Highlights Older carers’ experiences are not dissimilar to those of other adult carers. These experiences may be particularly challenging due to their age. Loneliness both outside and within relationships is common. Older carers worry about the future when they cannot care. Older carers often fail to ask for support.

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Four women whose husbands had aphasia were asked to talk about their lives in several indepth interviews. Themes from their accounts were used to plan, deliver, and evaluate a support course. Themes from their initial interviews were used to create a course plan containing skill training, provision of information, and discussion topics. Themes emerging from their reports during course discussions provided a means for participants to explore and problem-solve their current issues. Evaluation of the course was based on themes drawn from two post-course interviews. Findings suggest that (1) aphasia affected these four participants differently, (2) themes from autobiographical reports were useful in planning content of a course to assure its relevance, (3) issues raised by participants during the course served to assure course relevance in its delivery, and (4) autobiographical descriptions offered a way of discovering whether and how the course experience had an ongoing impact on the lives of the participants. It is concluded that the collection and analysis of autobiographical reports provide an effective way to design, deliver and evaluate learning in a support course for partners of those with aphasia.

Purpose: Very little is known about how older people from black and minority ethnic (BME) groups caring for someone after a stroke access and engage with social care services. This paper explores both the experiences of carers whose relative was receiving social care services in their own home and the value of a theory of humanising care to understand and explain these experiences. Method Conclusions:Carers from BME and White British groups share many experiences of homecare although language and cultural difference may exacerbate common pressures and stresses. The framework for humanising care is a useful tool to evaluate aspects of home care that are responsive to dignity and diversity.

Purpose: Using a theory-led action research process test applicability of humanizing care theory to better understand what matters to people and assess how the process can improve human dimensions of health care services. Consideration of the value of this process to guide enhancements in humanly sensitive care and investigate transferable benefits of the participatory strategy for improving human dimensions of health care services. Methods: Action research with service users, practitioners and academics, with participatory processes led through the application of theory via a novel Humanizing Care Framework in two diverse clinical settings. Results: Participants engaged in a theory-led participatory process, understood and valued the framework seeing how it relates to own experiences. Comparative analysis of settings identified transferable processes with potential to enhance human dimensions of care more generally. We offer transferable strategy with contextualized practical details of humanizing processes and outcomes that can contribute to portable pathways to enhance dignity in care through application of humanizing care theory in practice. Conclusion: The theoretical framework is a feasible and effective guide to enhance human dimensions of care. Our rigorous participative process facilitates sharing of patient and staff experience, sensitizing practitioners' understandings and helping develop new ways of providing theoretically robust person-centred care based on lifeworld approaches.

The effect of restructuring of healthcare on the quality, quantity, and nature of aphasia management is largely unknown. The current study is the first to examine access, diagnostic, treatment, and discharge patterns of patients with aphasia in Australia, Canada, the UK, the US private sector (US-Private), and the US Veterans Health Administration in the Department of Veterans Affairs (US-VA). The authors developed a 37-item survey to be completed by clinicians working with aphasic patients. The survey focused on eight areas: access to care, evaluation procedures, group treatment, number and duration of treatment sessions, limitations of the number of sessions, termination of treatment, follow-up practices, and resumption of treatment. 394 surveys were distributed and 175 were returned completed (44% return rate). Respondents represented a range of ages, work experiences, and work settings. There was considerable consistency among respondents from our five healthcare systems. Results suggest that patients may be routinely denied treatment in direct contradiction to the research literature. Just as we carefully monitor the progress of patients receiving our treatment, we are obliged to monitor the effects of managed care on our patients, fellow clinicians, and our profession.

Highlights This paper adds to what is known about the support needs of older carers. Older carers’ experiences may be particularly challenging. These carers’ ambivalence about requesting support may compound their difficulties. Loneliness and anxiety about their loved ones’ future care were highlighted. Their specific support needs require recognition by those working with older carers.