Tina Fear

An evaluation of primary care led dementia diagnostic services in Bristol.

BackgroundTypically people who go to see their GP with a memory problem will be initially assessed and those patients who seem to be at risk will be referred onto a memory clinic. The demographic forces mean that memory services will need to expand to meet demand. An alternative may be to expand the role of primary care in dementia diagnosis and care. The aim of this study was to contrast patient, family member and professional experience of primary and secondary (usual) care led memory services.MethodsA qualitative, participatory study. A topic guide was developed by the peer and professional panels. Data were collected through peer led interviews of people with dementia, their family members and health professionals.ResultsEleven (21%) of the 53 GP practices in Bristol offered primary care led dementia services. Three professional panels were held and were attended by 9 professionals; nine carers but no patients were involved in the three peer panels. These panels identified four main themes: GPs rarely make independent dementia diagnosis; GPs and memory nurses work together; patients and carers generally experience a high quality diagnostic service; an absence of post diagnostic support. Evidence relating to these themes was collected through a total of 46 participants took part; 23 (50%) in primary care and 23 (50%) in the memory service.ConclusionsPatients and carers were generally satisfied with either primary or secondary care led approaches to dementia diagnosis. Their major concern, shared with many health care professionals, was a lack of post diagnostic support.

Supporting independence for people with dementia in extra care housing

References Courtney, M., Tong, S., & Walsh, A. (2000). Acute-care nurses’ attitudes towards older patients: A literature review. International Journal of Nursing Practice, 6(2), 62–69. Kerr, B., Gordon, J., MacDonald, C., & Stalker, K. (2005). Effective social work with older people: A paper prepared for the Scottish Executive by the Social Work Research Centre, University of Stirling as part of the 21st century social work review. Edinburgh: Scottish Executive. McKinlay, A., & Cowan, S. (2006). “If you’re frail you’ve had it”: A theory of planned behavior study of student nurses’ attitudes towards working with older patients. Journal of Applied Social Psychology, 36(4), 900–917. Morhardt, D. (2006). Educating medical students on Alzheimer’s disease and related disorders: An overview of the Northwestern University Buddy Program. Dementia: The International Journal of Social Research and Practice, 5(3), 448–456. Vallelly, S., Evans, S., Fear, T., & Means, R. (2006). Opening doors to independence: A longitudinal study exploring the contribution of extra care housing to the care and support of older people with dementia. London: Housing 21.

A mixed-method approach to evoke creative and holistic thinking about robots in a home environment

Discovering older adults’ perceptions and expectations of domestic care service robots are vital in informing the design and development of new technologies to ensure acceptability and usability. This paper identifies issues that were elicited from older adults using different methods to promote creative thinking about domestic robots at an emotional level, as well as pragmatic level. These included exploring people’s ideal embodiment preferences and requirements for a domestic care service robot, and also what embodiments and functional aspects will not be acceptable. We analysed our findings using relevant constructs from the Unified Theory of Acceptance and Use of Technology, and Technology Acceptance models. In addition to some already well-established findings, we discovered some surprising aspects concerning interaction, behaviour and appearance and the ability for the robot to fit the relevant context, both physically and conceptually. Categories and Subject Descriptors Assistive technologies for persons with disabilities, Requirements Elicitation General Terms Design, Human Factors

Responding to the harassment and abuse of older people in the private rented sector: Legal and social perspectives

Independent living, and hence active ageing, is seen by some governments as being supported through enabling and encouraging older people to live in mainstream housing. However, this emphasis upon ‘staying put’ and ‘ageing in place’ needs to recognise the major housing difficulties that are faced by some older people. This paper presents findings from an exploratory study, funded by Help the Aged, of the harassment and abuse of older people within the private rented sector. Examples of the wide range of arguments, disputes and conflicts with landlords and other residents will be provided. The second half of the paper considers the legal remedies that might be available for tackling some of these problems and the present obstacles to their use. Finally, legal remedies will be compared with more social policy based approaches which draw upon the framework relating to the protection of vulnerable adults.

Primary care-led dementia diagnosis services in South Gloucestershire: Themes from people and families living with dementia and health care professionals

Background Primary care-led dementia services are an increasingly common form of service delivery; however, little is known about how these services are understood by their main stakeholders: the patients, family members and health care professionals. A primary care-led dementia service was piloted in the South Gloucestershire area during 2012, in which general practitioners (GPs) led the process of assessment and establishing a diagnosis. Of the 26 surgeries in the area, 11 initially agreed to participate in the pilot, with 12 more joining the project by the end of December 2012. Aim The aim of this study was to provide a qualitative analysis of the experiences of health care professionals, patients and their families, of the new process of assessment, diagnosis and treatment of dementia within a primary care service. Methods Four patients, three care-givers and eight health care professionals were interviewed by peer researchers – all of whom were current care-givers. Interviews were transcribed and analysed using thematic analysis following Braun and Clarke’s model. Data were also gathered about the number of referrals and what happened to these referrals. Results Themes gathered into four main areas: ‘the journey’, ‘what next?’, ‘the benefits and limits of primary care’ and ‘are GPs getting it right’? Conclusions The analysis provided a perspective on the experiences of patients, family members and health care professionals involved in the relocation of part of the memory service, from secondary care (memory clinics) to primary care, being piloted in South Gloucestershire. This identified both practical issues to be improved upon as well as possible barriers.

Home or hell: older tenants' experiences in the private rented sector

Issues raised here are drawn from the findings of a housing investigation that explored harassment and abuse of older tenants in the private rented sector. The project examined older peoples experiences and raised important links between health and housing. The article highlights financial abuse directed towards these older people and examines implications for professionals and agencies.