Browsing Health and Social Care by Journal
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The neoliberal university, social work and personalised care for older adultsThis article critically examines the impact of the neoliberal university upon social work education and practice relating to older people. It appraises market-led pedagogical reforms, including of the training of social workers who go on to work with older adults, such in support of policies including personalisation. Influence is drawn from the work of Nancy Fraser (2019): specifically, her understanding of ‘progressive neoliberalism’, or the improbable fusion of free market ideals with the politics of recognition to create a rejuvenated hegemonic bloc. This theoretical framework is utilized to analyse the prevalence of emancipatory constructs such as empowerment, participation, anti-oppression, equality, choice and independence within acutely underfunded, bureaucratic, and risk-averse fields of social care and social work. While benefiting some older ‘service users’, it is argued that personalisation policy regularly disadvantages or excludes older people within fragmented adult social care sectors. Progressive neoliberalism has helped to promote policies which envisage participative self-care whilst more often excluding or objectifying older adults, especially those with higher level needs.
Older adults and violence: An analysis of domestic homicide reviews in England involving adults over 60 years of ageDomestic Homicide Reviews (DHRs) are conducted when an individual aged 16 or over appears to have died from violence, abuse or neglect by a person to whom they are related or with whom they are in an intimate relationship or who is a member of the same household. DHRs aim to identify lessons to be learned, to improve service responses to domestic abuse, and to contribute to prevention of domestic abuse/ homicide. We submitted freedom of information requests to English Local Authorities to identify DHRs where victim, perpetrator, or both were aged over 60. Collected Reports and/ or Executive Summaries were thematically analysed. Analysis identified four key themes in the context of the key relationship and caring: major mental illness of the perpetrator; drug and/or alcohol abuse; financial issues; and a history of domestic abuse in key or family relationships. We analysed 14 adult family homicides, 16 intimate partner homicides, and five homicide-suicides. Age per se did not emerge as a significant factor in our analysis. Terminology needs to be standardised, and training/ education regarding risk assessment improved in relation to age, myths around ageing/ dementia, and stresses of caring. Management of mental illness is a key factor. A central repository of DHR Reports accessible for research and subject to regular review would contribute to maximising learning and improving practice.
Some limits and political implications of participation within health and social care for older adultsThis paper critically examines service user participation and involvement for older adults. It concentrates upon research and community-led engagement for older people, and maintains that despite extensive support and expansion, participation offers a complex form of governance and ideological control, as well as a means by which local governments and some welfare professions seek to legitimise or extend their activities. Some of the paradoxes of participation are discussed, including tensions that persist between rhetorical claims of empowerment, active citizenship and democratic engagement on one hand, despite tendencies towards risk-aversion, welfare retrenchment and participant ambivalence on the other. The paper also highlights practical problems in relation to participative research and community involvement, and questions arguments that participation may challenge the authority of welfare professionals. Critical theory is drawn upon to contextualise the role of participative narratives within wider welfare, including its role in moving debate away from ownership or redistribution while masking and validating policy related goals which can counter many older people’s needs. Tension is also noted between participation projects represented as resource to support ageing identities as opposed to those representing technologies for social regulation and conformity.