168 research outputs found
Supplementaries – Supplemental material for Reducing time in acute hospitals: A stepped-wedge randomised control trial of a specialist palliative care intervention in residential care homes
No full textSupplemental material, Supplementaries for Reducing time in acute hospitals: A stepped-wedge randomised control trial of a specialist palliative care intervention in residential care homes by Liz Forbat, Wai-Man Liu, Jane Koerner, Lawrence Lam, Juliane Samara, Michael Chapman and Nikki Johnston in Palliative Medicine</p
What can systemic psychotherapy offer clinical practice and public debates on assisted dying?: Assisted dying and systemic psychotherapy
No full textDebates around assisted dying have not to date been informed by family and systemic psychotherapy. This article sets the context of legalized assisted dying with a précis of the international terrain. Case examples of people facing terminal or chronic illness are presented alongside the research literature, to illustrate the bio‐psycho‐social domains inhabited by those seeking assisted dying. The article then presents a case for what systemic psychotherapy has to offer, suggesting a range of approaches, methods and techniques. Following core tenets of systemic psychotherapy, the article is not predicated on an either/or standpoint. Rather, neutrality and curiosity are centralized, to facilitate discussion, debate and new insights. The article concludes that systemic psychotherapists have a latent and untapped skill‐set in understanding the repercussions of someone who wants assisted dying. The profession can usefully contribute to and explicate understandings regarding the wider systemic reverberations of one person's desire to end their life, including the impact on family, clinicians and communities. Further, systemic practitioners can draw on specific family therapy theories and methods in order to both contribute to public debates, and to be key members of a multidisciplinary team providing direct support for families affected by assisted dying
Strengthening the position of family therapy and systemic practice through methodology
No full textFirst paragraph: There is little doubt that there is a fit at method, theory and epistemological levels between constructionist/constructivist therapy and research. Qualitative research has a resonance with systemic practitioners with a desire to see/hear the voices of participants, in a way that is isomorphic with the therapeutic endeavour. A recent paper has begun to tease out some of the important convergences between qualitative research and family therapy (De Haene, 2010). In this paper the author focuses on dialogical methods from the qualitative stable, suggesting an essential joining of therapy and research. Through an argument based around constructivism she suggests that language-based research is itself interventive, and thereby concludes that "the division between research and therapy no longer stands" (p. 9)
Valuing People: Hopes and dreams for the future
No full textThis paper outlines the views of key policy makers, implementers and practitioners on Valuing People (Department of Health, Valuing people. A new strategy for learning disability for the 21st century, The Stationary Office, London, 2001). It reports a series of interviews conducted in 2003/2004 with a diverse selection of people involved in English policy construction and implementation around the support needs of people with a learning disability and/or around older people and dementia. Interviewees talked about what they perceived to be the strengths and weaknesses of policies for this client group, which led to thinking particularly about the gaps in provision for people with a learning disability as they age. The findings discussed here introduce interviewees' reported hopes and dreams for social policy in 10 years' time. The interviewees highlighted satisfaction and dissatisfaction in the connections between policy and practice. Areas for policy development and, crucially, ways of improving provision to people with a learning disability who develop dementia are highlighted
Relationship Difficulties in Dementia Care: A discursive analysis of two women's accounts
No full textThis article reports on a small-scale study where people giving and receiving care were invited to talk about their relationship. It draws on one care dyad of a woman (who has a diagnosis of dementia) and her daughter (who has provided care for her mother). A short series of interviews was conducted with both women, focusing on their biographies and current relationship. This article reports the account given by the mother and how this intersects with the account given by the daughter. The discursive analysis presented centralizes a concern with attending to the accounts of people with dementia. Analysis of the talk of people with dementia can make a valuable contribution to understanding care relationships. Such analysis has the potential for shedding light on difficulties in care relationships. The article ends by outlining some salient issues for professionals and family members involved in dementia care
The ripple effect in community nursing
No full textCarers have long been a focus of health and social care policy and practice, with a clear marker being set down in the 1995 Carers (recognition and services) Act (Department of Health (DH), 1995). Since that time, a range of other policies have encouraged practitioners to consider not just the patient, but also the person providing unpaid care for them, often highlighting the cost savings to governments in the informal provision of care. Such caregiving is provided in the context of a wide range of illnesses, such as progressive and degenerative conditions like dementia, acute onset such as stroke or relapsing/remitting disease such as multiple sclerosis
Attitudes toward assisted-death services, perceived supporting norms, and emotional distress
No full textThis paper summarises three studies examining the association between (un)favourable attitudes toward assisted-death services and emotional distress in contexts where the service is proposed, as well as the moderating role of norms supporting assisted-death services. In three studies, the participants (i.e., community members, veterinarians, and health practitioner students) reported their level of distress after exposure to scenarios of assisted-dying that are relevant to their respective contexts. We found that supportive norms (i.e., perception that referent group support the action) could reduce emotional distress from considering assisted-death contexts. In addition, in two studies, supportive norms were also found to strengthen the impact of attitudes, such that unfavourable attitudes toward assisted-death services were associated with emotional distress more strongly when norms supported the practice. We conceptualize assisted-death distress as a possible indicator of practitioner well-being risk, as well as a marker of practitioner and community acceptance of (or resistance to) the behaviour. https://mc.manuscriptcentral.com/omega OMEGA-Journal of Death and DyingOutput Status: Forthcomin
Concepts and understandings of dementia by 'gatekeepers' and minority ethnic 'service users'
No full textIn this article I outline research which seeks to explore the intersections of dementia, ethnicity and family care. My focus is how research that aims to focus on dementia care and ethnicity illuminates the experiences of members of minoritized ethnic groups in accessing statutory services. I reflect on how the intersections of racialized identities and western medical terminology make researching and providing services across racialized boundaries and health/illness a complex procedure. This commentary has direct implications for the care of people with dementia, their family members and for service development within health and social care fields
The Care and Abuse of Minoritized Ethnic Groups: The Role of Statutory Services
No full textAbuse in care relationships is an increasing concern in social policy and service provision. Attention has been drawn to the abuse of cared-for people in their own homes, the abuse of carers by family members and the abuse of people in institutional settings. Drawing on qualitative research with carers/carees from South Asian and African-Caribbean backgrounds, this paper explores a different conceptualization of abuse which moves away from an interpersonal understanding, to one that recognizes structural inequalities as a form of ‘institutional’ abuse of carers and those who receive care. This reconceptualization of abuse gives particular attention to forms of racism and discrimination in the provision of services to minoritized carers/cared-for people. It therefore makes significant contributions to discussions of caring and race equality in the health and social care fields
'Tinged with bitterness': Re-presenting stress in family care
No full textThe provision of care within families, and specifically the difficulties within such relationships, has become the focus of much research, legislation and debate in recent years. This paper explores carers' and carees' talk about 'stress', home-based care, and comments on how such talk is reflected in UK social policy. Carers' and carees' accounts are presented to theorise the construction of difficulties in the present relationship --focusing in particular on the taking up of or resistance to roles and responsibilities within the family. The way in which competing discourses and discursive strategies are deployed to achieve certain effects within the family, social services and other support agencies is also explored. Family care is re-presented with a focus on language, and a reflection on how such relationships can become tinged with bitterness
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