bluuebunny/crossref_metadata_2025 huggingface dataset:
The state retirement age: Common misconceptions about retirement and the state pension
Authors: Zeilig Hannah , Tinker Anthea , Salvage Ann
Published: September 2011

The Age Partnership Group (APG) and the Department for Work and Pensions (DWP) recently commissioned a number of studies under the general heading: ‘Extending Working Life’, as part of a national guidance campaign. The campaign aims to raise employers' awareness of flexible employment and retirement opportunities prior to the implementation of age legislation towards the end of 2006. In general this legislation will ensure that employers will no longer be able to recruit, train, promote or retire people on the basis of their age. As part of the DWP framework, the Institute of Gerontology at King's College London was asked to examine recurrent misconceptions about pension ages and retirement ages. These take the form of misunderstandings, confusions, and in some instances even fictions that are perpetrated via the media and sometimes by those organisations that hope to clarify matters around pensions. This work was aimed at a professional audience. Therefore the focus of this article is predominantly on practical rather than theoretical issues. However, the policy and practice implications that arise, when the most basic topics associated with pensions and retirement are not properly understood, are profound. These can affect people on the verge of pension age, as well as those who are attempting to plan for retirement and also their employers. Without a clear understanding of the facts about entitlement to a state pension, for instance, individuals and their employers may not pursue the opportunities open to them. In this article, the most salient of these misconceptions are examined and redressed. This was undertaken through an extensive literature review, which examined not only a wide range of media reports (from the press, internet and radio) but also encompassed government documents and academic papers. The Pensions Policy Institute (PPI) in particular gave guidance and advice.
Information about the information: Navigating services and supports for older people
Authors: Ballantyne Alison , Cheek Julianne , Gillham David , Quan James
Published: September 2011

Having an ageing population is an issue facing many countries, particularly western nations. With governments and service providers focusing on healthy ageing and ageing in place, notions of choice and active participation for older people in selecting services appropriate to remaining in the community are also emphasised. Central to this is the issue of information navigation: knowing what services are available and how to get that information, for older people and those who support them. Based on a series of qualitative studies of service provision and using perspectives from older people, their families and those who provide services for them, this paper argues that greater attention needs to be paid to the process of information navigation as opposed to providing ever more information content.
Retirement resources
Authors: Rowlingson Karen , McKay Stephen
Published: September 2011

There is currently a major debate about the future of pension provision in Britain. Much of that debate concerns levels and sources of income. But there is also growing interest in the role that assets and bequests might play in raising people's living standards in later life. Based on a major new survey of attitudes to inheritance and assets, this article argues that assets will not fill the pensions gap for those on the lowest incomes as these groups are least likely to have assets and among those that do, there is more support for the concept of preserving assets for inheritance than among more affluent groups. Bequests will also fail to help those most in need of a windfall as receipt of inheritances currently benefits the most affluent groups. However, among those with assets, there does seem to be more interest in liquidating assets, including housing assets, than previous research has suggested. Some people, therefore, are prepared to liquidate their assets in later life to supplement their income.
An exploration of the relationship between place of residence, balance of occupation and self‐concept in older adults as reflected in life narratives
Authors: Hearle Deb , Prince Jane , Rees Valerie
Published: September 2011

In 2002 there were 19.8 million people in the United Kingdom over the age of 50 and it is estimated that by 2031 there will be close to 27 million (UK National Statistics Office, 2005). Predictions about the older population changes in the next twenty years indicate that although overall growth will be low, the numbers of ‘young old’ (65‐74) and ‘middle old’ (75‐84) remaining stable until 2011, the ‘old old’ (85+) will show a substantial increase (Grundy, 2004).Bowling et al (2002) stressed the importance of maintaining independence and control over one's life with ageing. This, together with having social roles and participating in social and voluntary activities/hobbies to include those performed alone, contributes to the foundation of good quality of life in old age. New European policies for older adults focus on the provision of equal opportunities, health promotion and stress their involvement in decision‐making (Fletcher, 2000). The increase in the ageing population is evident in the corresponding rise in the growth of nursing and residential homes, sheltered accommodation and home care support and it is anticipated that greater provision will be needed (Wittenberg et al, 1998), particularly if the aspirations of European policy are to be realised. However, some studies (eg, Sheppard, 2003) have documented the paucity of rehabilitation in residential and nursing homes and highlighted the disempowerment experienced by residents. The process of transition in the later stages of the life span from full independence in a familiar home environment to one of total care while providing security may engender feelings of helplessness with a decrease in psychological well‐being.This article outlines and discusses the findings of a study using narratives with older adults, undertaken to explore such effects of life changes, including transition, on their self‐concept.
EQUAL: New horizons for ageing research
Authors: Lansley Peter
Published: September 2011

The Engineering and Physical Sciences Research Council (EPSRC) extending quality life (EQUAL) initiative, specifically supports interdisciplinary user‐focused design, engineering and technology research concerned with enhancing the independence and quality of life of older and disabled people.As well as establishing a new UK community of researchers and a new scientific approach to ageing research the initiative has successfully contributed across a broad front to policy and practice. In a short time it has provided a much‐improved understanding of the potential contribution of new approaches to design, engineering and technology to enhancing the lives of older people and has engendered confidence in the potential of this type of ageing research.
Does technology have a role to play in assisting stroke therapy?: A review of practical issues for practitioners
Authors: Islam Nargis , Harris Nigel , Eccleston Christopher
Published: September 2011

Assistive technology is a term used to describe any device ranging from simple equipment to complex technologies that can assist a person with a disability. The term is now applied to new technological devices to facilitate active rehabilitation as well as to equipment to enable a person to live with their condition. Current developments such as technology for stroke rehabilitation are rarely brought to the attention of health and social care practitioners, even though frontline staff will be at the forefront of implementation, and their views of the nature of devices and their appropriateness is pivotal. This paper describes some of the technologies being developed to assist the process and delivery of stroke rehabilitation, their potential benefits in practice and stakeholder perceptions of these new technologies.
The symbolic value of tai chi for older people
Authors: Scourfield Peter
Published: September 2011

This article is based on a small‐scale study into a tai chi class for older people at risk of falling. The aims of the research were first, to explore what benefits the class members felt they derived from practising tai chi and second, and more specifically, whether or not the class members actually practised tai chi at home. The study was based on two broad assumptions. The first being that the practice of tai chi has benefits for older people at risk of falling. The second assumption being that, such benefits that might result from tai chi, increase with more frequent practice. The latter assumption prompted the desire to investigate whether the class members practised tai chi at home. It was hoped that if it was discovered that class members derived benefits from tai chi, and were, for whatever reason, prevented from practising at home, that some solutions could be found in order to facilitate further practice.The research revealed, somewhat surprisingly, that the members did not believe that tai chi had necessarily reduced their risk of falling. However, notwithstanding this, their commitment to tai chi was very strong. The findings suggest that tai chi had a symbolic value for this predominantly middle‐class group. It allowed them to ‘buy into’ a third age lifestyle, despite increasing intimations of entering the fourth age. The members used tai chi, not only to improve balance and fitness, but also as a means of achieving a positive self‐image. It was therefore an age‐resisting strategy that operated on both a physical and symbolic level.
Improving the provision of information about assistive technology for older people
Authors: McCreadie Claudine , Wright Fay , Tinker Anthea
Published: September 2011

The importance of assistive technology (AT) in helping older people maintain independence is increasingly recognised in policy. The article reports on a modest piece of research, funded by the Helen Hamlyn Foundation, that looked at an important corollary of this development — the provision of relevant and appropriate information about AT. The research involved mapping both AT and information sources, focus groups with 28 users aged 75 and over and 12 carers, interviews with 40 professionals and information providers and a postal questionnaire to 131 care home managers (response rate of 45%). The findings point to the large volume of available information, but suggest that there are problems in identifying needs and in accessing all necessary information. Professionals share these problems and organisational issues impact on professional capacity to provide satisfactory information. The situation in care homes appears ambiguous in terms of responsibility for AT provision for residents and hence for information. The researchers concluded that there is considerable scope for improving both access to information and the design of that information. They also concluded that there are terminology issues that need addressing in further research.
Why are older women in the UK poor?
Authors: Price Debora
Published: September 2011

Income in later life is an important factor in ensuring good health, quality of life, social engagement and subjective well‐being, yet it is now well known that women in later life are much poorer than men. In this article, data from the General Household Surveys 2001 and 2002 is used to show that this is largely the result of women's individual, and hidden, poverty within marriage. Dependency on men for income during the working life combines with the structure of the UK system to leave married men and married women with very unequal incomes after retirement. The median income of married and cohabiting women was only £53 per week, compared with men's £172; only 27% of married women had any private pension provision at all, compared with 75% of married men. Even among this 27% of women, half receive less than £35 a week from their pensions. Apart from the implications of this for potentially unequal access to money when cohabiting, the vast majority of women live alone for at least part of their retirement. When women become divorcees or widows, they cannot make up for lost income from their partners. Widows are thus relatively poor when compared with older women who have never married, but divorced women are on average the poorest of all. Social policies improving basic pension provision to all women in later life are urgently needed.
Transitions in care homes: towards relationship‐centred care using the ‘Senses Framework’
Authors: Nolan Mike , Davies Sue , Brown Jayne
Published: September 2011

Long‐term care in general, and care homes in particular, have never enjoyed high status as a place to live and work. This remains the case. In large part this marginalised position is due to the continued failure to value the contribution that care homes make to supporting frail and vulnerable older people. In order to promote a more positive vision of what can be achieved in care homes, this paper argues for the adoption of a relationship‐centred approach to care. The need for such a model is described, and how it might be applied using the ‘Senses Framework’ is considered. It is argued that adopting such a philosophy will provide a clearer sense of therapeutic direction for staff working in care homes, as well as more explicitly recognising the contribution that residents and relatives can make to creating an ‘enriched environment’ of care.
Moving from victim blaming to an appreciative inquiry: Exploring quality of life in care homes
Authors: Meyer Julienne , Heath Hazel , Holman Cheryl , Owen Tom
Published: September 2011

This paper highlights the need for researchers to work across disciplinary boundaries in order to capture the complexity that care practitioners have to engage with everyday in care home settings. Drawing on findings from a literature review on the complexity of loss in continuing care institutions for older people, the case is made for less victim blaming and more appreciative approaches to research. The way this thinking informed the development of a further literature review on quality of life in care homes (My Home Life) is discussed. Findings from this second study are shared by illustrating key messages with quotes from older residents, relatives and staff living, visiting and working in care homes. These best practice messages focus on: transition into a care home; working to help residents maintain their identity; creating community within care homes; shared decision‐making; health and health services; end‐of‐life care; keeping the workforce fit for purpose, and promoting positive culture. The importance of collaborative working in both research and practice is discussed. The paper is likely to be of interest to all those concerned with improving and developing evidence‐based practice in the care home sector, including users and service providers, managers, commissioners and inspectors, policy‐makers, researchers and teachers.
Mind your step! A falls prevention programme designed to reduce falls in those over 75 years
Authors: Conn Lorna
Published: September 2011

Falls among older people cause significant mortality and morbidity, thus presenting a serious issue for older people and health and social care professionals alike. The simple occurrence of a fall conceals the range of physical, psychological, social and environmental factors, which can contribute to this event. Research advocates that professionals should engage with health promotion and develop individualised preventions in order to minimise risk of falling. In this study, a multi‐disciplinary, falls prevention initiative was developed with older people who had recently fallen. The initiative started with a common assessment but was followed by a variable, individualised programme of different interventions. The older people involved were assessed pre‐ and post‐intervention, using a questionnaire checklist, on several different dimensions associated with falling. Outcomes were assessed in terms of reduction in risk and the incidence of falls, both of which were found to be statistically significant in several of the identified dimensions post‐intervention. Consequently, it could be estimated that approximately 44 falls were prevented through this nine‐month initiative. This study would support the integration of this falls prevention initiative into routine community care practice through the existing over‐75 health check and the development of a specialised falls team. Further research would be beneficial to follow up whether the reduction in the incidence of falling is sustained over time. Enhanced participation of user, carer, voluntary and community partners is recommended as this would allow older people themselves to play an active role in improving their own well‐being and that of others.
Respect for the person with dementia: fostering greater user involvement in service planning
Authors: Lorentzon Maria , Bryan Karen
Published: September 2011

Respect for people with dementia and their involvement in service planning is explored, based on selected research publications and policy papers, mainly from the Department of Health and the Alzheimer's Society. This article supports the inclusion of people with dementia care in service planning as part of person‐centred care. Necessary adjustments to research methods and ethics committee procedures for gaining informed consent are discussed, as is the importance of ethical policy formation and implementation, in order to achieve person‐centred care. This will ensure a high degree of active involvement by people with dementia, enhancing self‐respect and responding to the needs of this often marginalised population.
‘The hard thing is the changes’: The importance of continuity for older men caring for their wives
Authors: Sandberg Jonas , Eriksson Henrik
Published: September 2011

Few studies have been conducted into the contextual and relational aspects of male caregiving that include analysis by gender and family relationships. The aim was to gain understanding of the experience of older men as caregivers for an ill spouse. A narrative approach was adopted for this study. Interviews were conducted with three older men between 65 and 78 years, who had been caring for their wives for between one and 12 years. Two main categories emerged: taking on a new and unfamiliar role, and learning to live with the new role. The results also show how the men seek to maintain continuity in their relationships with the wives they are caring for. The findings can be understood in the light of a major life transition of how older men providing care for a spouse create new roles and how they cope with the changes in the marital relationship. A sense of continuity in the process of caring is important for men to help them find the strength to continue as caregivers.
‘You can get in alright but you can't get out’: Social exclusion and men with dementia in nursing homes: insights from a single case study
Authors: Bartlett Ruth
Published: September 2011

The social exclusion of people with dementia is a problem. Older men with dementia in nursing homes are at considerable risk of social exclusion due to factors associated with age, gender, mental health status and this setting. It is not known whether older men in this situation experience it as social exclusion or not. Drawing on a detailed case study from a male participant involved in a larger study on social exclusion, this paper highlights and explores masculine experiences of, and responses to, nursing home life. In this single case study it was found that social exclusion was experienced in an economic, spatial and emotional sense, and the participant aligned himself with other men in the home and masculine behaviours, perhaps to deal with that. Implications for care home practice and research are discussed. The paper concludes that more attention needs to be paid to the influence of gender and, in particular, to the different needs and experiences of older men with dementia in receipt of care generally.
Social networks, befriending and support for family carers of people with dementia
Authors: Charlesworth Georgina , Tzimoula Xanthippe , Higgs Paul , Poland Fiona
Published: September 2011

Social networks are seen to influence the use of health and social care services. In a secondary analysis of data from a longitudinal study of befriending of carers of people with dementia, we studied the relationship between network type and support from family/ friends, voluntary sector befriending and residential/nursing care. Using Wenger's typology of social networks, findings suggest that the pattern of support use varies by differences in the structure of networks. It is recommended that questions on social networks should be widely incorporated into carers' assessments to help identify need for social support interventions and to enable the sensitive selection of appropriate types of carer support to be provided.
Education and the quality of life in later years
Authors: Jamieson Anne
Published: September 2011

This article explores the benefits to older people of participation in formal study, and considers these in the context of the general debate about the constituents of quality of life. It is based on a study of older students who attended extra‐mural type classes at a London University college. The findings of a postal questionnaire survey are presented as context for a discussion of in‐depth interviews with a selection of participants. Illustrative case studies are presented, highlighting the discourses related to the benefits of study and their meanings in the different lives of the individuals. The second part of the analysis links these findings to issues related to the measuring of quality of life. It is argued that while the emotionally based concerns of individuals often figure most highly in their definition of quality of life, their need to spend time meaningfully is an additional, important dimension. Thus, formal study ‐ through the process itself as well as its outcomes ‐ plays an important role in contributing to the quality of life of older learners, giving them a feeling of ‘time well spent’.
Baby boomers and adult ageing: issues for social and public policy
Authors: Biggs Simon , Phillipson Chris , Leach Rebecca , Money Annemarie
Published: September 2011

This paper provides a critical assessment of academic and policy approaches to population ageing with an emphasis on the baby boomer cohort and constructions of late‐life identity. It is suggested that policy towards an ageing population has shifted in focus, away from particular social hazards and towards an attempt to re‐engineer the meaning of legitimate ageing and social participation in later life. Three themes are identified: constructing the baby boomers as a force for social change, a downward drift of the age associated with ‘older people’ and a shift away from defining ageing identities through consumption, back towards work and production. The paper concludes with a discussion of the implications for future social and public policy.
Improving quality and value in healthcare for frail older people
Authors: George James , Sturgess Ian , Purewal Sarbjit , Baxter Helen
Published: September 2011

This article reports an important multi‐centre practice‐based review that identifies good practice and an ideal pathway for the healthcare of frail older people, which, if replicated nationally, could result in improved quality of care and better value for money for the NHS. Data on healthcare resource groups (HRGs) in England were examined as a marker for the management of elderly people through the healthcare system. Care pathways in several different NHS trusts were explored via staff interviews. A high variation in treatment outcomes across centres was found. Principles of best practice were identified and include: comprehensive geriatric assessment; the availability of specialist geriatric teams and wards; and shared assessment and co‐ordination between care agencies.
Keeping the thread: older men's social networks in Sydney, Australia
Authors: Hall Cerdic , Brown Anthony , Gleeson Suzanne , Zinn Jack
Published: September 2011

Objective: to find out more about older men's experience of social activities including their preferences for creating and maintaining satisfying social connections and to identify barriers and enablers to their participation in social activities.Method: men aged 65 and older living in Central Sydney Area Health Service (CSAHS) were recruited for five focus groups (n=29). The men were asked about their experience of social interaction, with the transcripts of the groups analysed thematically.Results: retirement, health changes, divorce, widowhood and changing personal relationships challenged social well‐being. Strategies employed to combat these challenges included: a positive attitude, physical and mental activity and involvement in meaningful activities. Participants outlined their preferences for socialising within activities and suggested these differed from women's.Conclusion: activities that men saw as meaningful helped them cope with challenging events. Older men have preferred ways of maintaining social well‐being and constructing social networks that may be influential in developing services.
The home‐visiting process for older people in the in‐patient intermediate care services
Authors: Hibberd Jane
Published: September 2011

Older people account for a significant proportion of users of health and social care services (Wanless, 2006). Within current constraints on health and social care services, it is essential that interventions such as home visits for older people can be seen to be appropriately deployed resources for facilitating their safe and timely discharge home. This paper discusses the findings of an evaluation project undertaken in 2003/04 within two in‐patient intermediate care services. The service provided short‐term intervention for older people, with an emphasis on rehabilitation to enable a safe return to their own home environment. A government audit report in 2003 concerning effective discharge of older patients from NHS acute hospitals stated that delayed discharges are a significant problem, with 17% caused by delays in assessing patients, shortages of occupational therapists and lack of integrated therapy services (House of Commons, 2003).
Polypharmacy: cure or curse?
Authors: Salam Abdul , Mandal Snighendhu , Kumar Anil , Almula Abrar
Published: September 2011

Polypharmacy is common in older people, who are more likely to have multiple co‐morbidities. Coupled with age‐related physiological decline, undoubtedly this carries the risk of adverse drug reactions, drug interactions and multiple adverse symptoms, with consequent increased hospital admissions. This article discusses a recent audit on polypharmacy in older people conducted by the authors in a district general hospital.
An exploratory study of nurses' knowledge of antipsychotic drug use with older persons
Authors: Armstrong‐Esther Christopher , Hagen Brad , Smith Christine , Snelgrove Sherrill
Published: September 2011

Aim: Previous research has documented the widespread use of antipsychotic drugs by nursing staff with older persons, although less is known about the knowledge that nurses actually have about these drugs. The purpose of this exploratory, descriptive study was to survey a sample of UK gerontological nurses from different work settings on their knowledge of antipsychotic drugs.Methods: An exploratory descriptive study design was utilised, whereby a sample of nursing staff was given a questionnaire developed to determine knowledge about antipsychotic drugs and their use with older persons. Questionnaires were distributed to 100 nursing staff, including registered general nurses, registered mental nurses, state enrolled nurses, nursing assistants and care assistants. Of the 100 questionnaires distributed, 62 were returned and 57 were completed substantially enough for data analysis.Results: Descriptive statistics including frequencies and means were calculated for demographic variables and the questionnaire responses. Results indicated that the use of antipsychotic drugs within the psychiatric hospital setting was substantial, with 43.7% of patients receiving antipsychotic drugs, for an average length of time of 1.8 years. Conclusions: Nursing staff participants from all three work settings revealed a number of significant knowledge gaps, particularly with regard to appropriate indications for antipsychotic drugs with older persons and the side‐effects of antipsychotic drugs. Summary: This paper adds new information regarding the use of antipsychotic drugs in the nursing care of older people.
How balance can overcome barriers
Authors: Carter Kathy
Published: September 2011

Balance is key to improving the quality of life for older patients. This article looks at barriers to participation, which exist in different forms in all areas of fitness and exercise, and are of an emotional or practical nature. The feature quotes a study published in The Gerontologist carried out by researchers at the University of Southampton's School of Psychology. They sought to identify factors that may inhibit uptake to falls‐related interventions. Dr Dawn Skelton discusses the importance of exercise to reduce the number of falls and fall‐related injuries in older people, and the BalanceMaster machine is highlighted.
A patient's experience of an NHS hospital: complaint and outcomes
Authors: Wenger G
Published: September 2011

As a retired academic, I have written many academic papers over the years. This is not an academic paper; it is a personal account of my experiences in autumn 2007 of six days in an NHS hospital in Wales. My previous experience of hospitals in the UK consisted of having my tonsils out in 1947 and visiting my husband and parents who were patients in the same hospital over the course of the last years of their lives and of visiting friends in hospitals.
An evaluation of the needs and service usage of family carers of people with dementia
Authors: Cascioli Traci , Al‐Madfai Hasan , Oborne Paul , Phelps Sue
Published: September 2011

This study investigated, by way of interview (n=45), the needs of those caring for a person with dementia and their satisfaction with current services in the Caerphilly County Borough of South Wales. Carers reported having the most difficulty coping with the demands on their time and the emotional strain associated with caring. Carers requested more information regarding available services, the diagnosis of dementia and the legal and financial aspects of caring. They also mentioned the need for a night‐sitter service, a 24‐hour helpline, more support groups and more visits from social workers and community psychiatric nurses (CPNs). On the whole, the carers were satisfied with the services provided, although their use of these services was not extensive. However, issues around lack of support, quality and availability of homes and hospitals and poor communications were identified as areas of concern. The findings were welcomed by strategic planners and the information is being used as a basis for developing and improving specific carer support services.
Care planning systems in care homes for older people
Authors: Worden Angela , Challis David
Published: September 2011

Care planning is important in the provision of good‐quality care and serves a variety of functions, including acting as a communication tool. An accessible format for care plans is therefore important. The National Minimum Care Standards in England now require that all residents in care homes have a service user plan. This study examined the format and content of 117 blank care plan documents used in Manchester and Cheshire care homes in 2001/02. Sixty‐eight per cent of homes used a problem‐orientated care plan document, 25% used a problem‐orientated care plan with assessment domains defined, 15% used standard care plans and five per cent used daily care plans. Although the government has stressed the importance of involving the user in the care planning process, only 16% of homes had a care plan that specifically asked for a resident's signature or agreement. There were also differences in content of care plans by home type, which may reflect the professional background and training of staff in nursing homes. The variety in types and format of care plans suggests that the interpretation and recording of care planning may not be uniform across homes and there is a need for further detailed work in this area using interviews or observational approaches.
Where will we live when we get older?
Authors: McLaughlin Tricia , Mills Anthony
Published: September 2011

Ageing populations, although exhibiting marked differences across countries and cultures, are a global phenomenon. Old‐age dependency ratios in most developed countries are projected to double by the year 2050. In Australia there will be a strain on economic growth as a large part of the population moves from pre‐retirement to post‐retirement age over the next 25 years. A disproportionate amount of this strain will be concentrated in aged‐care housing or retirement accommodation. Current evidence suggests that existing housing stock for older people is inadequate. As the Australian population ages, the maintenance and long‐term performance of retirement housing is a key concern of government and housing providers. This study looked at four aged‐care or retirement providers across Australia and examined the performance of the current housing stock managed by these providers. The interviews revealed that housing design decisions in retirement stock, although critically important to the changing needs of occupants and the adequate supply of suitable housing, are often ill‐considered. The findings critically question the idea of simply building ‘more of the same’ to relieve demand. This study has major implications for the future of Australian retirement housing, especially as the population ages dramatically.
Family relationship quality after admission to a long‐term facility
Authors: Weeks Lori
Published: September 2011

This research examined how moving to a residential care home, a specific form of long‐term care facility, influences the quality of the relationship between seniors and their family members and how policies in these homes can facilitate relationships between residents and their family members. In this exploratory study, a total of five non‐spousal family members participated in a focus group discussion, and an additional 10 family members participated in face‐to‐face interviews. The two main themes that emerged identified that admission to a long‐term care facility had no influence on family relationships, or it had a positive influence on family relationships. The respondents identified how policies in the home can maintain or enhance family relationships. In particular, they appreciated very flexible policies that included few restrictions on when and where they could interact with their relatives and appreciated facilities providing private spaces to accommodate family interaction. The results of this study, and future research, will aid administrators in long‐term care facilities to develop policies that most support and enhance the experience of seniors and their ongoing relationship with their family members.
Copying letters to older people in mental health services ‐ policy with unfulfilled potential
Authors: Clark Michael , Benbow Susan , Scott Vanessa , Moreland Neil , Jolley David
Published: September 2011

The important initiative from the Department of Health (Working Group on Copying Letters to Patients, 2002) to require that letters between clinicians should be copied to the patient has not been implemented as widely as was intended. There have been concerns about logistics and fears that patients might be confused or frightened by communications they are not equipped to understand. Yet, modifications of the system to allow patients the choice to receive or not receive such letters and suitable training for clinicians offer safeguards. There is no doubt that copying letters provides an inexpensive mechanism for involving patients in their own care and treatment, offering transparency and confirming respect for equality in the relationship between patient and clinician. This paper reports experience with copying letters to patients and families with dementia. The process was warmly received by patients and carers, including families in a black and minority ethnic (BME) community, and few adverse comments were made. The routine application of this initiative will have benefits for the quality of service experience for older people, including those with dementia.
Screening for dementia in primary care: how is it measuring up?
Authors: Culverwell Alison , Milne Alisoun , Guss Reinhard , Tuppen Jackie
Published: September 2011

Despite evidence that early identification of dementia is of growing policy and practice significance in the UK, limited work has been done on evaluating screening measures for use in primary care. The aim of this paper is to offer a clinically informed synthesis of research and practice‐based evidence on the utility, efficacy and quality of dementia screening measures. The study has three elements: a review of research literature; a small‐scale survey of measures employed in three primary care trusts; and a systematic clinical evaluation of the most commonly used screening instruments. The authors integrated data from research and clinical sources. The General Practitioner Assessment of Cognition (GPCOG), Memory Impairment Screen (MIS) and Mini‐Cognitive Assessment Instrument (Mini‐Cog) were found to be: brief; easy to administer; clinically acceptable; effective; minimally affected by education, gender, and ethnicity; and to have psychometric properties similar to the Mini Mental State Examination (MMSE). Although the MMSE is widely used in the UK, this project identifies the GPCOG, MIS and Mini‐Cog as more appropriate for routine use in primary care. A coherent review of evidence coupled with an in‐depth evaluation of screening instruments has the potential to enhance ability and commitment to early intervention in primary care and, as part of a wider educational strategy, improve the quality and consistency of dementia screening.
Developing services for people with dementia: Findings from research in a rural area
Authors: McDonald Ann , Heath Becky
Published: September 2011

Services for people with dementia in the UK have developed piecemeal in the context of wider agency agendas. Health and social care agencies located in rural areas face particular challenges if they are to be able to support people with dementia within their communities. This article describes a piece of work carried out in three rural counties in East Anglia designed to map services across the statutory, voluntary and private sectors, and to describe the ways in which national policy is being interpreted to meet local need. Examples of innovative practice, as well as gaps in service design and delivery, were identified through an examination of local policy documents and qualitative interviews with strategic managers, frontline managers and practitioners, and local carers of people with dementia. The findings confirm that services for older people with dementia are under‐developed in comparison with services for older people generally, and in comparison with mental health services for working age adults. There are particular gaps with respect to rarer types of dementia, services for people with learning difficulties, and services for people from minority ethnic groups. Historically, a lack of strategic planning has meant that service development has been patchy and unco‐ordinated. Carers have been affected by a shortage of joined‐up information, high eligibility criteria and a change to short‐term working by practitioners. Nevertheless, the potential for developing community‐based and inclusive services for people with dementia is apparent, and the adaptability required of rural areas may, subject to further evaluation, provide a template for service development elsewhere.
Sociological perspectives on the baby boomers: An exploration of social change
Authors: Leach Rebecca , Phillipson Chris , Biggs Simon , Money Annemarie
Published: September 2011

The ‘baby‐boom’ generation has emerged as a significant group in debates focusing on population change. The demographic context concerns the increase in the birth rate across industrialised countries from the mid‐1940s through to the mid‐1960s. From a sociological perspective, boomers have been viewed as a group with distinctive experiences that set them apart from previous generations. In the UK context, however, there have been relatively few detailed studies of the characteristics of the boomer generation and, in particular, that of first‐wave boomers (born between 1945 and 1954) now entering retirement. This article draws on a research project exploring changes in consumption and identity affecting this cohort. The paper reviews some of the key social and demographic changes affecting this group, highlighting a mixture of continuities and discontinuities over previous cohorts. The article concludes with an assessment of the value of sociological research for furthering understanding of the baby‐boomer generation.
Death, dying and end‐of‐life care
Authors: Leishman June
Published: September 2011

Death is a certainty for all of us. For many old people in Western society age, illness and social death are inextricably linked. It is predicted that the number of people in the world who are over 60 years old will double by 2050. This brings fundamental changes to societal demographics. Many older people live in good health well into old age, but there remains a significant number for whom growing old includes the development of complex physical and social needs, requiring both health and social care. This poses a particular challenge to health and social care providers. This paper seeks to provide insights into the ways in which older people in contemporary society make sense of death and dying and makes a case for improvements in end‐of‐life care for this population.
Considerably better than the alternative: Positive aspects of getting older
Authors: Garner Jane
Published: September 2011

Older people tend to be viewed negatively ‐ as being needy, dependent and frail. Such assumptions may be reinforced by policies that, despite good intentions, focus on the consequences of physical and mental decline. This paper argues for a more balanced and positive view. Ageing is associated with increased diversity, creativity and continuing psychological development and sexual activity. The wisdom and experience of older people is a vital, and as yet largely untapped, resource for UK society.
Suicide and self‐harm in older people
Authors: Dennis Michael
Published: September 2011

Suicide is a tragic cause of death and causes considerable distress for families, carers and healthcare professionals. Thankfully, suicide rates in older people in the UK have steadily declined for both men and women since the mid‐1980s. An understanding of the clinical and demographic characteristics of both completed suicide and non‐fatal self‐harm in older people is important in informing the development of preventative strategies to sustain this decline. Non‐fatal self‐harm in older people is relatively uncommon compared with younger age groups, but research indicates that self‐harm among older people is frequently a failed attempt at suicide. Thus, the important factors associated with self‐harm in this age group are similar to those linked with completed suicide, particularly high rates of clinical depression, poor physical health and social isolation. Unfortunately, there is also a high rate of subsequent completed suicide. For this reason, self‐harm in later life needs to be taken very seriously and a careful assessment of risk and need by a specialist in older people's mental health should be conducted. The identification and appropriate management of older people with depression in the community and general hospitals is a key area for the prevention of self‐harm and suicide in this age group and requires further attention, particularly with targeted support programmes for those at high risk.
Psychodynamic observation and emotional mapping: A tool for continuing professional development and research in services for older people
Authors: Davenhill Rachael
Published: September 2011

Psychodynamic observation and emotional mapping (POEM) is a professional development (CPD), supervisory and research process, which works from the ‘inside out’. It aims to ensure that staff experience is placed at the heart of understanding meaningful, relationship‐centred care in the workplace. Central to this process is the assumption that feelings occurring ‘under the surface’ in both staff and patients are important channels of communication impacting on staff, care practice and the service setting. In terms of good psychological health for staff and patient, the POEM approach facilitates the digestion and understanding of both conscious and unconscious processes in the workplace. It also contributes towards a healthier, more open workplace in which staff teams are supported in their capacity to think and respond effectively and honestly to everyday clinical and organisational pressures.
In the balance: silver tsunami or longevity dividend?
Authors: Perry Daniel
Published: September 2011

While still early in the 21st century, nations are experiencing an unprecedented rise in people living into their 80s, 90s, and even longer. Many national leaders view with alarm a possible tidal wave of chronic age‐related disease and disability. Competing scenarios predict insurmountable social and economic stress; or alternatively, a future in which older people continue to function and contribute during extended healthy years of life made possible by scientific and medical advances. The latter vision, termed the 'longevity dividend', is discussed in terms of strategies for achieving this goal.
Ageing and work
Authors: Ball Chris
Published: September 2011

HR managers have known for many years about the demographic time bomb, and more recently have been urged to take age positive1 approaches to the management of their organisations. However, conversations and seminars with many of those who devise and steer human resource management policies in organisations, suggest that understanding of demographic change is sometimes limited and coping strategies often absent or inchoate. This paper will briefly explore the demographic context and comment briefly on the main policy responses in relation to workforce issues. It will then consider the sorts of measures that might be needed to make work compatible with a significantly older working population. Taken together, these strands will hopefully weave a picture that meets our purpose of forward looking conjecture.
Re‐visioning respite: a culture change initiative in a long‐term care setting in Eire
Authors: Kelly Marguerite , McSweeney Eileen
Published: September 2011

Respite care is one of the services most frequently requested by family carers, but places are often not taken up because of carers' concerns about the quality of the respite experience. This paper describes the formation of a new respite unit at St Ita's Hospital in Western Ireland and staff's efforts to create a respite experience that more closely reflects the older person's home environment. The initial focus was on providing more choice in terms of the food served and the times of meals. The challenges of introducing even small changes to the delivery of care are considered, and the need for a more widespread and sustained approach to culture change is promoted.