Managing care environments: reflections from research and practice

This chapter considers the role of senior staff in managing the use of space and the physical environment within care settings. These day and residential settings come under the broad umbrella of social work and social care but the care may also be organized from within health. This is a subject that does not appear on the curriculum of many management courses in the UK, but arguably it is critical in relation to social work and social care where managers are involved with residential homes, day centres and other provision where the physical environment can enhance or be detrimental towards service users' wellbeing. In such settings many activities go on under one roof, particularly in group care or when the care is provided in a person's own home. The care environment is complex and can be bounded within space, place, time and behaviour. Activities and time available compete or have different meanings for the participants. Managers have different kinds of relationships with workers and with service users. The environment in which care takes place often frames these

Managing environments

Although a context might be solid - like a building - it has different meanings for the people who use it. The impact of the physical space is the focus for 'Managing environments'. Peace and Reynolds note that any one environment may be multifunctional. Taking an innovative approach to management, they argue that a residential care home, for example, may be simultaneously a place for living for residents, working for staff and managers and visiting for relatives and other professionals. The atmosphere in a care home makes a critical difference to the experience of service users who live there. The authors review how the environmental factors that influence care may be managed and how the careful design and us of space can contribute to improved quality of life in the management of care. Peace and Reynolds also consider relationships between people, places and quality, recognising the impact of the manager on caring environments. A focus on practice here emphasises the role of the manager in drawing out debates over values and best practice to help care workers feel supported and confident about the care they provide

Reflections on Cross-Cultural Comparison of the Impact of Housing Modification/Adaptation* for Supporting Older People at Home: A Discussion

Home modification or adaptation is an important global issue, especially for older people living with disabilities in ordinary housing of varying ages, and pre-dating concerns about accessibility in design. Comparisons of research from five developed nations identify common themes: variation in integrated service development; public and private financial investment; deferred health costs; workforce expansion and training; and the value of the user perspective. Further discussion identifies the importance of retrofitting alongside new build, and argues for sustainable housing that recognizes population aging but also issues of climate change and the need for more inclusive design of housing for all ages

Homely residential care: a contradiction in terms?

Accommodation and care for older people is commonly thought of in relation to residential care homes: the collective settings with communal lounges and dining rooms, where older people may live what seems to be a fine balance between individual and group routines. Yet, while there have been changes to the living arrangements of people in relatively large collective groups, the ideal put forward as a basis for care settings has remained that of 'home', with the family model still central. With the tensions between public and private, domestic and institutional living, regulated and non-regulated settings, all too obvious, this article uses a pilot study in Bedfordshire, Buckinghamshire and Hertfordshire of registered small homes with less than four residential places, often run by the proprietor and her family, to consider whether residential homes may replicate a homely environment, or whether the model has run its course

Stepfamilies and older people: evaluating the implications of family change for an ageing population

The changing nature of family life has become a major issue in contemporary Britain. Concerns that change will bring moral decline and social fragmentation are countered by a more optimistic view which focuses on a future of more equitable and flexible family ties. Research drawing on area-based data in Luton amongst older, middle-aged and younger people with experience of family change suggests that so far as inter-generational relations, caring, and transfers of family wealth are concerned, traditional attitudes towards blood ties, household independence and care and support survive alongside new step relationships. The research also suggests that although several respondents had more than one generation of experience of family change, the language of step relationships is still one which is not yet completely accepted, or one with which people feel completely at ease

Older people's experiences of their kitchens: 2000 to 2010

Purpose – This paper aims to present the quantitative results based on a comparison and evaluation of older people's experiences, needs and wants from their current kitchens, combining and comparing the results obtained from two studies conducted in 2000 and 2010 to see what progress has been made. Design/methodology/approach – A study in 2010 investigated the life-long and contemporary experiences of kitchens of 48 people aged over 60 years of age. The research included detailed questionnaire interviews asking people about their experiences of living in their current kitchen. A previous study, conducted in 2000, asked many of the same questions of 22 people in the same age group. Findings – By combining and comparing the two sets of data it seems that only limited progress has been made in terms of kitchen design meeting the needs of older people between 2000 and 2010. Research limitations/implications – Owing to the small sizes of the samples it is not possible to compare the figures statistically or present them as fully representative of the British older population but while the two samples are limited both had similar characteristics of age and gender, so differences do show potential trends over time. Practical implications – The research refers to guidance and a computer based design tool and identifies a number of practical implications for design. Social implications – As people age their abilities and needs can change and their kitchen may no longer be as accessible or appropriate to their needs. Originality/value – This paper adds to the relevant guidance for designers, developers and managers of buildings where the continued personal use of a kitchen is important for continuing independence of older people

A Better Life - What Older People With High Support Needs Value

Finding the best way to develop and fund support for the increasing numbers of older people in society is a political priority. Understanding, measuring, improving and monitoring their overall quality of life (not just the quality of their care) will be the main challenge. This study presents the views of older people with high physical and mental support needs who have described what they want and value in their lives, and proposes a model to assist policy-making, research and practice

Cross-Cultural Comparison of the Impact of Housing Modification/Adaptation for Supporting Older People at Home: An Introduction

Foreword to Special Issue of Journal of Aging and Environment The desire of older people to age in place and government policies intended to support people living in their own homes suggests that future-proofing this environment is fundamental to improving person-environment congruence at a time of global aging. The UK-initiated genHOME network, founded by the Royal College of Occupational Therapists, promoted the health and well-being of older and disabled people and their families through the co-ordination and dissemination of international research on home modification or adaptation and housing design. In 2017, researchers attached to the network from five developed countries with diverse housing types, tenure, space standards, regulations and funding opportunities took part in a symposium at the IAGG World Congress, debating empirical research and common priorities. The symposium was chaired by the editors of this Special Edition of the Journal of Aging and Environment. Aiming to inform national and international policy there is recognition of diversity in the evidence presented, and a need for consistent methodology and outcome measures (see Adams & Hodges, 2018). The introduction and discussion address the priorities raised, including: housing design and environmental barriers, financing adaptations (public and private), user satisfaction with adaptations, concern over housing assets, developing robust assessment tools, and the future of inclusive design. Finally, consideration is given to whether current understanding of culturally specific home adaptations can lead to wider discussion of more inclusive design and architectural practice for new build housing, and how this relates to population growth in times of climate change

Kitchen Living in Later Life: <i>Exploring Ergonomic Problems, Coping Strategies and Design Solutions</i>

The kitchen is an important area in the home serving many purposes both functional and social. It is central to enabling people to stay within their own homes in their later life. As part of a detailed study of ‘past’ and ‘present’ kitchen living, semi-structured interviews were conducted with 48 older people about their current kitchen and how well it met their needs. It was found that personal problems with reaching, bending, dexterity and sight were more likely to be experienced with increasing age while for specific tasks, ironing and cleaning created the most difficulty. The paper reports on coping strategies and simple innovations made by the participants to address the problems they experienced. A challenge for kitchen designers, manufacturers and installers is to think in terms of kitchens that are more flexible and adaptable to people’s changing needs