Introduction: Themed Section on the Costs of Long-Term Care for Older People

Cost has long been a preoccupation in policy documents concerned with the care and support of older people (Means and Smith, 1998; Royal Commission, 1999). A history of moral panic about the ageing population coupled with a stereotype of older people as a dependent and ‘unproductive’ sector of society have combined to produce negatively focused debate, lacking in evidential support. Most recently, Wanless (2006) has highlighted the limitations of the evidence base and the narrowness of debate concerning the provision of social care services, arguing both for more informed debate and for consideration of the impact of developments in services and alternative funding models

Research on the Costs of Long-Term Care for Older People -- Current and Emerging Issues

This review explores debates concerning the costs of long-term care for older people, and aims to give an overview of the recent and current research agenda in this area, referring primarily to work published 2000–2006. The focus of much work is on the identification of costs, their distribution and the contexts of policy and delivery of services in which these operate. Live debates concern future costs, their control and related issues of social justice and equity

Designing Environments for People with Dementia

The ebook edition of this title is Open Access and is freely available to read online. This review systematically explores and assesses the quality of the evidence base for effective and supportive design of living environments for people living with Dementia. Dementia is a major challenge for all countries, as the population with the condition is growing rapidly. Societies desperately need to identify measures which mean that they can continue to thrive with a large population of people who are cognitively impaired. Medical treatments are poor, and there is little indication of better medications appearing in the coming decades. There is urgent need for non-medical advances which can address the challenge including ensuring environments are conducive to living better with Dementia. Whilst there is a lot of activity in this area of Dementia friendly design, the evidence base remains poorly synthesized and weak. This book pulls evidence together to provide a solid reference point from which further research and further developments in the field of Dementia care and support can proceed

RemoDem: Delivering support for people with dementia in remote areas

RemoDem aimed to develop, test and evaluate services for people with dementia in remote areas of the Faroe Islands, Greenland, Sweden and Scotland. Formative and summative evaluation used a flexible research design including collection of baseline data, interviews and focus groups with key informants and data relating to service users, i.e. people with dementia and their carers. Challenges for service providers included organisational difficulties, lack of clear information about their populations with dementia and lack of knowledge in local communities. Test sites which developed services building on their particular local starting points adopted both specialist and ‘off the shelf’ technologies and found that these were generally helpful for people with significant support needs. The flexible research design was found to be essential in the real world conditions of the service development and evaluation. Services were more successful where more mature and less experimental technologies were used. The new services promised to address effectively challenges of remoteness including distance, communication and workforce deployment issues

Time for care: exploring time use by carers of older people

First paragraph: The contribution of carers, as 'people who provide support, in the context of familial or other prior affective relationships, to a person with long-term care needs, experiencing frailty in old age or with serious illness or disability' (Yeandle et al 2017:10), to the support and care of older people is recognised world wide, and researchers internationally are attempting to develop better understanding of its quantity and quality. This paper focuses on the temporal dimensions of what carers do. We take a critical perspective both on time and temporality, and on prevalent assumptions about care that are reproduced in research literature. We argue that the focus on time can be used to generate novel possibilities for research that learns from carers' experiences. As Milne and Larkin (2015) suggest is necessary, we draw on two traditions in care research: 'gathering and evaluation', which considers the quantity and nature of caring and evaluates policy and practice; and 'conceptualising and theorising' which is concerned with caring in its context, questions prevalent assumptions and critically examines established ideas

Free Personal Care for Older People in Scotland: Issues and Implications

Drawing on recent quantitative and qualitative research, we consider lessons of the Scottish policy of free personal care for older people. The policy is embedded in political debates about devolution and interacts with various changing policies on care and support for older people. Evaluation is complicated by these interactions and by gaps in relevant data, especially concerning costs. Operationally, policy implementation has presented varying difficulties for local authorities. For clients and informal carers it remains popular, but is part of a service-led model of provision which does not reflect their own views of their care and support needs

That's what I am, I'm an England player: exploring the gendered, national and sporting identities of England's elite sportswomen

According to Robinson (2008), England exists more in imagination than it does anywhere else, except on the sports field. However, Englishness remains relatively unexplored in discussions of sporting nationalism. For so long, academics have focused on the ways in which male sport plays a key role in (re)producing national identities, with the contribution of women to the relationship between sport and national identity formation undeniably ignored. Based on interviews with 19 elite sportswomen from England s netball, football, rugby and cricket teams, this thesis examines the relationship between gendered, national and sporting identities, giving a voice to England s heroines of sport . These sports were chosen as the women had only represented England, rather than Great Britain, in international sport. Few research studies have adopted this approach of speaking to athletes about their national identities, although significantly, those that have were not concerned with women (see Tuck, 1999; Tuck and Maguire, 1999; McGee and Bairner 2011). The challenge was not only to integrate personal experiences into discussions of sport and national identity, but also to try to incorporate gender into these very discussions. The question here is whether women s sport has a place in the national imagination, and how do those very women who embody their nation on the field of play articulate their experiences. Central to this research is an understanding of the ways in which we perform aspects of our identity. Building on work by Butler (1990) and Edensor (2002), we can understand how international sport provides a site where multiple identities are performed. Findings suggest that performances of femininities are contextual, and that elite sport is an arena where displays of heteronormative femininity are inappropriate. In addition, sport serves to clarify imaginings of Englishness, where previously it may have been confused or conflated with conceptions of Britishness. What was clear throughout the research, however, was the performative nature of the participants identities, as well as the way in which their identities can be conceptualised as multiple and fluid, subject to change depending upon context and circumstance

Literature review: the cost effectiveness of assistive technology in supporting people with dementia

Despite much emphasis on the potential of assistive technologies of many varieties to deliver cost effective ways of supporting people with dementia, and clear indications of this potential, rigorous cost-effectiveness studies of these technologies for this group remain largely absent. The review includes consideration of the indicative evidence. This report describes the process and results of the literature review. Extensive searches identified a large literature, of which 59 items were systematically reviewed and quality assessed.We are indebted to the Dementia Services Development Trust who funded the study as part of the work of the Dementia Services Development Centre in Northern Ireland. This work is supported by the Atlantic Philanthropies and the Northern Ireland DHSSPH

Networks of Informal Caring: a Mixed-Methods Approach

Care for older people is a complex phenomenon, and is an area of pressing policy concern. Bringing together literature on care from social gerontology and economics, we report the findings of a mixed-methods project exploring networks of informal caring. Using quantitative data from the British Household Panel Survey (official survey of British households), together with qualitative interviews with older people and informal carers, we describe differences in formal care networks, and the factors and decision-making processes that have contributed to the formation of the networks. A network approach to care permits both quantitative and qualitative study, and the approach can be used to explore many important questions