Demi Patsios

Formal and Informal Community Care to Older Adults: Comparative Analysis of the United States and Great Britain

Support to frail elders is of international and growing importance. This article compared receipt of assistance with ADL limitations, home health help, any assistance received, and unmet needs in functionally impaired individuals aged 70 years old or older in the United States (n = 1847, 80% women, Mage = 80 years) and Great Britain (n = 1203, 57% women, Mage = 78 years). Informal and formal assistance levels were higher in Great Britain, and rates of unmet need did not differ across ADL domains measured. Receipt of formal and informal care were associated positively, which is consistent with both supplementary and complementary perspectives on the formal-informal care interface. Few individuals in either country received formal services alone. Results suggest that community-based formal support does not substitute for family help. Implications for family and economic policy are discussed.

Outcomes of Short Course Interprofessional Education in Parental Mental Illness and Child Protection: Self-Efficacy, Attitudes and Knowledge

Living with a parent with mental illness may expose a child to a degree of risk of abuse and neglect. Consequently, both adult mental health services and childrens services share a responsibility for safeguarding children and promoting their welfare. However, there is evidence in England that these services do not work together very effectively. Interagency training for social workers and other professionals is provided by Local Safeguarding Children Boards with the aim of increasing knowledge, improving attitudes to interagency working and developing the self-confidence of participants in using local safeguarding policies and procedures. This study evaluates the outcomes of seven two-day courses using a pre-/post-design and a self-report rating scale. The scale was developed to assess participants’ self-efficacy, attitudes and knowledge. Over half of the 95 participants were social workers and one-third were nurses. Two-thirds of participants were working in childrens services. Results showed statistically significant increases in self-efficacy and attitudes between the start and end of the courses (p < 0.001) with evidence of a strong effect size. However, there was a statistically significant decrease in mean total knowledge scores (p < 0.001), also with a strong effect size. Possible explanations for this surprising finding are considered. This study provides some limited support for the effectiveness of short course interagency training for social workers and other professionals involved in safeguarding children in the context of parental mental illness. It also demonstrates the importance of evaluating more than one level of outcome of educational interventions.

Outcomes of Short Course Interprofessional Training in Domestic Violence and Child Protection

The interrelationship between domestic violence and child protection is well established, yet deficiencies in interprofessional collaboration have been reported and training is advocated as a solution. This study evaluates the outcomes of short interagency and interprofessional training in domestic abuse. Participants’ attitudes and knowledge were assessed using a self-report scale and compared in a double-baseline time-series design. Participants (N = 177) were recruited from a range of agencies in England. There were consistent, statistically significant improvements in participants’ attitudes, knowledge, and self-confidence between the start and end of course (p < .001). The long-term outcomes of training and the implementation of learning, however, remain uncertain.

A Daughter to ELSI - NILSI: A Northern Ireland Standard of Living Index or Problematising Wealth in the Analysis of Inequality and Material Well-being

When the measurement of inequality is being considered in Ireland and the UK the poor and socially excluded are routinely the focus of debate. Building on methodology developed in New Zealand this paper outlines the development of a more wide ranging approach through the construction of a Northern Ireland Living Standard Index (NILSI). It then utilises this tool to explore dimensions of inequality in Northern Ireland and present findings on the living standards of different subgroups.

Deprivation of Liberty Safeguards: What determines the judgements of Best Interests Assessors? A factorial survey:

Summary The Deprivation of Liberty Safeguards were introduced in England and Wales to protect the interests of people with learning disabilities, dementia and neurological conditions resident in hospitals and care homes. The Safeguards apply when residents lack capacity to make decisions about their care and treatment in circumstances that may amount to a deprivation of their liberty. Best Interests Assessors must establish whether a deprivation of liberty has occurred. However, there is no definition in statute; instead, the identification of factors which define a deprivation of liberty is evolving through case law. A factorial survey was used to identify the factors which influenced the professional judgements of 93 Best Interests Assessors (three-quarters social workers) who generated 798 responses to randomly generated vignettes. Findings Coercive staff behaviour was the strongest statistical predictor of a deprivation of liberty judgement, followed by the resident’s response. Other indicators of staff control, including the use of medication to reduce agitation, restriction of movement and family unhappiness with care were also significant. The resident’s condition, gender/age and the setting were not significant predictors. Best Interests Assessors were generally confident in their decision making; there were no differences in confidence associated with Best Interests Assessors’ professions. Applications Reviews of the operation of the Safeguards stress significant complexity in defining a deprivation of liberty. Nevertheless, this study suggests that the factors which Best Interests Assessors take into account are rooted in the fundamental principles of the Safeguards and an informed appreciation of case law. Best Interests Assessors and local authorities, in their role as supervisory bodies, must keep up to date with developments.

Interprofessional and interagency training for working with young people with harmful sexual behaviours: An evaluation of outcomes

Abstract This study evaluates the outcomes of short interagency training courses provided by six Local Safeguarding Children Boards in England. The aim was to develop practical skills in recognising and responding to the needs of children with harmful sexual behaviour in an interagency context. The courses all employed interactive learning and teaching methods as well as presentations of case studies, research findings and statutory guidance. Professionals (n=147) from a range of agencies participated in the evaluation. Their attitudes, knowledge and self-confidence were assessed using a specially designed 20-item self-report scale. Scores at registration 6 weeks in advance and at the start and end of the course were compared in a double-baseline, time–series design. There was strong evidence of overall improvements in scores on most of the scale items, which are attributable to the course. However, concerns are also raised about the small numbers of criminal justice professionals participating compared to child welfare professionals.

Inequalities in old age: the impact of the recession on older people in Ireland, North and South

Purpose – This paper attempts to assess the consequences of the existing and unfolding inequalities in older age in Northern Ireland (NI) and the Republic of Ireland (RoI).Design/methodology/approach – The research involved both quantitative and qualitative methods including focus groups and analysis of existing data on social exclusion and poverty in NI and RoI.Findings – The analysis on publicly available data in the north and south of Ireland revealed few comparable measures on poverty and social exclusion. The study was, however, able to establish key pre‐ and intra‐recession differences between older people in both jurisdictions. The qualitative analysis (focus groups with older people, online surveys with financial advisors) detailed the similarities and differences in the impact of the recession in north and south.Originality/value – This paper reports on the first systematic, comparative study into the impact of the recession on older people in NI and RoI. The paper also makes recommendations for ...