Emotional robots: principles and practice with PARO in Denmark, Germany and the UK

As societies age there will be a significant increase of those over 80 and a predicted increase in people with dementia. We know that loneliness increases with old age, and those living with dementia are at risk of social isolation. Also opportunities for sensory stimulation and engagement in pleasurable activities are reduced in old age. The question is what technologies can be used to extend the range of available interventions that can enhance well-being. Emotional robots have been developed for activity and therapeutic purposes. This article explores experiences of the emotional robot PARO in Denmark, Germany and UK, and provides principles of this robot as an activity or activity with a therapeutic purpose

‘I feel like a salesperson’: the effect of multiple-source care funding on the experiences and views of nursing home nurses in England

The difficulties faced in the recruitment and retention of nursing staff in nursing homes for older people are an international challenge. It is therefore essential that the causes of nurses' reluctance to work in these settings are determined. This paper considers the influence that multiple-source care funding issues have on nursing home nurses' experiences and views regarding the practice and appeal of the role. The methodology for this study was hermeneutic phenomenology. Thirteen nurses from seven nursing homes in the North East of England were interviewed in a sequence of up to five interviews and data were analysed using a literary analysis method. Findings indicate that participants are uncomfortable with the business aspects that funding issues bring to their role. The primary difficulties faced are: tensions between care issues and funding issues; challenges associated with 'selling beds'; and coping with self-funding residents' changing expectations of care. The findings of the study suggest that multiple-source care funding systems that operate in nursing homes for older people pose challenges to nursing home nurses. Some of these challenges may impact on their recruitment and retention

Life as a care home resident in later years : "living with care" or "existing in care"

Despite a widely accepted view of the importance of understanding experience from the point of view of the individual using services in modern western society, there are relatively few studies that have explored day-to-day living in a care home from the older person's perspective. This study aimed to present the voice of the untold stories of care home residents through an interpretative study that was informed by a biographical approach and narrative method. Eight older people who lived in four different care homes in England participated in a sequence of up to eight narrative interviews over a six month period. Through the process of listening to, retelling and interpreting the residents' stories the resident world was explored. There were three stages to the interpretative process that focused on:- developing a naïve or surface understanding to acquire a sense of the whole sequence of a participant's interviews; a structural analysis that examined the interviews to investigate what the text said and how it was said; and a critical in-depth examination of the interpretation within the wider social context. The interpretation revealed the unique way that each participant lived in a care home. These older people worked hard to reconstruct their life following the move to a care home and as they lived there. Though the residents were limited by physical, functional and cognitive problems, they developed strategies with the aim of influencing the life that they lived within a care home. Where they were able to implement those strategies they reconstructed their life in ways whereby they 'lived with care.' In this sense they were active biographical agents shaping this phase of their life. This is an alternative biography, to that of older people 'existing in care' as an outcome of care received. This thesis provides new insights into the residents' world. The overriding conclusion that can be drawn from these stories is that these older people were trying to live as active biographical agents who were instrumental in shaping their own life. They were able to do this to a greater or lesser extent and the conceptual model of biographical living that has been developed from the resident stories provides a framework to depict the complex interactions that shape an individual's experience in this environment. An inherent feature of this model is recognition that residents can be active agents throughout their lives in care homes. In summary, residents' desire to 'live with care' and this is not only possible, it is achievable

Hydration practices for high-quality dementia care

Drinking an adequate amount of fluid is essential to life. It is therefore self-evident that supporting those who are unable to meet this daily requirement without support is an important component of car. It was illustrated to one of the authors, during her mother’s recent emergency respite admission to a residential care home, that care staff recognised that some individuals need increased support with hydration. It was so reassuring for the family to observe that following an initial assessment by a senior carer that this individual was set a daily fluid target. The target was calculated against evidence based guidelines. Throughout her stay in this care home hydration was flagged as a significant aspect of her care. Also, drinking an adequate amount of fluid was discussed with her, and all her visitors. Having the opportunity to be involved in her care, whilst in the care home, was really welcomed by the whole family. The decision to agree to the respite care admission had been very difficult and supporting her to drink adequate fluids was something that the family could all contribute to. She had access to water and other types of drinks throughout the day. Whilst she really enjoyed the nutritious smoothies and iced fruit juices that she was offered, we were also able to offer advice on her preferred drinks. The staff were not aware that a member of the family was a consultant nurse with a particular interest in hydration for vulnerable older people. The practices that she observed when visiting her mother highlighted the in-depth knowledge of this staff group regarding fluid requirements of older people; their flexibility in responding to many difficult and challenging situations when residents refuse to drink or cannot drink. They were compassionate in their responses to residents and worked with family and visitors to identify innovative ways to encourage residents to do a very natural activity – drinking. In contrast to the experience of this women and her family, there are many situations where people with dementia do not drink adequate amounts of fluid. As a consequence residents can be sub optimally hydrated and are at high risk of dehydration. The following discussion explores some of the difficulties that people with dementia can experience, and different ways that care staff can support residents to drink

Making a move: care-home residents' experiences of relocation

This paper is based on data from older people concerning their experiences of relocating to a care home. It provides a framework to promote re-thinking of ways that older people are and can be involved in decision-making when making the move to a care home

A literature review to explore integrated care for older people

PURPOSE: This paper reports on some of the findings of a literature review commissioned to explore integrated care for older people. METHODS: The process of revising included finding and selecting literature from multidisciplinary sources, and encompassed both published papers and ‘grey’ literature, i.e. material which had not been reviewed for publication. RESULTS: The study found that thinking has moved on from a focus on the problems of accessing services to exploring ways in which they may function in an integrated way. CONCLUSIONS: The study shows how thinking on integrated care for older people has developed, and knowledge of micro, mezzo and macro strategies is now more available

Perspectives on credit scoring and fair mortgage lending: article two

Credit scoring systems ; Mortgages

Older people’s views and experiences of engagement in standardised patient simulation

Background - The last two decades have witnessed initiatives aimed at improving the care of older people, including educating nurses so that they are equipped with the skills to care for older people with frailty and complex multimorbidities. It has been suggested that involvement of older service-users in nurse education can facilitate the development of nurses’ caring skills by promoting understanding of the reality of older people’s situations. One method of involving older service-users is standardised patient simulation. While some recent studies have acknowledged the importance of considering standardised patients’ experiences and perceptions of simulation, to-date few have focused specifically on the experiences of older people. Methods - In this qualitative study, data was collected via focus groups whereby older people were invited to discuss their views and experiences of involvement in SPS. Data were analysed using open coding. Findings - Four themes emerged from the data, demonstrating that involving older people in SPS may be beneficial for their wellbeing. The four themes were: ‘using personal experiences to improve care’, ‘having a sense of purpose’, ‘preparation and support for SPS’, and ‘feeling appreciated’. Discussion - Whilst most participants reported that they enjoyed the SPS activities, engagement appeared to have had a much deeper significance for them. Many participants’ responses suggested that involvement assisted them to ‘make sense’ of their experiences of illness and healthcare, and also gave a sense of purpose, of belonging and of being valued. Conclusion - Findings support the need for nurse educators to consider developing SPS programmes that involve older people