• Commentary on "Older carers of people with learning disabilities: Their experiences with local authority assessment processes and personnel"

      Gant, Valerie; University of Chester
      Purpose - The purpose of this paper is to provide a commentary on "Older carers of people with learning disabilities: their experiences with local authority assessment processes and personnel" written by Rachel Forrester-Jones. Design/methodology/approach - The commentary considers the experiences of older carers in the context of research, legislative and policy changes over the last 30+ years. Findings - The needs of older carers of adults with learning disabilities are well recognised within the (limited) literature. Less attention has been given to practical strategies to identify and support such carers or to their broader family context. Originality/value - This commentary highlights that assessors carrying out carers' needs assessments should consider whether adults with learning disabilities are providing care to their older relative. The recognition of possible mutual or reciprocal care needs to be acknowledged and appropriate support offered.
    • Does integrated health and care in the community deliver its vision? A workforce perspective

      Wain, Linda Marie; University of Chester
      Purpose –The purpose of this paper is to explore and capture workforce perceptions, experiences and insights of the phenomena of integrated care (IC) in a community health and care NHS trust in England; including whether there are any associated factors that are enablers, barriers, benefits or challenges; and the level of workforce engagement in the process of integrated health and care. Design/methodology/approach – A qualitative design based on an interpretivist research paradigm was used with a purposive sampling technique. Five in-depth semi-structured interviews were conducted with community nursing, social workers and allied health professionals. Colaizzi’s (1978) descriptive phenomenological seven-step method was applied to analyse data, with the emergence of 170 significant statements, 170 formulated meanings and 8 thematic clustering of themes to reveal 4 emergent themes and 1 fundamental structure capturing the essential aspects of the structure of the phenomenon IC. Findings – This study revealed four interdependent emergent themes: (1) Insight of IC and collaboration: affording the opportunity for collaboration, shared goals, vision, dovetailing knowledge, skills and expertise. Professional aspirations of person-centred and strength-based care to improve outcomes. (2) Awareness of culture and professionalism: embracing inter-professional working whilst appreciating the fear of losing professional identity and values. Working relationships based on trust, respect and understanding of professional roles to improve outcomes. (3) Impact of workforce engagement: participants felt strongly about their differing engagement experience in terms of restructuring and redesigning services. (4) Impact of organisational structure: information technology (IT) highlighted a barrier to IC as differing IT platforms prevent interoperability with one system to one patient. Shared positivity of IC, embracing new ways of working. Originality/value – This study proposes considerations for future practice, policy and research from a local, national and global platform, highlighting the need for any IC strategy or policy to incorporate the uniqueness of the “voice of the workforce” as a key enabler to integration developments, only then can IC be a fully collaborative approach.
    • Guest editorial

      Skellern, Joanne; University of Chester (Emerald, 2016-06-13)
      This is the editorial for a special edition entitled 'Intellectual Disabilities: Nursing' of the Journal of Intellectual Disabilities and Offending Behaviour.
    • Older adults and “scams”: Evidence from the Mass Observation Archive

      Bailey, Jan; Taylor, Louise; Kingston, Paul; Watts, Geoffrey E; University of Chester
      Purpose The issue of financial abuse is highlighted the Care Act (2014). One category of financial abuse is consumer fraud or “scams”. Evidence suggests that scams are becoming increasingly ubiquitous, yet how scams impact older adults remains under-researched. This paper reports the data from 80 older adults’ written response to a Mass Observation Archive Directive, commissioned in autumn 2015, focusing on scams. Study design/methodology/approach A qualitative approach was utilised with data captured via written responses to a set of questions. There was no limit on the length of written accounts and respondents remained anonymous. Data were analysed thematically, resulting in 4 key themes. Findings The data indicated scams impact individuals in terms of health and wellbeing, irrespective of whether they have experienced financial loss, and trigger implementation of strategies intended to avoid being defrauded. There was also evidence of scam related stigma with individuals who are defrauded being subject to derision and censure. Originality/value This paper adopts an original approach to collecting rich, candid data about an under-researched topic. The authors highlight that anti-scam interventions should equip individuals to identify and avoid scams without inciting fear or anxiety; proposing this may be facilitated by drawing on health and safety risk assessment protocol when designing anti-scam interventions. Social implications Individuals who have been victimised by fraudsters may need access to practical and emotional support. This requires the design of appropriate interventions and the stigma associated with being scammed to be addressed.
    • Spontaneous concerns about risk and abuse reported by people with dementia and their carers

      Benbow, Susan M.; Kingston, Paul; University of Chester (Emerald, 2017-04-10)
      Purpose To look at concerns about risk/ abuse expressed spontaneously by people with dementia (PwD) and their carers in narratives describing their journeys with dementia. Method Thirty-five narratives were elicited from PwD, carers of PwD and couples where one partner was living with dementia as part of a study on the impact of producing narratives on PwD and their carers. Participants were found to allude to risk/ abuse, or specifically mention thoughts on risk and abuse in their narratives. A secondary analysis of the theme of risk/ abuse is reported here. Findings Concerns about risk/ exploitation were often expressed in the narratives, and covered a range of areas including driving; safety in the home; safety outdoors; falls; finances; risk to PwD from others; risk to others from PwD; potential or actual police incidents; and neglect. Research limitations The narratives were elicited as part of another project and participants were not asked directly about risk: themes reported here were brought up spontaneously by participants. Practical implications In relation to dementia a wide range of risk/ abuse issues is of concern to PwD and their carers, including driving and financial vulnerabilities. PwD and carers are prepared to talk about risk/ abuse when given an opportunity. It is important to investigate and understand experiences and concerns about risk/ abuse if they are to be addressed in health and social care practice. Originality The narratives offer unique insights into the concerns of PwD and family carers.
    • The Care Act 2014: a new legal framework for safeguarding adults in civil society

      Penhale, Bridget; Brammer, Alison; Morgan, Pete; Kingston, Paul; Preston-Shoot, Michael (Emerald, 2017-08-14)
    • What’s in a name? Family violence involving older adults

      Benbow, Susan M.; Bhattacharyya, Sharmi; Kingston, Paul (Emerald, 2018-12-10)
    • Working through interpreters in old age psychiatry: a literature review

      Farooq, Saeed; Kingston, Paul; Regan, Jemma; University of Chester; Staffordshire University (Emerald, 2015-03-09)
      Purpose – The purpose of this paper is to systematically appraise the effect of use of interpreters for mental health problems in old age. The primary objective of the review is to assess the impact of a language barrier for assessment and management in relation to mental health problems in the old age. The secondary objectives are to assess the effect of the use of interpreters on patient satisfaction and quality of care, identify good practice and make recommendations for research and practice in the old age mental health. Design/methodology/approach – The following data sources were searched for publications between 1966 and 2011: PubMed, PsycINFO, CINAHL and Cochrane Library. The authors found in previous reviews that a substantial number of papers from developing and non-English speaking countries are published in journals not indexed in mainstream databases, and devised a search strategy using Google which identified a number of papers, which could not be found when the search was limited to scientific data bases only (Farooq et al., 2009). The strategy was considered especially important for this review which focuses on communication across many different languages. Thus, the authors conducted a search of the World Wide Web using Google Scholar, employing the search term Medical Interpreters and Mental Health. The search included literature in all languages. The authors also searched the reference lists of included and excluded studies for additional relevant papers. Bibliographies of systematic review articles published in the last five years were also examined to identify pertinent studies. Findings – Only four publications related specifically to “old age” and 33 addressed “interpreting” and “psychiatry” generally. Four articles presented original research (Parnes and Westfall, 2003; Hasset and George, 2002; Sadavoy et al., 2004; Van de Mieroop et al., 2012). One article (Shah, 1997) reports an “anecdotal descriptive account” of interviewing elderly people from ethnic backgrounds in a psychogeriatric service in Melbourne and does not report any data. Therefore, only four papers met the inclusion and exclusion criteria and present original research in the field of “old age”, “psychiatry” and “interpreting”. None of these papers present UK-based research. One is a quantitative study from Australia (Hasset and George, 2002), the second is a qualitative study from Canada (Sadavoy et al., 2004), in the third paper Van de Mieroop et al. (2012) describe community interpreting in a Belgian old home and the final paper is an American case study (Parnes and Westfall, 2003). Practical implications – Interviewing older patients for constructs like cognitive function and decision-making capacity through interpreters can pose significant clinical and legal problems. There is urgent need for training mental health professionals for developing skills to overcome the language barrier and for interpreters to be trained for work in psychogeriatrics. Social implications – The literature on working through interpreters is limited to a few empirical studies. This has serious consequences for service users such as lack of trust in services, clinical errors and neglect of human rights. Further studies are needed to understand the extent of problem and how effective interpreting and translating services can be provided in the routine clinical practice. It is also essential to develop a standard of translation services in mental health that can be measured for their quality and also efficiency. At present such a quality standard is not available in the UK, unlike Sweden (see www.regeringen.se/sb/d/3288/a/19564). This omission is disturbing – especially when decisions on human rights are being considered as part of the Mental Health Act. Such a standard can best be achieved by collaboration between medical profession and linguists’ professional associations (Cambridge et al., 2012). Originality/value – Whilst translation/interpretation has been addressed more generally in mental health: specific considerations related to old age psychiatry are almost absent. This needs urgent rectification given that a large proportion of older people from BME communities will require translation and interpretation services.