Hazel Heath

The challenge of sexuality in health care

Introduction Section One: Sexuality, Concepts and Influences 1. Before the Sexual Revolution 2. The Sexual Revolution 3. Post HIV / AIDS: Emergence of a New Morality 4. Nursing as a Sexualised Occupation 5. Nurses, the Body and Bodywork Section Two: Sexuality Through the Lifespan 6. Sexuality, childhood and adolescence 7. Sexuality and people with a learning disability 8. Sexuality, fertility and reproductive health 9. Sexuality and later life 10. Sexuality and people who are dying Section Three: Sexuality in Health and Illness 11. Sexuality and people with mental health needs 12. Sexuality and people affected by sexually transmitted infections 13. Sexuality and people with acute illness 14. Sexuality and people with disability or chronic illness 15. Sexuality and people with disfigurement Section Four: Current Approaches and Future Developments 16. Facilitating expression of sexuality: challenges for contemporary practice Conclusion

Moving from victim blaming to an appreciative inquiry : exploring quality of life in care homes

This paper highlights the need for researchers to work across disciplinary boundaries in order to capture the complexity that care practitioners have to engage with everyday in care home settings. Drawing on findings from a literature review on the complexity of loss in continuing care institutions for older people, the case is made for less victim blaming and more appreciative approaches to research. The way this thinking informed the development of a further literature review on quality of life in care homes (My Home Life) is discussed. Findings from this second study are shared by illustrating key messages with quotes from older residents, relatives and staff living, visiting and working in care homes. These best practice messages focus on: transition into a care home; working to help residents maintain their identity; creating community within care homes; shared decision‐making; health and health services; end‐of‐life care; keeping the workforce fit for purpose, and promoting positive culture. The importance of collaborative working in both research and practice is discussed. The paper is likely to be of interest to all those concerned with improving and developing evidence‐based practice in the care home sector, including users and service providers, managers, commissioners and inspectors, policy‐makers, researchers and teachers.

Shifting the focus: outcomes of care for older people

Internationally there is commitment to work towards eradicating the abuse of older people and to develop services that promote their equality, dignity and human rights. The emphasis on service users is gradually increasing and, along with this, the focus within health and social care policy, service provision and professional practice is shifting. In UK health and social care policy the emphasis on service structure and provision is being replaced by a focus on outcomes for service users, including outcomes which patients themselves evaluate. The focus of UK Adult Protection services is also shifting from intervention to prevention through developing greater understanding of the factors which contribute to abuse, changing attitudes towards entrenched poor care, identifying preventative services and safeguarding vulnerable adults. Nursing literature is also beginning to acknowledge the evolution of an outcomes focus. This paper discusses the shifting emphasis in UK health and social care in the safeguarding of vulnerable people and in nursing practice. It offers an overview of literature on outcomes. The paper then describes a research study which sought to identify outcomes of care for older people living in UK care homes. The outcomes framework developed through the research is offered, along with a discussion of the advantages of an outcome-focused approach to care and some of the remaining challenges. A case example is offered to illustrate an outcomes-focused approach. Finally, the paper draws conclusions on how shifting the focus of care delivery from traditional problem-orientated approaches and ritualized practice towards the outcomes of care that individual older people choose and evaluate for themselves offers potential towards eradicating abuse and neglect in formal care settings.

Strengths, weaknesses, opportunities, threats

Meeting fellow older people enthusiasts is always a pleasure and this months encounters particularly so. The annual conference of the two RCN older people forums offered its usual blend of innovative ideas, stimulating debate, esoteric humour and a camaraderie shared with strangers as well as friends. Working with multidisciplinary colleagues on the West Midlands pilot development programme for leaders of older people services was equally inspiring. Despite the ongoing challenges of competing priorities, inadequate resources and ageist attitudes, committed teams around the UK are striving to offer high quality services to older people.

Developing outcome indicators in continuing care: part 1: In the first of two articles, the authors describe the development of outcome measures for nursing older people in a continuing care setting. They describe why such a process was initiated and the framework which guided the project, including current nursing and government policy and theories of knowledge and expert practice. The second article will appear next week

In the first of two articles, the authors describe the development of outcome measures for nursing older people in a continuing care setting. They describe why such a process was initiated and the framework which guided the project, including current nursing and government policy and theories of knowledge and expert practice. The second article will appear next week.

The Telomere Effect: A Revolutionary Approach to Living Younger, Healthier, Longer Blackburn Elizabeth and Epel Elissa The Telomere Effect: A Revolutionary Approach to Living Younger, Healthier, Longer 417pp £14.99 Orion Books 9780297609230 0297609238

Elizabeth Blackburn received a Nobel prize for discovering the molecular nature of telomeres (the ends of our chromosomes that serve as protective caps) and telomerase (the enzyme that maintains telomeres).

Uptake of a newly implemented advance care planning program in a dementia diagnostic service

Through a three-stage project in a specialist memory clinic in Australia, researchers introduced ACP to clients with mild cognitive impairment or recently diagnosed dementia and their families. Clients and carers were initially posted a survey assessing completed documentation for future care, understanding of the principles of ACP and willingness to receive further information. Those wanting more information were invited to a seminar introducing the ACP programme and service. Participants wanting to complete ACP documentation could make an appointment with the ACP clinicians.

Advance care planning for nursing home residents with dementia: policy vs. practice

Despite the potential benefits of ACP for nursing home residents with dementia, the authors of this study highlight that hardly any research has focused on the involvement of residents/families in ACP and that ACP is rarely realised for these people. Their research aimed to evaluate the ACP policy for people with dementia in nursing homes and to gain insight into the involvement of residents with dementia and their families in ACP.

Advance care planning for people with dementia

Advance care planning (ACP) provides a framework for discussing and documenting care preferences in preparation for situations in which a person loses the cognitive capacity to make decisions. It can be particularly valuable in assisting people in the early stages of living with a dementia, supported by their families, to document their preferences for care at the later stages of their illness. While the potential benefits of ACP are widely acknowledged, there remain gaps in the research evidence on ACP and challenges in implementing ACP in practice. The three recently-published studies described below address these issues.

Forum focus. Get a fresh perspective on emerging issues.

PUBLISHED AT the perfect time, with political will in tune with professional and public awareness of demographic changes and service weaknesses, this book offers a clear overview of organisational issues and some of the drivers and mechanisms for effecting transformation. This text would be ideal for a team or trust aiming to upgrade their service structure and workforce competencies and looking to understand the international and national contexts, policies and organisational structures. There is some overlap in the content and approach of early chapters, which