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Social Work, Mental Health, Older People and Covid19

2020-05, Brennan, John, Reilly, Patrice, Cuskelly, Kerry, Donnelly, Sarah

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.

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Age Related Inequalities and Covid19

2020-09-23, Donnelly, Sarah

Invited speaker to Social Work in the Community first webinar on Covid and Inequality, Collaboration between Department of Health(NI) and University of Ulster.

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Care Planning Meetings with Older People: Issues for Policy, Social Work Practice and Patient Participation Symposium on Decision-Making Practices in Gerontological Social Work ESWRA 2019, Leuven

2019-04-11, Donnelly, Sarah

In recent years there have been national and international policy advances around capacity and decision-making and an apparent burgeoning human rights-based approach to the issue all of which have the potential to impact on the experiences of older people. There is little evidence however on whether these policies and principles are being translated into gerontological social work practice and whether traditional paternalistic approaches to decision-making are being challenged within our professional social justice remit. Although Care-Planning Meetings (CPMs) are an increasingly common part of gerontological social work within multidisciplinary teams (MDTs), 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 on 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 in the decision-making process. The purpose of this presentation is to draw on best practices within the research literature as well empirical research on CPMs with older people carried out in the Irish context. This research highlights considerable variability in how older people participate and are involved in decision-making around their care. The findings show that family dynamics and existing relationships can also play a role in how older people participate and are involved. The facilitators and barriers to effective participation and decision-making for older people are considered and best practice guidelines for social workers in CPMs will be discussed which could help promote an individualised approach to participation that best reflects the older person’s will and preferences.

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'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?

2016-06-03, Donnelly, Sarah, O'Brien, Marita, Begley, Emer, Brennan, John

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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Care Planning Meetings: Issues for Policy, Multi-disciplinary Practice and Patient Participation

2017-10-13, Donnelly, Sarah, Cahill, Suzanne, O Neill, Desmond

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.