Textbooks, monographs and policy-focused books on our Health and Social Care list push forward the boundaries of teaching, theory, policy and practice. The list covers areas including global health, health inequalities and research into policy and practice.
Key series include Transforming Care which provides a crucial platform for scholars researching early childhood care, care for adults with disabilities and long-term care for frail older people, and the Sociology of Health Professions, offering high-quality, original work in the sociology of health professions with an innovative focus on their likely future direction. Our leading journal in the area is the International Journal of Care and Caring.
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Physical activity is beneficial for overall health; however, informal carers may have lower levels of physical activity than non-carers. The primary aim of this systematic review was to identify barriers and facilitators to physical activity from the perspective of carers internationally, excluding the UK. The study found that barriers to physical activity include lack of time, fatigue, lack of motivation and lack of support. Facilitators of physical activity include health and well-being as a motivator, using physical activity as a coping mechanism, and social support. Participating with the care recipient and care duties were both barriers and facilitators depending on the study or participant.
Old age is still an under-researched stage in the lives of people with a learning disability. Providing support to people towards the end of their lives can be challenging for services and involves complex ethical decision-making processes. This study explores the experiences of social care staff in two life-sharing communities where adults with a learning disability and staff live together. Four main themes were identified, highlighting different dimensions of care. These included an emphasis on relational care, responsive care and collaborative care, and an acknowledgement of barriers to care and caring that allowed people to live and die within the communities.
Namibia’s lengthy colonial history and current high levels of inequality foreshadow care in the context of poverty and marginalisation, and within families that are diverse and whose care capacities are poorly understood. Focus group interviews with family carers of older people in two marginalised communities provide insights into their experiences of care. We highlight three findings: first, contexts of care perpetuate and entrench marginalisation; second, care is not widely shared within families, raising questions of what it means to ‘do family’; and, third, care has negative consequences for carers and their families, foreshadowing generational replication of carer exclusion.
The article highlights the heterogeneity of employed women’s experience of family care for older persons by focusing on multigenerational households. First, I argue that care for older persons must be understood in the context of multiple family responsibilities. Second, I show that care for older persons occurs in a context of inequalities that remain in post-colonial settings where there is highly uneven access to material resources, high levels of unemployment, poverty and limited social welfare provision. From this understanding of care, I argue that women’s position within wider care relations reveals elements of differentiation between women who occupy different class and racial positions.
Eldercare arrangements are intricately woven and complex. While adult children are socially extolled as legitimate caregivers, ayahs working in ayah centres are making revolutionary strides in Kolkata. Drawing across this context, the article explores multiple essences of lived experiences through which care actors like ayahs, elderly care receivers, their kin and ayah-centre managers produce and reproduce ‘care practices’. These establish ayahs and ayah centres as a social resource for the elderly, enabling them to reflect on their mundane ageing and ‘personhood’ in Kolkata.
Reablement is introduced with the aim of improving functioning in daily activities for older people, but also has implications for care workers in changing the aim and tasks of the work. Using Danish reablement as a case, this chapter looks into how reablement affects care work.
It is based on qualitative interviews with reablement care workers in two local settings in Denmark in order to unfold their experiences of how reablement has changed their approach to their work and their understanding of quality of care. It also applies representative and national survey data among Danish care workers in order to understand the further implications for the attractiveness of working in the sector.
Results show that the care workers find it attractive to work with reablement. Reablement appears to provide care workers with more professional autonomy and flexibility in the planning of their daily work while they also receive more support and attention from managers. The care workers find that the introduction of reablement enables them to better meet the clients’ individual needs and preferences. The new motivational approaches and working as change facilitators encouraging clients towards achieving independence is found meaningful and professionally rewarding by the care workers. The attractiveness of working with reablement means that they are less likely to want to quit their job.
The results are important, since there is otherwise a high turnover in the home care workforce, and it is difficult to recruit young people to the sector.
In this concluding chapter, a number of the authors reflect on the content of the book chapters, based on a facilitated online discussion. The chapter summarises the key learnings and messages from the book and, using quotes from the discussion, illustrates the potential implications for reablement practice and research. Moreover, the editors reflect in the conclusion over the key issues discussed in the book, learning points and the way forward.
This chapter looks at the evidence regarding the effectiveness of reablement for older people themselves. The most commonly examined client-level outcomes are daily functioning, physical function and quality of life. The evidence relating to each of these is described in separate sections, while that pertaining to less commonly used measures is described together. When assessing the evidence, most weight is given to studies with more rigorous research methodologies which are considered to be higher on the evidence hierarchy. Overall, the evidence that reablement enables older adults to have better personal outcomes than if they had received conventional home care, was found to be relatively weak, although in relation to outcomes such as quality of life or wellbeing, perhaps promising. On the other hand, there is little evidence that the outcomes for reablement participants are any worse than for non-participants and service evaluations found that the majority were satisfied with the service and what they felt they had achieved.
This chapter describes client-level outcomes used for evaluating reablement. The authors have examined outcomes and instruments used in empirical, clinical trials regarding reablement, and provide an overview of this. A literature review and a comparative analysis have been conducted to examine which client-level outcomes and instruments have been used in different countries across the world. An analysis including 18 studies deriving from nine countries has been conducted. In all, 12 categories of client-level outcomes were identified. Functional independence in ADL, physical functioning and health-related quality of life were the most frequently used outcomes. In all, a total of 40 instruments were used, of which the Barthel ADL Index, EQ-5D and TUG were the ones most frequently used.
Our societies are ageing, and we need to identify sustainable and empowering solutions for supporting frail older people in their homes.
Reablement offers an approach that may reduce the need for long-term care by actually reducing need for care, as well as supporting quality of life. It offers a radical new integrated and interprofessional care approach which seeks to support older people to regain and maintain functioning and independence through training in daily activities.
Reablement implies the provision of active, person-centred, and goal-oriented support; it should be seen as an alternative to other types of support that merely compensate for care needs and thereby increase the risk of the client becoming passive. In fact, understanding the client’s own priorities and concepts of independence is considered to be key to the potential for enhanced effectiveness. In other words, reablement has the potential to change the way societies approach long-term care policies and implement them into practice.
This interdisciplinary book provides a comprehensive introduction to the remarkable, if haphazard, international growth in reablement practices and policies in aged care over the past 20 years. The book introduces reablement models, and their ideational foundation, implementation, and outcomes across the world. Incorporating theoretical and empirical research, it critically considers the benefits for older people and care workers, the cost-saving potential, and how reablement may be provided for persons with dementia. Finally, the book reflects on key findings, challenges, and the way forward for applying reablement in long-term care for older people.
