Care for older people in early twenty-first-century Europe: dimensions and directions of change

Kröger, Teppo; Bagnato, Angela

doi:10.4337/9781786432117.00019

Cited by 19 publications

(13 citation statements)

References 17 publications

(23 reference statements)

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“…Caregivers’ contributions were frequently required to facilitate an episode of HAH, and the relational resources of family and social networks acted as a bridge to continuity of healthcare. Close to half of those we interviewed lived alone and received informal care from caregivers living elsewhere, confirming previous research on complex informal care arrangements [ 23 , 24 ]. Caregivers who were able to provide support in older people’s homes valued continuity of the familiar environment and routine, particularly during patients’ experiences of confusion.…”

Section: Discussionsupporting

confidence: 83%

The work of older people and their informal caregivers in managing an acute health event in a hospital at home or hospital inpatient setting

et al. 2020

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Background There is limited understanding of the contribution made by older people and their caregivers to acute healthcare in the home and how this compares to hospital inpatient healthcare. Objectives To explore the work of older people and caregivers at the time of an acute health event, the interface with professionals in a hospital and hospital at home (HAH) and how their experiences relate to the principles underpinning comprehensive geriatric assessment (CGA). Design A qualitative interview study within a UK multi-site participant randomised trial of geriatrician-led admission avoidance HAH, compared with hospital inpatient care. Methods We conducted semi-structured interviews with 34 older people (15 had received HAH and 19 hospital care) alone or alongside caregivers (29 caregivers; 12 HAH, 17 hospital care), in three sites that recruited participants to a randomised trial, during 2017–2018. We used normalisation process theory to guide our analysis and interpretation of the data. Results Patients and caregivers described efforts to understand changes in health, interpret assessments and mitigate a lack of involvement in decisions. Practical work included managing risks, mobilising resources to meet health-related needs, and integrating the acute episode into longer-term strategies. Personal, relational and environmental factors facilitated or challenged adaptive capacity and ability to manage. Conclusions Patients and caregivers contributed to acute healthcare in both locations, often in parallel to healthcare providers. Our findings highlight an opportunity for CGA-guided services at the interface of acute and chronic condition management to facilitate personal, social and service strategies extending beyond an acute episode of healthcare.

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Section: Discussionsupporting

confidence: 83%

The work of older people and their informal caregivers in managing an acute health event in a hospital at home or hospital inpatient setting

et al. 2020

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“…Ageing in place also reflects the preferences of older adults to live at home for as long as possible (Stones & Gullifer, ), even up to the stage when they become frail and need additional care and support (Löfqvist et al, ). A variety of formal (home) care services are provided, and informal caregivers are encouraged to support frail, older adults (Kröger & Bagnato, ). However, as a consequence of budgetary cuts in institutional care and home care services, informal caregivers are compelled to increasingly take responsibility for the care of their loved ones (Kröger & Bagnato, ).…”

Section: Introductionmentioning

confidence: 99%

“…A variety of formal (home) care services are provided, and informal caregivers are encouraged to support frail, older adults (Kröger & Bagnato, ). However, as a consequence of budgetary cuts in institutional care and home care services, informal caregivers are compelled to increasingly take responsibility for the care of their loved ones (Kröger & Bagnato, ). Amongst others, the Flemish informal care plan stimulates older adults to access their social network before using formal home care services (Vandeurzen, ).…”

Section: Introductionmentioning

confidence: 99%

Relational aspects of mastery for frail, older adults: The role of informal caregivers in the care process

Lambotte

Kardol

Schoenmakers

et al. 2018

Health Soc Care Community

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Frail, older care recipients are often thought of as individuals with a decreased mastery of everyday life skills. Various authors have proposed to acknowledge a relational dimension of mastery, defined as the ability to maintain control over one's life with the help of others. This study explores how frail, older adults experience relational aspects of mastery and the role of their informal caregivers in maintaining these aspects of mastery over the care process. Qualitative interviews (N = 121) were conducted in 2016 with potentially frail, community‐dwelling older adults participating in the Detection, Support and Care for Older people: Prevention and Empowerment (D‐SCOPE) project. A secondary analysis of 65 interviews reveals that, according to frail, older adults, informal caregivers contribute in various ways to the preservation of their mastery. This differs across the four elements of care: caring about (attentiveness), taking care of (responsibility), care‐giving (competence), and care‐receiving (responsiveness). However, in some cases, older adults experienced a loss of mastery; for example, when informal caregivers did not understand their care needs and did not involve them in the decision, organisation, and provision of care. A relational dimension of mastery needs to be acknowledged in frail, older care recipients since stimulating mastery is a crucial element for realising community care objectives and person‐centred and integrated care.

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“…En primer lugar, la precariedad previa del sistema. El retroceso de los Estados de bienestar europeos desde el neoliberalismo de los años ochenta y la crisis de 2008 (Anttonen & Meagher, 2013;Kröger En segundo lugar, el hecho que las personas mayores ingresadas en centros residenciales son especialmente vulnerables para poder contraer enfermedades. La fragilidad de los propios enfermos con necesidades de cuidados y la incapacidad para poder seguir autónomamente medidas de higiene personal (Care et al, 2020), lo que se ve doblemente agravado en el caso de las personas con demencia quienes requieren un incremento de recursos para ser atendidos (Wang et al, 2020).…”

Section: La Crisis De Los Centros Residenciales En Españaunclassified

COVID-19 and care homes and nursing homes crisis in Spain: ageism and scarcity of resources

Deusdad

2020

RASP

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The European Welfare State crisis since 2008 has shown the weakness of these European welfare systems to cope with a health crisis such as COVID-19, which in turn has not guaranteed the rights and wellbeing of older people. This article aims at shading light on the scarcity of resources in Spanish care homes and nursing homes system, while analyzing its integrated care failure and the urgent legislative measures implemented to overcome COVID-19 health crisis. At the same time, this paper advocates for a reflexion on ageist practices, so as to foster a debate on the ‘desisntitucionalization’ process of older adults in Spain. In this COVID-19 context, it has become utmost in implementing an older adults’ policy to guarantee older adults rights as vulnerable population; likewise, which has already been done in respect to laws protecting children rights.

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Care for older people in early twenty-first-century Europe: dimensions and directions of change

Cited by 19 publications

References 17 publications

The work of older people and their informal caregivers in managing an acute health event in a hospital at home or hospital inpatient setting

The work of older people and their informal caregivers in managing an acute health event in a hospital at home or hospital inpatient setting

Relational aspects of mastery for frail, older adults: The role of informal caregivers in the care process

COVID-19 and care homes and nursing homes crisis in Spain: ageism and scarcity of resources

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