Now showing 1 - 6 of 6
  • 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.
      1815
  • 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.
      1072
  • 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.
      1553Scopus© Citations 33
  • Publication
    Understanding Carer Harm
    (University College Dublin and Family Carers Ireland, 2023-03-28) ;
    The global challenge of ageing populations and increasing numbers of people requiring care mean that by 2030, one in five Irish people will be a family caregiver (Family Carers Ireland, College of Psychiatrists of Ireland & UCD, 2019). Family Carers Ireland (FCI) research carried out in 2019 surveyed 1,102 family carers, 90% of whom were female. Almost half (44%) of carers reported that they regularly experienced either physical aggression or verbal/emotional abuse as part of their caring role. The study findings also suggested specific challenges for family carers of people living with dementia (PLWD) and autistic children/adults.
      308
  • 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).
      1777
  • Publication
    Falling Through the Cracks: The case for change. Key developments and next steps for Adult Safeguarding in Ireland
    (University College Dublin, 2019-12-11) ;
    Adults are at risk of and experiencing harm and abuse all over Ireland, and for a variety of reasons including psychological, physical and financial abuse. According to a report commissioned by the Banking & Payments Federation Ireland (BPFI), entitled ‘Financial Abuse in Ireland, 2019’, 20% of adults have experienced financial abuse and physical abuse of vulnerable adults has been witnessed/suspected by 1 in 3 adults. Last year there were 11,780 safeguarding concerns received by HSE Safeguarding and Protection Teams across Ireland according to the National Safeguarding Office Annual Report. This study sets out to explore how the absence of Adult Safeguarding legislation in the Irish context may be impacting on adults within the current safeguarding system from the perspective of social work practitioners, professionals or advocates who are working with them. The study seeks to shed light on how practitioners are navigating cases in the absence of primary legislation and to explore what benefits or challenges there might be should Adult Safeguarding legislation be fully enacted in the Irish context.
      1281