Culture and activity in aging

The cumulative effects of illness and disability in older age can lead to individuals being less able to make positive decisions about involvement in activities for pleasure and socialization. This lowered self-efficacy can in turn lead to erosion of confidence and ultimately to social exclusion. Older tenants in sheltered housing schemes are at particular risk of isolation and exclusion as the move to age-specific housing is usually triggered by a sudden or gradual decline in ability and/or personal circumstances. In conjunction with this, assumptions that social networks naturally occur in communal retirement communities and that people will individually or collectively arrange activities can lead to peoples' aspirations for meaningful activities in later life being overlooked. This problem is further compounded as housing staff find their time is taken up building maintenance and ensuring that tenants receive basic housing and environmental services. This chapter reports on the findings from a needs analysis that aimed to identify the activities that older tenants in a sheltered housing scheme had enjoyed during their lifetime, were no longer able to do but wanted to resume, and any new interests they were interested in pursuing. This is followed by a description of a one-year activity and culture program developed out of this needs analysis, underpinned by previous work conducted in Sweden

Community care in Scotland

This ethnological perspective of Community Care in Scotland will focus on historical, political, and social contexts and their influences on the community care arrangements for individuals within various types of communities in Scotland today

Older People, Telematics and Care

About the book: What are the implications of current economic, social and political trends in Britain for older people? Social and demographic changes have led to traditional areas of welfare being transformed. The contributors to this book take a critical look at the current situation and assess the implications for future practice. They debate the assumptions and values underlying established welfare programmes and consider the case for change as growing demands put health and social services under increasing pressure. The second part of the book discusses specific areas in detail, ranging from the organisation of effective domiciliary social care to the impact of new technologies on older people's lives. This book provides a comprehensive and practical overview of the provision of services for older people and will be a valuable and thought-provoking resource for anyone involved in caring for and supporting them

Transforming dementia and end-of-life care by investing in learning and development

Improving care for people with dementia is now recognised as an international priority. However, this is a complex issue as the quality of dementia care is dependent on a wide range of care-providers including registered practitioners, support staff and informal carers. In this guest editorial we discuss how learning and development can play a vital role in transforming care and equipping staff with the knowledge, skills and confidence they need in order to provide high quality, person-centred and compassionate care

Sleep quality, sleep duration and sexual health among older people: findings from the English Longitudinal Study of Ageing

Context: How sleep quality and sexual health are associated among community-dwelling individuals remains largely unknown. Objective: We examined the association of sleep disturbance and sleep duration with a range of measures assessing sexual activities, functioning and concerns in a representative sample of older people. Methods: Participants were community-dwelling adults aged 50-90+ years from wave 6 (2012/2013) of the English Longitudinal Study of Ageing (ELSA) who reported any sexual activity in the last year. Sleep disturbance, sleep duration and sexual health were measured by self-report at wave 6. Retrospective reports of restless sleep (waves 1-6 [2002-2013]) were also examined. The association between sleep measures and sexual health was assessed using logistic regressions stratified by gender and adjusted for demographic, health and lifestyle factors with results expressed as odds ratios (OR) and 95% confidence intervals (CI). Results: Among both men and women disturbed sleep was associated with reported declines in sexual activity and function over the last year, and increased concern about their sexual desire, frequency of sexual activity and sexual functioning. Robust associations between high sleep disturbance and vaginal pain (OR=1.67, 95% CI=1.21, 2.31) and vaginal dryness (OR=1.69, 95% CI=1.24, 2.30) were also observed among women. Retrospective reports of restless sleep showed a dose-response relationship with reported declines in sexual health over the last year, and increased concerns about sexual expression and functioning. Conclusions: Self-reported sleep disturbance and retrospective restless sleep were mainly associated with subjective assessments of recent declines in sexual activity and functioning, and higher levels of sexual concerns

A hermeneutical study of professional accountability in nursing

Aims This paper presents findings from a hermeneutical study which sought to explore how registered nurses experienced and perceived their professional accountability in clinical settings. Background Professional accountability encompasses the ideals and standards of nursing practice. Nurses are accountable for their actions under civil, criminal and contract law to their; employing organisation, their regulatory body and the patients for whom they care. Design and methods This paper reports on a Heideggerian hermeneutical study involving seven registered nurses, working in clinical practice in the National Health Service in the United Kingdom. The study adopted purposive sampling, collecting data by means of in‐depth interviews. Data was analysed using the hermeneutic circle. COREQ checklist was used as a reporting guideline for this study. Results The findings suggest that professional accountability in nursing practice is a complex phenomenon, which can be compromised by many factors which are historically, socially or politically driven. Participants experienced challenges through a lack of resources and poor managerial support, which comprised their ability to deliver high quality patient care. However, collegiality strongly impacted upon resilience and positively influenced their wellbeing. Relevance to clinical practice Amid the challenges of the clinical workplace, a positive workplace culture with visible managerial support is a fundamental requirement in supporting professional accountability, development and retention of nurses. Findings highlight the view that leadership should be seen as a collective responsibility, which empowers staff to positively change the practice environment

The Education of Nurses Working in Care Homes for Older People: An Appreciative Inquiry

Aim To explore the education and developmental needs of care home nursing staff. Background With an increasing ageing population, the need for high quality care provision is set to rise and will require nursing staff with the desired knowledge, skills and values. However, multiple concerns have been identified when considering the development of nurses working in care homes. Moreover, challenges in the care home sector have also contributed to a situation where some nurses view care home work as being of low status, and choose this work to fit around other commitments, rather than viewing it as a viable career pathway. Method A qualitative approach based on the principles of Appreciative Inquiry. Fifteen participants working in five care homes with nursing, based in England (UK) took part in this study. Data were collected during 2016 – 2017 and involved managerial, qualified and unqualified staff. Results Data analysis revealed three distinct themes: an effective learning environment; the care home as a nursing student placement; the need for financial investment. These themes were found to have the most influence on the development and education of care home nursing staff. Conclusion This research provides important insights into the care home as an educational environment, not only for nursing students but for those employees already working in such settings. Exploration of the ways in which higher education organisations and care home teams could collaborate more closely could be mutually beneficial to the quality of care and to raising the profile of care home work. Implications for Practice Care homes can provide a rich learning environment for both staff and nursing students. Collaboration and appreciative ways of working enhance opportunities for developing practice and care

Assessing the Accuracy of an Algorithm for the Estimation of Spatial Gait Parameters Using Inertial Measurement Units: Application to Healthy Subject and Hemiparetic Stroke Survivor

We have reviewed and assessed the reliability of a dead reckon- ing and drift correction algorithm for the estimation of spatial gait parameters using Inertial Measurement Units (IMUs). In particular, we are interested in obtaining accurate stride lengths measurements in order to assess the effects of a wearable haptic cueing device designed to assist people with neurological health conditions during gait rehabilitation. To assess the accuracy of the stride lengths estimates, we compared the output of the algorithm with measurements obtained using a high-end marker-based motion capture system, here adopted as a gold standard. In addition, we introduce an alternative method for detecting initial impact events (i.e. the instants at which one foot contacts the ground, here used for de- limiting strides) using accelerometer data. Our method, based on a kinematic feature we named ‘jerkage’, has proved more robust than detecting peaks on raw accelerometer data. We argue that the resulting measurements of stride lengths are accurate enough to provide trend data needed to support worthwhile gait rehabilitation applications. This approach has potential to assist physiotherapists and patients without access to fully-equipped movement labs. More specifically, it has applications for collecting data to guide and assess gait rehabilitation both outdoors and at home