Now showing 1 - 10 of 16
  • Publication
    Adult Safeguarding Legislation and Policy Rapid Realist Literature Review
    The investigation of, and intervention into the alleged abuse of older people has become a dominant feature of social work in Ireland. The international definition of elder mistreatment adopted in most western countries including Ireland, is: ‘Elder abuse is a single or repeated act or lack of appropriate action occurring within any relationship where there is an expectation of trust which causes harm to an older person’ (WHO, 2008; WHO/INPEA, 2002). Operationalising this abstract definition is to describe types or categories of abuse that older people can be subjected to - physical, sexual, psychological, financial and neglect. Although valuable, the limitations of these narrow and mutually exclusive categories are increasingly recognised (Anand et al., 2013; O’Brien et al., 2011; Naughton et al., 2012). There is a major lack of understanding of the voice and experiences of older people in relation to abuse (Anand et al., 2013; Charpentier and Souliéres, 2013; WHO, 2002b). Irish research has demonstrated that older people conceptualise elder abuse as the loss of voice and agency, diminishing status in society, violation of rights and wider societal influences that undermine a sense of individualism and ‘personhood’ (O’Brien et al., 2011; Naughton et al., 2013).
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  • Publication
    Speaking Up About Adult Harm: Options for Policy and Practice in the Irish Context
    (University College Dublin, 2018-03) ;
    Current mechanisms for responding to the prevention and the protection of adults at risk of abuse in Ireland can be described as ad hoc and reactionary. For example, media reports exposing cases of abuse and neglect, such as Leas Cross and Áras Attracta, have resulted in the introduction of new safeguarding policies and inspection regulations. Whilst the current measures in place to identify and prevent harm and potential harm to adults at risk offer some protection, it is evident that deeply embedded resistance to cultural change within institutions and organisations demand that safeguarding procedures need to be placed on a statutory basis to ensure the safeguarding process is applied in a consistent and effective way.
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  • Publication
    Ethics and Ethical Decision-Making in Adult Safeguarding Practice
    (2019-10-15)
    Invited Keynote presentation to HSE National Safeguarding Office Annual Learning Forum.
      357
  • Publication
    'I'd prefer to stay at home but I don't have a choice': Meeting Older People's Preference for Care: Policy, but what about practice?
    (University College Dublin. School of Social Policy, Social Work and Social Justice, 2016-06-03) ; ; ;
    Background: Research indicates that most older people would prefer to live in their own homes and have support services provided to enable them to do so for as long as possible (Barry, 2010). However, there is an evident tension between this objective and the promotion of 'ageing in place', with the consequent heavy reliance on the Nursing Home Support Scheme (NHSS) in the Irish context (Donnelly and O¿Loughlin, 2015). This study set out to explore the perspectives and experiences of social workers in Republic of Ireland working with older people to identify issues/barriers in accessing community supports and to examine older people's involvement in decision-making, including those with a cognitive impairment/dementia. Methods: A mixed methods study design was adapted and the study consisted of two phases: Phase 1 consisted of an on-line survey of social workers using Survey Monkey. Phase 2 consisted of in-depth semi-structured telephone interviews with at least two social workers from each Community Health Office area. Results: Geographical inconsistencies were revealed in social workers ability to access community supports and clear tensions were found as home supports are only delivered within the framework of what is available. A growing emphasis on responding only to those with the most severe level of need, coupled with increased budgetary constraints, means that little or no support can be accessed through home help services to assist older people with domestic tasks.Social workers also reported that many older people with a mental health issue and/or dementia were excluded from decision-making processes related to their care. Conclusions: Older people's preference for receiving care and support in their home and community is not being realised often resulting in unnecessary or premature admission to nursing home care.
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  • Publication
    Submission to Oireachtas Special Committee on Covid-19 Response: Nursing Homes and Other Institutional Care Settings: A Framework for Examining the State's Response to the Covid-19 Pandemic
    We write to propose a human rights-based framework for the examination of the State’s response to the COVID-19 pandemic as it has concerned and continues to concern people in nursing homes and other institutional (or, ‘congregated’) care settings.
      232
  • Publication
    Multiprofessional Views on Older Patients’ Participation in Care Planning Meetings in a Hospital Context
    Care planning meetings (CPMs; sometimes referred to as family meetings) for older patients involve group decision-making between the multidisciplinary team, the older person and their family. However, service user participation is challenged by the inequity of knowledge and power between participants, together with organisational and resource pressures for timely discharge. The effective use and perhaps, potential misuse of communication strategies within CPMs is of ethical concern to all participants. Habermas' essential critique of participatory communication provides insight as to how older people's involvement can be either enabled or blocked by healthcare professionals (HCPs) depending on their use of communication strategies. Seven discipline specific mini-focus groups provided an opportunity for HCPs to reflect on the participation of patients over 65 and their families in CPMs. Findings explore HCPs' understanding of older patients involvement based on key dimensions of communicative participation, namely, mutuality, inclusiveness, patient centredness and clear outcomes. Whilst the benefits of collaborative decision-making were confirmed, legitimate concerns as to the quality of participatory practices, limited attention to group work processes and the exclusion of older patients with cognitive impairment were identified.
      356Scopus© Citations 17
  • Publication
    How are people with dementia involved in care-planning and decision-making? An Irish social work perspective
    In recent years, there have been national and international policy advances around capacity and decision-making and an apparent burgeoning rights-based approach to the issue, all of which have the potential to impact on the experience for people with dementia in Ireland. There is little evidence however on whether these policies and principles are being translated into practice and whether traditional paternalistic approaches to decision-making are being challenged. To gain insight into current practice, research was undertaken with social workers working with older people in Ireland; reporting on the involvement of people living with dementia in care-planning processes. Data collection included a mixed method approach; an on-line survey of social workers from across the country who reported on their open caseload during the month of June 2015 (N = 38 social workers reporting on the experiences of 788 older people, of which 39% of older people had a formal diagnosis of dementia). In addition, semi-structured telephone interviews were conducted with social workers working in the nine Community Health Organisation areas (N = 21). Findings show that people with dementia were high users of social work services, accounting for 44.5% of the client group. Social workers reported that there were no standardised approaches to how Health and Social Care Professionals involved people with dementia in care planning and decision-making. Overall, people with dementia were more likely to be excluded from decision-making processes due to (i) assumptions that they lacked capacity, (ii) family members preferences that the person was not involved, (iii) communication difficulties, (iv) time constraints, (v) little or no opportunity given or (vi) the person delegated decision-making to others. Good practices were identified through multidisciplinary team approaches and formal care planning meetings. This research highlights variability in how people with dementia participate in decision-making around their care. It sheds light on existing barriers which challenge the full implementation of the Irish Assisted Decision-Making legislation; highlighting the need for appropriate guidance and education for Health and Social Care Professionals. The findings also show that family dynamics and existing relationships can play a role in how people with dementia participate and are involved. To ensure consistent opportunities for participation, effective practices and approaches to supporting the participation of people living with dementia in care planning needs to be developed and rolled out in all care settings through increased training and adoption of standardised approaches.
      1211Scopus© Citations 29
  • Publication
    Age Related Inequalities and Covid19
    (2020-09-23)
    Invited speaker to Social Work in the Community first webinar on Covid and Inequality, Collaboration between Department of Health(NI) and University of Ulster.
      44
  • Publication
    Survey of Bereaved Relatives:Voices MaJam
    (Mater Misericordiae University Hospital and St. James's Hospital, UCD and TCD., 2017-06) ; ; ; ;
    End-of-life care is an experience that touches the lives of everyone on a personal or professional level. Of all people that will die in Ireland this year, 43% will die in adult acute hospital settings. Acute hospitals are busy places with a predominant focus on diagnosis, treatment and cure. However, caring for people who are seriously ill is also an important responsibility. The Mater Misericordiae University Hospital and St. James’s Hospital are striving to ensure that people who are diagnosed with a life-limiting illness or who die in our care, experience a place of sanctuary where they are cared for in comfort and dignity and their families are supported in their bereavement. The Mater Misericordiae University Hospital and St. James’s Hospital have targeted end- of-life care as an area for improving the quality of care for patients and their families. To enable this, both hospitals have actively sought to improve end-of-life care through their active participation in the Hospice Friendly Hospitals Programme, an initiative of the Irish Hospice Foundation. Measuring the quality of care provided is recognised as being fundamental to quality assurance and provides information to further enhance patient and family care. This study sought to ascertain the quality of care provided to patients and their families during their last admission to hospital from the perspective of bereaved relatives.
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  • Publication
    What are the mechanisms that enable the reciprocal involvement of seldom heard groups in health and social care research? A rapid realist review protocol
    Background: The University College Dublin (UCD) PPI Ignite Connect Network will fundamentally embed public and patient involvement (PPI) in health-related research, education and training, professional practice and administration in UCD’s institutional structures and procedures. A significant focus of the programme of work is on actively engaging and developing long-term reciprocal relationships with seldom heard groups, via our ten inaugural partners. Methods: This rapid realist review will explore what are the mechanisms that are important in actively engaging seldom heard groups in health and social care research. The review process will follow five iterative steps: (1) clarify scope, (2) search for evidence, (3) appraise primary studies and extract data, (4) synthesise evidence and draw conclusions, and (5) disseminate findings. The reviewers will consult with expert and reference panels to focus the review, provide local contextual insights and develop a programme theory consisting of context–mechanism–outcome configurations. The expert panel will oversee the review process and agree, via consensus, the final programme theory. Review findings will follow the adopted RAMESES guideline and will be disseminated via a report, presentations and peer-reviewed publication. Discussion: The review will update and consolidate evidence on the mechanisms that enable the reciprocal engagement and participation of ‘seldom heard’ groups in health and social care research. Via the expert and reference process, we will draw from a sizeable body of published and unpublished research and grey literature. The local contextual insights provided will aid the development of our programme theories. This new evidence will inform the design and development of the UCD PPI Ignite program focused on ensuring sustained reciprocal partnerships.
      387