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Innovation alters who is accountable for social care and how they are held to account. This article shows how organisational, institutional and technological innovation in infrastructures of social care can reconfigure accountability instruments and propel change between distinct modes of accountability. However, innovation also sustains neglect, both in terms of issues, objects and subjects missing from research, and in terms of low levels of institutional reflexivity mobilised to evaluate and direct innovation’s impacts. Evidenced using two-level situational analysis – across a UK research portfolio and within a public robotics lab – we argue that confronting this neglect is critical for post-pandemic reform.

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There is international evidence that informal or unpaid carers have poorer mental health and experience higher levels of isolation and stress than others in the population. Identifying approaches that promote carer well-being is critical to supporting this essential role in the community. This study presents the findings of the evaluation of a brief carer intervention designed to improve carers’ well-being delivered by a community service organisation. The manualised programme provided information and psycho-education to adult carers in five regional locations in Victoria, Australia. Positive change was noted in carers’ knowledge of good mental health and well-being, supports, and social connectedness.

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Author: Chiara Giordano

Home care service providers have been considerably affected by the COVID-19 crisis. Since the beginning of the pandemic, their internal organisation has undergone important changes, including in terms of time schedules, to adapt to the needs of the older population and those of workers. In most cases, they had to reduce the provision of services, either because care workers – the majority of whom are women – were no longer available to cover the shifts, or because families had cancelled the services. In other cases, they had to meet increased demand. The most dramatic consequences were borne by female care workers, who had to combine working time adjustments with family obligations. Drawing from the material collected before and after the impact of the pandemic in Belgium, which includes interviews with public and private home care providers, this article explores the consequences that time adjustments had on frontline care workers and on the organisations themselves.

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The COVID-19 pandemic poses specific risks to vulnerable population groups. Informal carers for older adults are especially at risk of increased strain, as support from social networks and professional care services is no longer available or in short supply. Already before the pandemic, caring was unequally distributed within societies, with women and people in lower socio-economic status groups bearing a higher risk of caring strain. In this article, we propose a conceptual framework of (unequal) caring strain during the pandemic. We then summarise the state of empirical research, suggest questions for future studies and outline implications for social policy.

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Sleep has been recognised as compromised in dementia care. This study aims to represent the experiences and needs of informal carers via sleep-related accounts. Retrospective interviews were conducted with 20 carers concerning sleep changes across the trajectory of dementia care. Key interactive narratives were around: ‘sleep as my sacrifice’; tensions between identities of being a ‘sleeper’ versus ‘guardian’; and ‘sleep as a luxury’. Maintaining healthy sleep and preferable sleep practices is challenging while balancing the responsibilities of dementia-related care. Acknowledging sleep as a sociological practice enables a greater understanding of carers’ nuanced experience and support needs.

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The adult social care sector in England has been encouraged to increase the role of volunteers in service delivery. To understand the volunteer role in care delivery and its impact upon paid care work, we undertook 94 qualitative interviews in seven care settings for older people in England. While the boundaries between care worker and volunteer were clearly established in some organisations, they were more indistinguishable in others. We discuss how both clear and murky boundary making, especially regarding ‘emotional’ and ‘bodily’ aspects of care, can contribute towards paid care work’s invisibility, lack of recognition and poor remuneration.

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Conducting research in care homes is difficult, and research originating from care homes is lacking. This article provides reflective insights into the determinants that affect research engagement among UK care home staff. The Capability, Opportunity, Motivation, Behaviour (COM-B) model of behaviour has been used to structure and explore our reflections relating to time, funding and skills. Our reflections suggest that wider determinants influence research engagement among care home staff and that a culture of research within care homes remains in its infancy. Our reflections highlight that more needs to be done to enable and empower care home staff to engage in research.

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Authors: Sian White and Suzanne Lewis

A tool to help carers gauge their readiness to provide care to a patient on discharge from acute care – the Carer Readiness Tool – was implemented on two cancer/renal inpatient units. Data on carer needs and concerns obtained from the Carer Readiness Tool revealed that relatively inexperienced carers focused their concerns on practical aspects of care, such as mobility, transfers, aids and equipment, transport and parking. More experienced carers reported fewer needs but more concerns, including respite from caring, costs of caring and end-of-life care. Challenges in engaging carers in research, which impacted the formal evaluation of the Carer Readiness Tool, are discussed.

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The ageing population and long-term care policies of the Organisation for Economic Co-operation and Development countries have put pressure on social care work, creating patterns of difficult ethical situations. This article contributes to contextualising such situations by applying a ‘micro-ethics’ perspective and a theoretical framework that connects micro-ethics to macro-sociological contexts, and combines the concept of ‘moral distress’ (of healthcare professionals) with feminist ethics. Based on two case studies from an ethnographic study of Norway’s long-term care, findings demonstrate how ethically difficult moments connect with structural factors, including bureaucratic, managerialist and de-professionalised models of social care work, and new relationships between older people and their families.

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