Now showing 1 - 7 of 7
  • Publication
    Social Work, Mental Health, Older People and Covid19
    (Cambridge University Press, 2020-05) ; ; ;
    In this commentary, we will explore the work of social work in Ireland in addressing the impact of the Covid-19 crisis on older people in general, and older people who have an enduring mental illness.
    Scopus© Citations 28  405
  • Publication
    “What Bothers Me Most Is the Disparity between the Choices that People Have or Don’t Have”: A Qualitative Study on the Health Systems Responsiveness to Implementing the Assisted Decision-Making (Capacity) Act in Ireland
    Objective: The Assisted Decision-Making (ADM) (Capacity) Act was enacted in 2015 inIreland and will be commenced in 2021. This paper is focused on this pre-implementation stage withinthe acute setting and uses a health systems responsiveness framework. Methods: We conductedface-to-face interviews using a critical incident technique. We interviewed older people includingthose with a diagnosis of dementia (n=8), family carers (n=5) and health and social care professionals(HSCPs) working in the acute setting (n=26). Results: The interviewees reflected upon a healthcaresystem that is currently under significant pressures. HSCPs are doing their best, but they are oftenhalted from delivering on the will and preference of their patients. Many older people and familycarers feel that they must be very assertive to have their preferences considered. All expressedconcern about the strain on the healthcare system. There are significant environmental barriers thatare hindering ADM practice. Conclusions: The commencement of ADM provides an opportunityto redefine the provision, practices, and priorities of healthcare in Ireland to enable improvedpatient-centred care. To facilitate implementation of ADM, it is therefore critical to identify andprovide adequate resources and work towards solutions to ensure a seamless commencement ofthe legislation.>
      285Scopus© Citations 12
  • Publication
    'It Took a Leap of Faith.' Care and Connect: A Model for Practitioner Research in Ireland
     Irish social work has been slow to develop a research culture and professional structure to support research capacity. International literature suggests that one of the major reasons for the lack of research activity amongst social work practitioners is the absence of collaborative links between university based researchers and social work practitioners in the field (March and Fisher 2005; Shaw 2003:2005; Gibbs 2001). In 2006, senior staff from Tallaght Hospital, Dublin and the School of Social Work and Social Policy, Trinity College Dublin, recognised the need for a strategic approach for the promotion of research capacity and activity amongst social work practitioners. This paper discusses an academic/hospital partnership project "Care and Connect", that sought to explore the opportunities for developing practice based research in a health care setting in Dublin.    
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  • 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.
      1514Scopus© Citations 32
  • Publication
    Care Planning Meetings: Issues for Policy, Multi-disciplinary Practice and Patient Participation
    (Taylor & Francis, 2017-10-13) ; ;
    Although Care-Planning Meetings (CPMs) are an increasingly common part of the practice of social work with older people and multi-disciplinary teamwork, it is uncertain how and by whom the voice and wishes of older people, including those with a cognitive impairment, are given due priority. In addition, there is little professional guidance as to how to best plan and facilitate CPMs for older patients with cognitive and communication deficits and other often complex needs. An added challenge is the wide, often diverse and conflicting range of perspectives held by health and social care professionals and other family members who may be involved. This scoping review article on CPMs for older people, considers the facilitators and barriers to effective participation as identified in the literature and proposes suggestions for best practices in CPMs which could help promote an individualised approach to participation that best reflects the older patient’s wishes.
    Scopus© Citations 6  514
  • 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.
    Scopus© Citations 21  481
  • 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.
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