrative of personalisation has been deployed in older people’s social care services. Personalisation is based on an espoused aspiration of empowerment and autonomy through universal implementation to all users of social care (encapsulated in the Making it Real campaign [Think Local, Act Personal (TLAP), no date)], which leaves unproblematised the ever increasing residualisation of older adult social care and the abjection of the frail (Higgs and Gilleard, 2015). In this narrative of universal personalisation, older people are paradoxically positioned as ‘the unexceptional exception’; ‘unexceptional’ in the sense that, as the majority user group, they are rhetorically included in this promised transformation of adult social care; but ‘the exception’ in the sense that frail older adults are persistently placed beyond its reach. It is this paradoxical positioning of older adult social care users as the unexceptional exception and its ideological function that we seek to explain in this article

Loneliness, social relations and health and wellbeing in deprived communities

There is growing policy concern about the extent of loneliness in advanced societies, and its prevalence among various social groups. This study looks at loneliness among people living in deprived communities, where there may be additional barriers to social engagement including low incomes, fear of crime, poor services and transient populations. The aim was to examine the prevalence of loneliness, and also its associations with different types of social contacts and forms of social support, and its links to self-reported health and wellbeing in the population group. The method involved a cross-sectional survey of 4,302 adults across 15 communities, with the data analysed using multinomial logistic regression controlling for sociodemographics, then for all other predictors within each domain of interest. Frequent feelings of loneliness were more common among those who: had contact with family monthly or less; had contact with neighbours weekly or less; rarely talked to people in the neighbourhood; and who had no available sources of practical or emotional support. Feelings of loneliness were most strongly associated with poor mental health, but were also associated with long-term problems of stress, anxiety and depression, and with low mental wellbeing, though to a lesser degree. The findings are consistent with a view that situational loneliness may be the product of residential structures and resources in deprived areas. The findings also show that neighbourly behaviours of different kinds are important for protecting against loneliness in deprived communities. Familiarity within the neighbourhood, as active acquaintance rather than merely recognition, is also important. The findings are indicative of several mechanisms that may link loneliness to health and wellbeing in our study group: loneliness itself as a stressor; lonely people not responding well to the many other stressors in deprived areas; and loneliness as the product of weak social buffering to protect against stressors

Food for life: Evaluation of the impact of the Hospital Food Programme in England using a case study approach

ObjectivesTo evaluate the impact and challenges of implementing a Food for Life approach within three pilot NHS sites in 2014/2015 in England. Food for Life is an initiative led by the Soil Association, a non-governmental organisation in the UK that aims to encourage a healthy, sustainable food culture across communities.DesignA case-study approach was undertaken using semi-structured interviews with staff and key stakeholders together with analysis of relevant documents such as meeting minutes, strategic plans and reports.SettingThree NHS Trusts in England.ParticipantsStaff and key stakeholders.Main outcome measuresSynthesis of key findings from semi-structured interviews and analysis of relevant documents.ResultsKey themes included the potential to influence contracting processes; measuring quality; food for staff and visitors; the role of food in hospitals, and longer term sustainability and impact. Participants reported that adopting the Food for Life approach had provided enormous scope to improve the quality of food in hospital settings and had provided levers and external benchmarks for use in contracting to help drive up standards of the food provided by external contractors for patients and staff. This was demonstrated by the achievement of an FFLCM for staff and visitor catering in all three organisations.ConclusionsParticipants all felt that the importance of food in hospitals is not always recognised. Engagement with Food for Life can produce a significant change in the focus on food within hospitals, and help to improve the quality of food and mealtime experience for staff, visitors and patients

Cognitive assistants

This work is supported by COMPETE: POCI-01-0145-FEDER-007043 and FCT - Fundação para a Ciência e Tecnología within the projects UID/CEC/00319/2013 and Post-Doc scholarship SFRH/BPD/102696/2014 (Angelo Costa) This work is partially supported by the MINECO/FEDER TIN 2015-65515-C4-1-R.Araujo, A.; Novais, P.; Julian Inglada, VJ.; Nalepa, GJ. (2018). Cognitive assistants. International Journal of Human-Computer Studies. 117:1-3. https://doi.org/10.1016/j.ijhcs.2018.05.008S1311

Developing a support group for carers of people living with dementia

There are significant numbers of people in the UK caring for someone living with dementia. Providing support to carers is both socially and economically important to enable them to continue in their caring role and improve their experiences. This article provides a dementia nurse specialist’s reflection upon running a 6-week educational support group for carers of people living with dementia. It describes the development of the group, challenges faced and discusses considerations for the future including a need to ensure sustainability through collaborative working. It highlights the positive outcomes described by carers who attended the course