Social Care For Older People Research Articles

Primary health and social care services in the UK: progress towards partnership?

There has been a shift in the theoretical debates around the ways in which organisations deliver the state's objectives of providing health and social care services for its citizens, focusing on issues of welfare governance and the encouragement of partnership working between organisations. This article develops these theories by focusing on developments in primary health and social care policy in the UK, which have undergone a radical change recently. Responsibility for commissioning health care services now falls to primary care groups and trusts (PCG/Ts), run by general practitioners, other primary care practitioners, managers and lay members, and there is some pressure on primary care groups and primary care trusts to engage in partnership working with social services, for example, to cut hospital waiting lists or provide intermediate care services. One policy option is for these organisations to form Care Trusts, integrating the commissioning of health and social care for older people and ending the historical organisational divisions between health and social care in the UK. This paper examines evidence from the first stage of a 3-year longitudinal quantitative and qualitative study of the development of partnership working between PCG/Ts and social services departments in England. It examines whether the evidence suggests that the integration of health and social care is feasible or desirable in older people's services.

Use of medicines in nursing homes for older people

The National Health Service (NHS) spent £10 billion (40%) of its total budget on people aged 65 and over in 1998/1999. The profile of the health and social care of older people has been raised recently by the publication of the National Service Framework (NSF) for Older People (Department of Health, 2001). The NSF contains standards that older people can expect when they receive health and social care (Box 1). The document also discusses in detail medication management issues in older people. Its two aims in this area are to ensure that older people gain the maximum benefit from their medication in order to maintain or improve quality and duration of life, and do not suffer unnecessarily from illness caused by excessive, inappropriate or inadequate consumption of medicines.

The Institute for Ageing and Health, University of Newcastle, UK

The Institute For Ageing And Health (IAH) is the largest cross-disciplinary research grouping within Newcastle University's Faculty of Medicine, which recently obtained the highest 5 or 5∗ ratings in all fields evaluated in the UK Research Assessment Exercise 2001. The IAH was set up in 1994 to bring together clinical, basic and social scientists in partnership with colleagues in the National Health Service. It builds upon a long tradition of outstanding clinical research on age-related disorders, particularly in the field of dementia where the pioneering studies of Tomlinson and Roth in the 1960s first showed Alzheimer's disease to be the commonest cause of cognitive decline in later life. The clinical research of the IAH now extends to both neurodegenerative and vascular dementia in a joint Medical Research Council-University Development for Clinical Brain Ageing, and to studies in many other areas including depression in later life, falls and neurovascular instability, stroke and ischaemic brain disease, and health services research on the medical and social care of older people. These diverse areas of clinical investigation are now complemented by strong research on the basic biology of ageing within the new Department of Gerontology with its programmes on the genetics of ageing and longevity; molecular mechanisms of cellular ageing, including oxidative stress, DNA damage and genomic instability, telomere reduction and regulation, mitochondrial DNA mutations, and accumulation of aberrant proteins; and theoretical models of the ageing process. An ambitious strategy for future research on ageing and age-related disorders is based on the synergy between these complementary approaches.

Le Mesurier, N. and Cumella, S. (2001) The rough road and the smooth road: comparing access to social care for older people via area teams and GP surgeries', Managing in Community Care, 9 (1), pp.7-13.

Journal Article Le Mesurier, N. and Cumella, S. (2001) ‘The rough road and the smooth road: comparing access to social care for older people via area teams and GP surgeries’, Managing in Community Care, 9 (1), pp.7–13. Get access Eileen McLeod Eileen McLeod Search for other works by this author on: Oxford Academic Google Scholar The British Journal of Social Work, Volume 32, Issue 1, 1 January 2002, Pages 123–125, https://doi.org/10.1093/bjsw/32.1.123 Published: 01 January 2002

Cumella, S. and Le Mesurier, N. (1999) Re-designing health and social care for older people: multi-skill case teams in primary care', Managing Community Care, 7 (6), pp. 17-24.

Cumella, S. and Le Mesurier, N. (1999) Re-designing health and social care for older people: multi-skill case teams in primary care', Managing Community Care, 7 (6), pp. 17-24.

Promoting the health and social care of older people: gaining a perspective from outside the UK.

With people living longer, getting sicker and entering nursing home care later in their lives, the global trends point to preventing premature institution as a major public health and social care goal. Compared with the UK--Australia, Canada and the USA have a longer track record for introducing government Acts, policies and strategies which contribute to supporting older people in maintaining their health, safety and independence. They also have government Ministers for the Aged. In the UK, it is only very recently that we are witnessing new Government programmes such as the NHS Plan and Modernizing Social Services that begin to demonstrate its more determined approach to improve the life of the older person. An ageing population brings new challenges to policy-makers and planners in the statutory sectors. Various international conferences have been held to address ways in which countries are providing or developing their services, and their research regarding older people. Yet, whatever country one considers, nursing home care continues to give rise to many concerns. Developments in the USA managed care programmes have recently come under even more scrutiny from the Federal and State governments, insurance agencies, nursing home owners and, of course, older people themselves. This article raises issues that still need to be addressed in the UK. It reports briefly on an international conference (attended during the undertaking of a Winston Churchill Fellowship) which had some forward-thinking presentations addressing existing and future care needs of older people. It then concentrates on highlighting some of the current developments in the USA care system that might be learning lessons for UK policy-makers. It concludes with some additional considerations for delivering a National Service Framework for Older People in order that "The needs of older people are at the heart of the reform programme for health and social services."

Crossing the housing and care divide: Integrating housing and social care for older people

The fundamental role of housing in community care has long been acknowledged. However, progress in achieving any real integration of housing and social care has been slow. This article reports the findings from the Crossing the Housing and Care Divide programme, which was jointly sponsored by the Housing Corporation and Anchor Trust. The programme aimed to stimulate developments in services for older people that would enable housing to become part of community care, lead to greater inter‐agency working, enhance the involvement of users in the planning, monitoring and delivery of services and deliver a high quality of service more cost‐effectively. The programme offers many practical lessons for the effectiveness of services.

The Rough Road and the Smooth Road: Comparing Access to Social Care for Older People via Area Teams and GP Surgeries

This article discusses the results of a comparative evaluation of a social worker in primary care with her equivalents in an area team. Direct referral is found to be more efficient than referral to the area team, enabling the attached social worker to manage a higher workload and improved levels of contact with service users and the primary care team. The options available for service users are thus enhanced, with consequent cost advantages for the social services department.

Changing systems in health and social care for older people in Japan: observations and implications for interprofessional working

The impact of a rapidly ageing population on the development of insurance policies and health and social care services of older people is a major concern in Japan. The discussion in this paper draws on information gained from recent visits to leaders of these services in Japan. The paper briefly reviews the policy and demographic background to recent legislative changes in the long-term care insurance system, models of care management and assessment and outstanding challenges for health and social care professionals. Some key issues have emerged with implications for interprofessional working, such as the lack of integrated care systems, contradictions within the scope and responsibilities of care management, and the absence of quality and ethical frameworks to safeguard the interests of the service user and carer.

Measuring satisfaction with social care amongst older service users: issues from the literature.

Issues of quality and accountability in social care for older people are of increasing importance. A key factor in determining quality is the extent to which older people themselves are satisfied with both the assessment of their needs and the services provided. The 1997 White Paper, Modernising Social Services, stated that local authorities will need to establish authority-wide objectives and performance measures to improve the quality and efficiency of services. In measuring quality, the White Paper stipulated that social service departments would need to design and administer satisfaction surveys as one means of capturing user and carer perceptions and experiences of services. This paper attempts to highlight some of the main issues to be considered when designing and conducting such surveys with older users of community care services. Through a review of the British and North American literature on older people's satisfaction with services, current approaches to measuring satisfaction are outlined and the relationship between the characteristics and circumstances of older people and their responses to satisfaction questions is examined. The paper concludes by offering some solutions to overcoming current problems by drawing conclusions about quality from survey findings, so that older people's opinions about the services they receive can begin to be assessed in a more meaningful way.

Defining responsibility for care: approaches to the care of older people in six European countries

This article examines the social care of older people in six contrasting European countries. Family, institutional and community care are compared, focusing on vulnerability, empowerment and the gatekeeping of resources. The article considers the position of older people in each care system by presenting individual case studies. The six countries include the family‐oriented systems of Ireland, Italy and Greece, and the individual‐oriented systems of Denmark, Norway and England. To improve the care of older people in any of these welfare cultures, resources need to be developed that work with existing sources of care but extend the rights of older people, at least to assessment and an equitable matching of needs to the care services available. Overall, the different levels of provision of organised social care services are a major aspect of inequality within and between the countries. Whilst there is little prospect for any major policy transfer across national boundaries, there is potential for selective cross‐national learning with regard to particular service developments.

Re‐Designing Health and Social Care for Older People: Multi‐Skill Case Teams in Primary Care

This article reviews the evidence on the benefits of innovative practice‐based social work, in the context of attempts to improve multi‐agency collaboration through structural change, procedural regulation and process redesign. It concludes that the model can generate improvements in productivity and in responses to customer needs.

Caring for older people in acute settings: Lessons learned from an action research study in accident and emergency

The health and social care of older people has never been so high on the political agenda. In particular, there has been growing concern about the care of older people in acute settings. This paper reports the findings of an action research study which explored the organisation of care for older people in an accident and emergency (A&E) setting. Although the findings cannot be generalised directly to all acute settings, the action research methodology generated unique exploratory data, which suggest older patients arrive at hospital with low expectations of care and appear to understand many of the constraints under which staff are working. However, while patients appear to be able to identify small ways in which care could be improved easily, staff instead appear to blame the wider organisation for poor care and give the impression of being disempowered to care. This is despite findings which suggest nurses could make changes in the priorities they give to different aspects of care. The lessons learned from this action research study suggest that nurses may need to work more closely together to foster the much-needed improvements in care of older people. With the National Service Framework for Older People on the horizon, nurses cannot afford to ignore the needs of such a significant group of patients under their care.

Overview: Outcomes of Social Care for Older People and Carers

Overview: Outcomes of Social Care for Older People and Carers

Pass the parcel: care of the elderly in the community

I have always had some conceptual difficulty with the division of health and social care, finding it difficult to make the distinction between personal care and nursing care. However, recent experience within the family has shed some light on this subject. I now know that I do not have to struggle to make sense of a division of health and social care for older people, since the definition depends not on the service but on who is providing it.