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  • Author or Editor: Robin Means x
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This article begins by looking at past policy assumptions about the importance of home and independence to older people. It is shown that it has long been argued that older people should stay in their own homes as long as possible but that this was not backed up with domiciliary services because of concerns that this would enable families to push caring responsibilities onto the state. The second half of the article looks at present day assumptions on this issue as addressed by the 1990 National Health Service and Community Care Act and compares this to what older people themselves have to say. By drawing on research on 39 older households the importance of home as a place of privacy and self identity is illustrated as is the rich and varied lives of these respondents both inside and outside their homes. It is argued that local authorities as the lead agencies in community care should help to foster such independence and that this requires them to develop a broad vision of community care which covers issues such as transport, leisure and household maintenance.

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This article will consider some of the ethical and practical problems associated with the construction of policy recommendations from what are increasingly referred to as implementation studies. Such studies are a form of policy research although there is considerable disagreement over whether it is possible to distinguish an activity called policy making (i.e. the setting up of goals) from an activity called implementation (i.e. the processes required to realise those goals). Whether those who stress that policy making continues well after the formal decisions have been made are right or not, it is clear that many government officials wish to encourage the study of what they perceive as implementation. However, the focus of this article will not be on the expectations of the main research sponsor (whether government or research council) but rather on those of implementing agencies, which allow access without funding the research.

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This chapter explores how future governments in the UK are likely to respond to the challenges of an ageing population especially in terms of the future funding of social care. It sets this challenge within the context of widespread ageism within British Society and the growing tendency to encourage conflict between the generations through a very unfair portrayal of so called ‘baby boomers’ as the selfish generation. It also provides a critique of the extent to which civic engagement or ‘the Big Society’ can reduce the need for the State to play a crucial role in ensuring a high quality of care and support for older people who are near the end of their lives.

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This chapter draws on both historical and contemporary perspectives to highlight the ways in which present government policies are creating a re-medicalisation of later life that is to the detriment of older people. It argues that recent policy developments have ignored the findings from research about how best to respond to the needs of those older people in the community with extensive health and social care problems. The dominant driver of recent policy has been to revert to a medical model in which the major desire of health seems to be to shunt cost onto local authority social services. This chapter takes the recent Green Paper on Independence, well-being and choice: Our vision for the future of social care for adults in England as a case study and shows that what is most striking are the continuities with the past rather than radical improvements.

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Australia and the UK have historically had very different systems of long-term care for older persons and others. Recent restructuring has led to interesting convergences of those systems - in large part, we argue, because of the limited set of policy levers available to reformers in both countries.

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This article reflects upon why a pluralistic evaluation approach was adopted by the research team concerned with the evaluation of a regional alcohol education programme. The article describes why such an approach was adopted and then discusses some of the advantages and disadvantages that have been encountered. It is argued that such an approach enables an evaluation team to map and contextualise the differential accounts about progress and blockages which tend to be generated by such programmes.

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This chapter examines policy developments in 2005 in social care for adults and older people, focusing on three key policy documents covering disabled people, adult social care and older people. It notes that the policies proposed seek to promote active citizenship, social inclusion, independence, an improved quality of life and enhance well-being. It explains that services relevant to these aims are envisaged as extending more broadly than those that have traditionally been considered the province of social care provision, including resources such as leisure, transport and housing support. It identifies a number of important problems in using individual consumer choice in quasi-markets as the means for ensuring equitable and appropriate social care provision. The chapter also identifies some important unresolved issues about the relationship between the direction of policy in relation to social care and current developments in the health service.

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The development of welfare services for elderly people 1939-1971
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Recent community care changes have raised fundamental issues about the changing role of the public, voluntary and informal sectors in the provision of social care to older people. They have also raised issues about the health and social care interface, the extent to which services should be rationed and the respective roles of residential care and care at home.

From Poor Law to community care sets these debates in the context of the historical growth of welfare services from the outbreak of the Second World War through to the establishment of social services departments in 1971. Based on extensive research on primary sources, such as the Public Records Office and interviews with key actors, the book considers the changing perceptions of the needs of elderly people, the extent to which they have been a priority for resources and the possibilities for a policy which combines respect for elderly people with an avoidance of the exploitation of relatives.

This is an updated second edition of The development of welfare services for elderly people, first published by Croom Helm, 1985. It is essential reading for practitioners and policy makers interested in gerontology, policy studies, community care and postgraduate students studying and training in a range of health and social care related professions.

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