Health, well-being and older people , livre ebook

icon

209

pages

icon

English

icon

Ebooks

2004

Écrit par

Publié par

Lire un extrait
Lire un extrait

Obtenez un accès à la bibliothèque pour le consulter en ligne En savoir plus

Découvre YouScribe en t'inscrivant gratuitement

Je m'inscris

Découvre YouScribe en t'inscrivant gratuitement

Je m'inscris
icon

209

pages

icon

English

icon

Ebook

2004

Lire un extrait
Lire un extrait

Obtenez un accès à la bibliothèque pour le consulter en ligne En savoir plus

In an ageing society, the health and well-being of older people has become a primary focus of concern for government, policy makers and practitioners. With moves towards greater integration of health and social care services, there is a need for improved understanding of the importance and benefits of a person-centred, holistic approach to work in these fields. This accessible text, the produce of a collaborative venture between older people's groups and academics, provides students, academics and practitioners across a wide range of health and social care professions, including, nursing, social work, social care and gerontology, with a guide to understanding the value of this approach.
Voir icon arrow

Publié par

Date de parution

31 mars 2004

Nombre de lectures

0

EAN13

9781447342397

Langue

English

Poids de l'ouvrage

8 Mo

HEALTH,฀WELL-BEING AND฀OLDER฀PEOPLE
Jan฀Reed,฀David฀Stanley฀and฀Charlotte฀Clarke
HEALTH,WELL-BEING AND OLDER PEOPLE
Jan Reed, David Stanley and Charl
otte Clarke
First published in Great Britain in March 2004 by Policy Press University of Bristol 1-9 Old Park Hill Bristol BS2 8BB UK t: +44 (0)117 954 5940 e: pp-info@bristol.ac.uk www.policypress.co.uk
North American office: Policy Press c/o The University of Chicago Press 1427 East 60th Street Chicago, IL 60637, USA t: +1 773 702 7700 f: +1 773-702-9756 e:sales@press.uchicago.edu www.press.uchicago.edu
© Jan Reed, David Stanley and Charlotte Clark 2004 Index © Jane Horton 2004 Transferred to Digital Print 2010 British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library. Library of Congress Cataloging-in-Publication Data A catalog record for this book has been requested.
ISBN 978 14473 4239 7 EPDF
Jan ReedandDavid Stanleyare Directors of the Centre for Care of Older People, Northumbria University.Charlotte Clarkeis Professor of Nursing Practice Development Research, School of Health, Community and Education Studies, Northumbria University. Glenda Cook, author of Chapter Eight, is a Senior Lecturer in the School of Health, Community and Education Studies, Northumbria University.
The right ofJan Reed,David StanleyandCharlotte Clarketo be identified as autho s of this work has been asserted by them in accordance with the 1988 Copyright, Designs and Patents Act.
All rights reserved: no part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise without the prior permission of The Policy Press.
The statements and opinions contained within this publication are solely those of the authors and not of The University of Bristol or The Policy Press. The University of Bristol and The Policy Press disclaim responsibility for any injury to persons or property resulting from any material published in this publication. The Policy Press works to counter discrimination on grounds of gender, race, disability, age and sexuality. Cover design by Qube Design Associates, Bristol. Front cover:photograph supplied by kind permission of Martin Parr at Magnum.
Fôéwô Açôwégéméŝ
Contents
Iôuçîô:The knowledge basis for working with older people EVîéçébàŝépàçîçé:éméàŝuéàmàôf pôféŝŝîôàpàçîçé Kôwégéôpîçŝ Lôçuŝôféxpéîŝé Kôwégéçàîŝ Wééôépéôpé’ŝôwégéfîŝîîŝbôô côçuŝîô
one
two
three
Ideas and models of growing older Iôuçîô Téôîéŝôfàgéîg Pôîçîmpîçàîôŝ Téŝôçîàpôbémôfôépéôpé côçuŝîô
Attitudes and images Iôuçîô Agéîŝmàŝééôpéŝôfôépéôpé cuuààŝôçîéàfàçôŝàŝàpéVîéwŝàéxpéçàîôŝôf ôépéôpé Oéàgéŝééôpéŝàçîgàôgŝîéôéŝééôpéŝôfgéé éîçîçàŝŝàŝéxuàîOépéôpé’ŝéxpéîéçéŝôfàgéîŝm Expôîgàgéîŝmààîuéŝ Empôwémé Impîçàîôŝfôçàgé
The body growing older Iôuçîô Bîôméîçàmôéŝôfpŝîçààgéîgpôçéŝŝéŝ Iîŝîçàgéîgéôîéŝ Exîŝîçàgéîgéôîéŝ îŝpôŝàbéŝômàéô LôgéVîàéàîôéàgé séfàŝŝéŝŝééà Mààgîgàéŝpôîgôîéà
3
9
1
6 7 7
12
15 15 18 20 22 26
31 31 33 35
36
37 39 42 42
47 47 49 51 52 53 53 55 56
îîî
Health, wellbeing and older people
four
five
six
seven
eight
îV
Oépéôpé’ŝVîéwŝôféà Impîçàîôŝfôquàîôfîféàŝuççéŝŝfuàgéîg côçuŝîô
The lived environment Iôuçîô Hôuŝîg TéçômmuîéVîômé pééŝîàŝààŝpô côçuŝîô
Memory: self, relationship and society Iôuçîô côgîîôéméîààfuçîôààbîî côgîîVéîŝàbîî Téîmpôàçéôfçôgîîôàéàîôŝîpŝ càébéôçôgîîô TééVôuîôôfmémôôŝŝ
Older people, sexuality and intimacy Iôuçîô séxuàîàéquàîôfîféàçôŝŝàgéŝ Imàgéŝôfôépéôpéàŝéxuàî îŝàŝé càgéŝîàîuéŝ séxuààçîVî PŝîçàçàgéŝôVéîmé Pŝçôôgîçàfàçôŝ sôçîàçôéxŝ séxuàîàîîmàç :éVîéwŝôfôépéôpé Pôféŝŝîôàŝuppô
Living in families and communities Oépéôpéàéîfàmîîéŝ Fîéŝîpàŝôçîàîŝîg AçîVîîéŝ
Money and financial resources in later life Glenda Cook Iôuçîô Kéîŝŝuéŝàçôçéôépéôpéégàîgmôé Téîmpàçôfîçôméôéquàîôfàéîfé Aîméôŝpémôéààŝàççuéôugôuîfé Içômé:ôôéôfmàéŝôuçéŝ Hàŝîméŝ:îféôàôwîçômé
59
57
61
67 67 67 74 77
79 79 80 81 82 87 88
95 95 97 97 99 100 101 102 102 103 103 106
111 115 119 122
127
128 129 130 130 131 132
nine
ten
eleven
Iéx
Pôôbééfîàéup Iàppôpîàéôuŝîgéàîgôîquîîpôbémŝ Fîàçîàîéàç Môéîŝàbîîîéààfàîîéçpàméŝàbôéàgéŝçéméŝ Aàîôààŝŝé:ôépéôpé’ŝçôîbuîôôŝôçîé côçuŝîô
Safety and risk Iôuçîô sàféàîVîg sàféîŝàpôféŝŝîôàpàçîçé îŝàîgàîŝmààgémé Ogàîŝàîôàîŝmààgémé côçuŝîô
Services, satisfaction and serviceuser involvement Iôuçîô Tépôîççôéx sàîŝfàçîôwîéŝéVîçéŝ sàîŝfàçîôàŝéVîçéuŝéŝ côçuŝîô
Issues for discussion and practice Péŝôôô sàîgàéxéçîŝîgpôwé juŝîçéàéquî Pàçîçé Pôîç éŝéàç Fîàçômméŝ
Contents
134 136 137 139 140 141 143
149 149 150 152 156 162 164
169 169 170 171 172 182
187 188 189 190 191 192 192 193
195
V
Health, wellbeing and older people
Foreword
It is difficult now to believe that it was almost seven years ago that the authors of Health, wellbeing and older peoplebegan asking groups of older people about the issues most important to them in their daily lives. It was an attractive proposition – that they would focus their book on issues raised by us. Older people in Newcastle are sometimes involved as passive subjects of university researchers, and are ‘consulted’ as users of services. This approach seems refreshingly different. The authors have drawn freely on material from reports, discussions, drama group scripts and performances, to illustrate each section. But now we can see older people’s concerns in relation to the authors’ discussion of findings from academic research, their analysis of policies, and their assessment of professional practice and attitudes. Older people’s knowledge may be experiential rather than scientific but still has value. Providing a context adds strength to our efforts, as individuals or groups, to change the stereotypes of older people, to overcome ageism in society and in services, and to demonstrate that older people are not just a problem but can contribute to solutions. There are many messages here for practitioners and policy makers. Each chapter has key points at the beginning, and exercises at the end, which provide a way of relating the issues highlighted to everyday professional practice. So there is something here for everyone with an interest in the processes of ageing, to increase our understanding as practitioners, as teachers, as researchers and as older people. In other words, a good read for everyone!
Vera Bolter, January 2004
Acknowledgements
The authors are grateful to the following:
Vera Bolter, Billie Cummings, Eileen DeVoy, Sheila Manley, Eddie Mottram (Action for health –Senior Citizens in Newcastle) Barbara Douglas (Better Life in Later Life, Newcastle) Stella Swinburne (Going Home from Hospital project group and Sexuality in Later Life group) Robert Weiner (Liaison Officer, North East Preretirement Association) Alan Curry (Age Concern, Newcastle) Peter Fulton (Older Person’s Champion, South Tees Hospitals NHS Trust) Sheila Rooney (Social Policy Coordinator,Washington Citizens’Advice Bureau) Sue Childs (Information Management Research Institute, Northumbr ia University)
Contents
Introduction
INTRODUCTION
The knowledge basis for working with older people
EVîéçébàŝépàçîçé :éméàŝuéàmàôfpôféŝŝîôàpàçîçé Kôwégéôpîçŝ Lôçuŝôféxpéîŝé Kôwégéçàîŝ Wééôépéôpé’ŝôwégéfîŝîîŝbôô côçuŝîô
Key points
3
9
• TééxpéîéçéŝàVîéwŝôfôépéôpéçàbémàgîàîŝéîé éVéôpméôfpôféŝŝîôàààçàémîçpàçîçé. • TééàéîffééfômŝôfôwégéàçàçôîbuéôéVîéçébàŝé pàçîçé. • Tébàŝîŝôfîŝbôôîŝîŝçuŝŝîôŝwîôépéôpéàbôuéîéxpéîéçéŝ àVîéwŝ.
6 7 7
12
This book has taken a long time to develop from an idea to publication – about seven years. Part of this delay was due to the usual everyday problems of getting anything done in a busy world, but other reasons for the delay point to a more enduring issue – the way in which older people can be excluded from debates about the services and support they receive. The history of this book can be summed up quite quickly – it is not a very complicated story. For some years we had been working with groups of older people who were energetic, interesting, inspiring and insightful. Some of this had been as social work and nursing practitioners, but in later years this had been as lecturers and researchers based in a university. Over time we had built up experience in many different types of activity with many different older people. This could be quite formal, such as interviewing older people as part of research projects, where interview agendas were restricted to a specific focus, or it could be less formal, as we began to participate in workshops, discussion groups and committees with older people. It must be said that the informal conversations
1
Health, wellbeing and older people
that we had with older people tended to be more interesting than some of the structured interviews that we did – partly because in these interviews we felt as if we were imposing our ideas of what was important, rather than listening to older people’s priorities. The workshops and other activities, however, allowed for much more exploration of experiences and wishes, not driven by research questions that had come from academic debates. Capturing and communicating these discussions seemed a natural next step. We had invited some groups of older people to contribute to teaching sessions, and these had always been successful, with students finding that the sessions were useful in grounding their ideas and practice in the reallife experiences of older people. We had also begun to adopt a more participative way of doing our research, with older people involved in writing proposals, collecting data, acting as advisors and writing papers and reports. It seemed that these experiences could be usefully shared with others who were working with older people. We developed a book proposal with groups of older people, asking them to suggest issues that they thought were key to their wellbeing, rather than simply follow the ideas of policy makers and educationalists about what was important. Having developed the proposal, we then sent it off to publishers. Every time, the proposal would be returned, rejected. The comments that we got back were mixed. Some reviewers complimented us on our ideas, saying that the book was much needed. Others commented on the ‘academic rigour’ of the proposal, feeling that the material from the older people might not be of a very high standard and, paradoxically, if it was of a high standard, then it would be from older people who were not ‘typical’ and therefore the book would be misleading. The comments from the publishers expressed equally mixed views, but often ended with the conclusion that it was difficult to place such a book, which was not a straightforward academic text but wasn’t a selfhelp book for older people either. It seemed that we were caught in a trap between the traditional academic discussion of issues, which we had become increasingly uncomfortable with, and the accessible but colloquial advice book. The problem seemed to be the contribution from older people, with many reviewers being unsure of what the book would look like and how this material would be presented and used. Eventually, with advice and support from a freelance editor, the proposal was accepted, and the book was written. The problems that we had, however, are important when thinking about the way in which the voices of older people are marginalised. If we treat their views and experiences simply as interesting phenomena to be researched, we make them less important than if we treat them as the starting point and arbiter for debate and discussion. By feeling uncomfortable about the way material from older people would be ‘used’ in this book, and by worrying over what category the book would belong to, the reviewers were echoing a widespread view of what is suitable knowledge for practitioners and researchers, and what is not. These views, of course, have to be placed in the context of debates about what constitutes appropriate knowledge, both for practice and for academic debate.
2
Introduction
In the following sections we outline some of these debates, starting with the current calls for practice to be ‘evidence based’. From this we go on to discuss what forms this evidence may take. The whole debate has implicit concerns with power – for whoever defines and identifies ‘good’ evidence has control over what is regarded as knowledge – and so our discussion moves on to this. Returning to this book, we then consider how these debates help to place it in the context of debates about types of knowledge, and how this book might be useful to those working with older people in a variety of different ways.
Evidencebased practice: the measure and mark of professional practice
One of the frequently used phrases in health and social care debates is ‘evidence based care’. In contrast to other bases for care – such as custom and practice, professional preference or opinion – evidencebased care is advocated as a more sound and scientific foundation for taking action. The evidencebased care movement fits in, therefore, with a range of other modernisation drives to improve services and practice, moving away from traditionbased justifications for action. Saying that you do something ‘because it has always been done this way’, then, is not enough – there has to be a scientific rationale. Delivering care in a way that is evidence based has become critical in contemporary health and social care practice as practice becomes increasingly open to scrutiny. One central feature of the evidencebased practice approach is that it is described as a logical decision making process in which as much of the proposed intervention is informed by good quality research as is possible. The judgement about the quality of the research base, is, of course, an area of dispute, with some restricting this to the ‘gold standard’ of the randomised controlled trial, and others including a range of research approaches, including qualitative and less structured methods. Evidencebased practice, then, is a goal set for practitioners, but there are still some disputes about what is meant by evidence. One way of summing up the types of knowledge used as evidence is to label them ‘scientific knowledge’, ‘intuitive/experiential knowledge’ and ‘moral/ethical knowledge’. We have used these terms in the following discussion of the nature of these types of knowledge.
Scientific knowledge
Scientific knowledge is the form of knowledge with the highest public profile, and which perhaps attracts the most approval. There are two forms of ‘scientific’ knowledge. The most common form is depersonalised and decontextualised ‘traditional’ science (Reed and Procter, 1995). It is knowledge that is generated by someone else, somewhere else and communicated to the user of the knowledge through research reports and professional or academic publications. This form of scientific knowledge is afforded considerable status and indeed researchers pay a great deal of attention to ensuring that the research is of a high quality
3
Voir icon more
Alternate Text