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1.
Health & Social Care in the Community ; 2023, 2023.
Article in English | ProQuest Central | ID: covidwho-20232790

ABSTRACT

In England, "easements,” introduced via the Coronavirus Act 2020, were brought in at the start of the pandemic to support English local authority adult social care services. They enabled local authorities to suspend some of their mandatory duties under the Care Act 2014. Easements were only adopted by eight local authorities and for short periods, and the provision was rescinded in late 2021. This article examines why a sample of 16 local authorities, some of which were statistically close to the eight local authorities that did decide to use easements, decided not to do so. It draws on data from interviews undertaken in 2021 with Directors of Adult Services and Principal Social Workers that explored their decision-making about using easements. It also outlines their preparations prior to the pandemic reaching England, how they had operated using "flexibilities” within the Care Act thus not needing to adopt easements, and their views on those authorities that had adopted them.

2.
PLoS One ; 18(5): e0283818, 2023.
Article in English | MEDLINE | ID: covidwho-2312854

ABSTRACT

BACKGROUND: The need to improve support following a diagnosis of dementia is widely recognised, but it is unclear how this can best be achieved within UK health and social care systems. A task-shared and task-shifted approach has been recommended, but there is limited guidance on how to achieve this in practice. As part of a programme of research, we developed an intervention to enhance the role of primary care in post-diagnostic care and support for people living with dementia and carers. METHODS: We used the Theory of Change to develop a complex intervention informed by initial literature reviews and qualitative work. The intervention was developed through an iterative series of workshops, meetings and task groups with a range of stakeholders, including the multidisciplinary project team, people living with dementia and carers, service managers, frontline practitioners, and commissioners. RESULTS: 142 participants contributed to intervention development through face-to-face or virtual meetings. The intervention comprises three complementary strands of work focusing on: developing systems, delivering tailored care and support, and building capacity and capability. Clinical dementia leads, based in primary care networks, will facilitate the intervention providing tailored expertise and support. CONCLUSION: The Theory of Change proved useful in providing structure and engaging stakeholders. The process was challenging, took longer and was less participative than intended due to restrictions caused by the COVID-19 pandemic. We will next conduct a feasibility and implementation study to explore whether the intervention can be successfully delivered within primary care. If successful, the intervention offers practical strategies for delivering a task-shared and task-shifted approach to post-diagnostic support that could be adapted for similar health and social care contexts internationally.


Subject(s)
COVID-19 , Dementia , Humans , Caregivers , Pandemics , Dementia/diagnosis , Dementia/therapy , Primary Health Care , COVID-19 Testing
3.
Health Expect ; 26(2): 613-629, 2023 04.
Article in English | MEDLINE | ID: covidwho-2249525

ABSTRACT

INTRODUCTION: Using co-design processes, we aimed to develop an evidence-based decision guide for family carers and hospital professionals to support decision-making about eating and drinking for hospital patients with severe dementia. METHODS: Following a systematic review, we interviewed people with mild dementia, family carers and hospital professionals in England. We then held co-design workshops with family carers and hospital professionals. In parallel with the workshops, we used a matrix to synthesize data from all studies and to develop a decision guide prototype. The prototype was iteratively refined through further co-design workshops and discussions among researchers and Patient and Public Involvement (PPI) representatives. We conducted user testing for final feedback and to finalize the decision guide. RESULTS: Most participants acknowledged the limited benefits of tube feeding and would not use or want it for someone with severe dementia. However, they found decision-making processes and communication about nutrition and hydration were emotionally demanding and poorly supported in acute hospitals. The co-design groups developed the aims of the decision guide to support conversations and shared decision-making processes in acute hospitals, and help people reach evidence-based decisions. It was designed to clarify decision-making stages, provide information and elicit the values/preferences of everyone involved. It encouraged person-centred care, best-interests decision-making and multidisciplinary team working. From user testing, family carers and hospital professionals thought the decision guide could help initiate conversations and inform decisions. The final decision guide was disseminated and is being used in clinical practice in England. CONCLUSION: We used rigorous and transparent processes to co-design the decision guide with everyone involved. The decision guide may facilitate conversations about nutrition and hydration and help people reach shared decisions that meet the needs and preferences of people with severe dementia. Future evaluation is required to test its real-world impacts. PATIENT OR PUBLIC CONTRIBUTION: People with mild dementia, family carers and hospital professionals contributed to the design of the decision guide through the interviews and co-design workshops. PPI members helped design study procedures and materials and prepare this manuscript.


Subject(s)
Dementia , Humans , Dementia/psychology , Caregivers/psychology , England , Hospitals
4.
British Journal of Social Work ; 53(2):1243-1262, 2023.
Article in English | CINAHL | ID: covidwho-2268557

ABSTRACT

People with care and support needs were often badly affected by Covid-19, although the impact on people employing Personal Assistants (PAs) has not been addressed. We aimed to explore the experiences of people employing PAs during the pandemic to inform care systems and social work practice. Remote qualitative interviews were conducted with seventy PA employers across England in 2021–2022. Data were analysed thematically to explore salient themes. The Covid-19 pandemic elucidated role tensions of PA employers: Navigating care arrangements during a time of unprecedented uncertainty reinforced participants' role as an employer, but exposed some aspects of employment responsibilities and legal obligations that participants felt ill-equipped to manage. Reports of contact with or by social workers were few and not perceived as helpful. The often-informal nature of PA arrangements and its blurred relational boundaries affected participants' expectations of their PAs. PA employers would welcome support from social workers in their employment role and flexibility with care plans, albeit with greater autonomy over their Direct Payment (DP) budget to enhance the potential of this arrangement. In the context of declining DP uptake in England, our study offers some potential explanations for this, with suggestions for systemic change and social work practice.

5.
British Journal of Social Work ; 53(2):1225-1242, 2023.
Article in English | CINAHL | ID: covidwho-2277880

ABSTRACT

Prior to the COVID-19 pandemic, social work and social care practitioners had some the worst working conditions of any sector in the UK. During the pandemic, data revealed that social care occupations had higher COVID infection and mortality rates than the general population. The article reports the changing working conditions (measured via the Work-Related Quality of Life scale) and well-being (measured via the Short Warwich–Edinburgh Mental Well-being Scale) of UK social care and social workers across three timepoints between May 2020 and July 2021 through an online cross-sectional survey of working conditions and well-being. Analysis of variance demonstrated that both well-being and working conditions were significantly poorer in July 2021 (phase 3 [ n  = 1,606]) than the previous two phases (n  = 2,523 and n  = 2,424, respectively), suggesting that both working conditions and well-being worsened within the social care and social work workforce across the pandemic. Furthermore, each of career satisfaction, working conditions, control, general well-being and home–work interface predicted poorer well-being at Time 3. Whilst chronically poor working conditions can lead to poorer individual psychological and physiological health outcomes, our findings highlight continually poor conditions in this sector, with potential further impacts on organisations and the service users that social care workers support. It is therefore important that individuals, organisations and government develop mechanisms to support these critical workers during and following the pandemic.

6.
Journal of Social Work ; 23(2):165-188, 2023.
Article in English | CINAHL | ID: covidwho-2277879

ABSTRACT

Summary : Stress and mental health are among the biggest causes of sickness absence in the UK, with the Social Work and Social Care sectors having among the highest levels of stress and mental health sickness absence of all professions in the UK. Chronically poor working conditions are known to impact employees' psychological and physiological health. The spread of the COVID-19 pandemic has affected both the mode and method of work in Social Care and Social Work. Through a series of cross-sectional online surveys, completed by a total of 4,950 UK Social Care and Social Workers, this study reports the changing working conditions and well-being of UK Social Care and Social Workers at two time points (phases) during the COVID-19 pandemic. Findings : All working conditions and well-being measures were found to be significantly worse during Phase 2 (November–January 2021) than Phase 1 (May–July 2020), with worse psychological well-being than the UK average in Phase 2. Furthermore, our findings indicate that in January 2021, feelings about general well-being, control at work, and working conditions predicted worsened psychological well-being. Applications : Our findings highlight the importance of understanding and addressing the impact of the pandemic on the Social Care and Social Work workforce, thus highlighting that individuals, organizations, and governments need to develop mechanisms to support these employees during and beyond the pandemic.

7.
British Journal of Social Work ; 53(2):939-955, 2023.
Article in English | CINAHL | ID: covidwho-2250869

ABSTRACT

This article reports findings from a study on the effect of the adjustments or 'easements' that were made to the 2014 Care Act when measures to manage the impact of COVID-19 were introduced in England in 2020. Only eight local authorities (LAs) implemented the changes permitted. The experiences of five are explored in this article. Data were collected in 2021 through interviews with Directors of Adult Social Services and other senior managers in these LAs and analysed using a thematic approach. Participants referred to the challenges under which they were working pre-pandemic, including resource pressures and problems recruiting and retaining staff. Despite the conditions attached to adopting easements these LAs had done so because of the uncertainties they were facing. All ceased to use them within a short time because they could manage without them. They had been shocked by the concerted opposition to easements and the time necessitated in responding to this. They contrasted their experiences with the apparent ease with which NHS colleagues had been able to change their practices. The experiences of these LAs may contribute to planning for the continuity of social care in any future emergency.

8.
The British Journal of Social Work ; 2022.
Article in English | Web of Science | ID: covidwho-2160937

ABSTRACT

People with care and support needs were often badly affected by Covid-19, although the impact on people employing Personal Assistants (PAs) has not been addressed. We aimed to explore the experiences of people employing PAs during the pandemic to inform care systems and social work practice. Remote qualitative interviews were conducted with seventy PA employers across England in 2021-2022. Data were analysed thematically to explore salient themes. The Covid-19 pandemic elucidated role tensions of PA employers: Navigating care arrangements during a time of unprecedented uncertainty reinforced participants' role as an employer, but exposed some aspects of employment responsibilities and legal obligations that participants felt ill-equipped to manage. Reports of contact with or by social workers were few and not perceived as helpful. The often-informal nature of PA arrangements and its blurred relational boundaries affected participants' expectations of their PAs. PA employers would welcome support from social workers in their employment role and flexibility with care plans, albeit with greater autonomy over their Direct Payment (DP) budget to enhance the potential of this arrangement. In the context of declining DP uptake in England, our study offers some potential explanations for this, with suggestions for systemic change and social work practice. How were people with care and support needs who employ social care Personal Assistants (PAs) affected by the Covid-19 pandemic? We interviewed seventy PA employers in England in 2021-2022 to ask them what happened to their care and support, and about their contacts with social workers from their local authority (LA). We found that employing a PA during the pandemic heightened many people's awareness of their employment responsibilities, particularly around trying to keep their PAs safe from the risk of the Covid-19 virus infection, and from the hardship of lost income during times when PAs were not working (e.g. during periods of national lockdown where 'social distancing' rules were in place). Several participants reported no or little contact with a social worker since the pandemic started which may have been the result of LAs postponing reviews. Some participants had wanted to use their Direct Payments differently and in a way that they thought would enable them to better meet their needs than previously agreed. When this was a problem or seemed to be so, LA staff were thought to lack understanding of the needs of people employing PAs during the Covid-19 pandemic.

9.
The British Journal of Social Work ; 2022.
Article in English | Web of Science | ID: covidwho-2134971

ABSTRACT

Prior to the COVID-19 pandemic, social work and social care practitioners had some the worst working conditions of any sector in the UK. During the pandemic, data revealed that social care occupations had higher COVID infection and mortality rates than the general population. The article reports the changing working conditions (measured via the Work-Related Quality of Life scale) and well-being (measured via the Short Warwich-Edinburgh Mental Well-being Scale) of UK social care and social workers across three timepoints between May 2020 and July 2021 through an online cross-sectional survey of working conditions and well-being. Analysis of variance demonstrated that both well-being and working conditions were significantly poorer in July 2021 (phase 3 [n = 1,606]) than the previous two phases (n = 2,523 and n = 2,424, respectively), suggesting that both working conditions and well-being worsened within the social care and social work workforce across the pandemic. Furthermore, each of career satisfaction, working conditions, control, general well-being and home-work interface predicted poorer well-being at Time 3. Whilst chronically poor working conditions can lead to poorer individual psychological and physiological health outcomes, our findings highlight continually poor conditions in this sector, with potential further impacts on organisations and the service users that social care workers support. It is therefore important that individuals, organisations and government develop mechanisms to support these critical workers during and following the pandemic. It is well known that having working conditions which are in a poor state over an extended period of time can impact the physical and mental health of employees. Across the pandemic, UK social workers and social care employees have been described as key and/or critical workers by the UK government. However, for a variety of reasons those working in these sectors had higher COVID-19 infection and death rates than the general population. The aim of this article is to chart the working conditions of UK social work and social care workers between May 2020 and July 2021, during the COVID-19 pandemic. We found that working conditions and well-being got consistently worse across the pandemic. Also, in July 2021, job satisfaction, working conditions, control, general well-being and home-work interface each predicted poorer psychological well-being. We suggest that, because of the relationship between poor working conditions, well-being and the physiological and psychological health of social workers and care workers, interventions should be put in place to support the deteriorating working conditions of these key workers. Doing so would lead to better outcomes for individual workers, their employers and ultimately service users.

10.
Health Soc Care Community ; 2022 Nov 08.
Article in English | MEDLINE | ID: covidwho-2108020

ABSTRACT

Social care Personal Assistants (PAs) are directly employed by individuals to assist with activities of daily living such as help or support with personal care, shopping, household tasks and community participation. This option is encouraged by UK public funding. In England, disabled people's support organisations initially offered assistance with such arrangements, although numbers doing this have declined. The Covid-19 pandemic provided the opportunity to ask those remaining organisations providing support for PA employers about their activities during this time and the questions being posed to them by PA employers. This paper reports data from 15 interviews undertaken March-July 2021 with disability support organisation representatives. We identified one overarching theme 'Working to prevent and challenge marginalisation of PA employers', with three related subthemes: (1) Advocating for the voice of a forgotten group; (2) Needing to be proactive and (3) Adapting to new tasks and ways of working. Participant accounts focused on representing the needs of disabled people to the authorities and providing concise, timely and accurate information to PA employers, particularly around the use of public funds during Covid-19. Remote working amplified the digital-divide, resulting in these organisations working hard to ensure PA employers received important information about their support options. Befriending services and Covid-hubs were established by some organisations to reduce isolation and risks of poor mental health amongst PA employers. Many of the challenges facing PA employers existed pre-pandemic but were perceived to have been heightened during it, reflecting the value of and need for the work of these local support organisations. Our findings suggest areas where effective contingency planning drawn from closer collaboration between disability support organisations and central and local government might usefully be focussed. The potential for specific services or organisations to be commissioned to provide such support is discussed.

11.
Psych ; 4(4):843-855, 2022.
Article in English | MDPI | ID: covidwho-2099729

ABSTRACT

This study explored and compared the psychological wellbeing, burnout, coping strategies and work-related quality of life amongst health and social care workers in older adults' care homes and community settings during the COVID-19 pandemic in the United Kingdom (UK) and Japan. A cross-sectional online survey was conducted in the UK (May–July 2021) and a postal survey conducted in Japan (September–October 2021). Participants recruited were health and social care professionals within nursing, social care and social work occupations working in care home or community settings in the UK and Japan during the pandemic. Data were analysed using SPSS. 1327 respondents across the UK and Japan completed the survey. Respondents' psychological wellbeing was significantly lower in Japan compared to the UK (p ≤0.001). UK respondents had significantly higher personal burnout (p < 0.05) and work-related burnout (p < 0.05) while those in Japan had significantly higher client-related burnout (p < 0.001). The novelty of this study relates to exploring mental wellbeing and quality of working life in two culturally contrasting countries. The overall psychological wellbeing and work-related quality of life of staff who work with older adults in the UK and Japan during the COVID-19 pandemic were lower than the population norm. Greater support and flexible working conditions for this workforce are needed to reduce burnout by improving wellbeing and work-related quality of life.

12.
Merits ; 2(4):374-386, 2022.
Article in English | MDPI | ID: covidwho-2099656

ABSTRACT

This paper shared the compared results on the psychological wellbeing and work-related quality of life amongst health and social care workers during the COVID-19 pandemic in the UK. Health and social care professionals within nursing, midwifery, allied health professions, social care and social work occupations working in the United Kingdom (UK) during the pandemic were recruited. Repeated cross-sectional online surveys were conducted during two time periods of the pandemic (May–July 2020 and May−July 2021). A total of 4803 respondents completed the survey. The findings revealed that over the pandemic, psychological wellbeing (SWEWBS measure) and work-related quality of life (WRQoL scale) scores significantly decreased in all five occupations (p < 0.001) with midwives having the lowest scores on both scales at all time points. Respondents were found to significantly (p < 0.001) use of negative coping strategies such as behavioural disengagement and substance usage. Analysis of variance revealed a statistical difference between occupations and wellbeing across 2020 and 2021, while work-related quality of life was only statistically significantly different in 2021. The findings revealed that due to this decrease, there is a distinct need for more support services and flexible working conditions within health and social care services, to improve wellbeing and work-related quality of life.

13.
Int J Environ Res Public Health ; 19(20)2022 Oct 11.
Article in English | MEDLINE | ID: covidwho-2071407

ABSTRACT

Maternity services cannot be postponed due to the nature of this service, however, the pandemic resulted in wide-ranging and significant changes to working practices and services. This paper aims to describe UK midwives' experiences of working during the COVID-19 pandemic. This study forms part of a larger multiple phase research project using a cross-sectional design based on an online survey. The online survey used validated psychometric tools to measure work-related quality of life, wellbeing, coping, and burnout as well as open-ended questions to further understand the experiences of staff working during the pandemic. This paper reports the qualitative data collected from the open-ended questions. The qualitative data were subjected to thematic analysis and the four main themes that emerged were 'relentless stress/pressure', 'reconfiguration of services', 'protection of self and others', and 'workforce challenges'. The key conclusions were that midwives experienced a reduction in quality of working life and significant stress throughout the pandemic due to a range of factors including staffing shortages, restrictions placed on women's partners, changes to services and management support, all of which compounded workforce pressures that existed prior to the pandemic. This research recommends consultation of front-line midwives in relation to possible changes in practice and workforce planning in preparation for crises such as a pandemic and to ensure equitable and supportive management with access to practical and psychological support.


Subject(s)
COVID-19 , Midwifery , Female , Humans , Pregnancy , Midwifery/methods , Cross-Sectional Studies , COVID-19/epidemiology , Self Report , Pandemics , Quality of Life , United Kingdom/epidemiology , Qualitative Research
14.
PLoS One ; 17(9): e0274036, 2022.
Article in English | MEDLINE | ID: covidwho-2039404

ABSTRACT

Nurse, Midwives and Allied Health Professionals (AHPs), along with other health and social care colleagues are the backbone of healthcare services. They have played a key role in responding to the increased demands on healthcare during the COVID-19 pandemic. This paper compares cross-sectional data on quality of working life, wellbeing, coping and burnout of nurses, midwives and AHPs in the United Kingdom (UK) at two time points during the COVID-19 pandemic. An anonymous online repeated cross-sectional survey was conducted at two timepoints, Phase 1 (7th May 2020-3rd July 2020); Phase 2 (17th November 2020-1st February 2021). The survey consisted of the Short Warwick-Edinburgh Mental Wellbeing Scale, the Work-Related Quality of Life Scale, and the Copenhagen Burnout Inventory (Phase 2 only) to measure wellbeing, quality of working life and burnout. The Brief COPE scale and Strategies for Coping with Work and Family Stressors scale assessed coping strategies. Descriptive statistics and multiple linear regressions examined the effects of coping strategies and demographic and work-related variables on wellbeing and quality of working life. A total of 1839 nurses, midwives and AHPs responded to the first or second survey, with a final sample of 1410 respondents -586 from Phase 1; 824 from Phase 2, (422 nurses, 192 midwives and 796 AHPs). Wellbeing and quality of working life scores were significantly lower in the Phase 2 sample compared to respondents in Phase 1 (p<0.001). The COVID-19 pandemic had a significant effect on psychological wellbeing and quality of working life which decreased while the use of negative coping and burnout of these healthcare professionals increased. Health services are now trying to respond to the needs of patients with COVID-19 variants while rebuilding services and tackling the backlog of normal care provision. This workforce would benefit from additional support/services to prevent further deterioration in mental health and wellbeing and optimise workforce retention.


Subject(s)
Burnout, Professional , COVID-19 , Midwifery , Pregnancy Complications, Infectious , Adaptation, Psychological , Allied Health Personnel , Burnout, Professional/epidemiology , Burnout, Professional/psychology , COVID-19/epidemiology , Cross-Sectional Studies , Female , Humans , Pandemics , Pregnancy , Quality of Life , SARS-CoV-2
15.
The British Journal of Social Work ; 2022.
Article in English | Web of Science | ID: covidwho-2017740

ABSTRACT

As part of the government's response to the Coronavirus pandemic, temporary changes were made to the 2014 Care Act. These changes-called 'easements'-reduced the requirement on English local authorities (LAs) to meet some of their usual duties where they were not able to do so either as a result of increased demand or where a large proportion of their workforce was absent. Only eight LAs chose to adopt easements. In the five LAs we studied the decision had been taken in the early stage of the pandemic when there was a considerable degree of uncertainty about how society would be able to respond. LAs were required to provide reasons for the decisions although it appeared that most of the five LAs studied had not faced overwhelming demand and had decided to adopt easements as a precaution. By the end of June 2020, no LA was still using easements. The five LAs in this study concluded they could manage without them, as the majority of LAs were doing. They had dealt with considerable opposition in the press and social media as well as Freedom of Information requests in the face of accusations that by using easements they were denying entitlements to care. With the benefit of hindsight, it is unlikely that they did anything very different from LAs that had not used easements. This article reports findings from a study on the effect of the adjustments or 'easements' that were made to the 2014 Care Act when measures to manage the impact of COVID-19 were introduced in England in 2020. Only eight local authorities (LAs) implemented the changes permitted. The experiences of five are explored in this article. Data were collected in 2021 through interviews with Directors of Adult Social Services and other senior managers in these LAs and analysed using a thematic approach. Participants referred to the challenges under which they were working pre-pandemic, including resource pressures and problems recruiting and retaining staff. Despite the conditions attached to adopting easements these LAs had done so because of the uncertainties they were facing. All ceased to use them within a short time because they could manage without them. They had been shocked by the concerted opposition to easements and the time necessitated in responding to this. They contrasted their experiences with the apparent ease with which NHS colleagues had been able to change their practices. The experiences of these LAs may contribute to planning for the continuity of social care in any future emergency.

16.
Journal of Social Work ; : 14680173221109483, 2022.
Article in English | Sage | ID: covidwho-1916853

ABSTRACT

SummaryStress and mental health are among the biggest causes of sickness absence in the UK, with the Social Work and Social Care sectors having among the highest levels of stress and mental health sickness absence of all professions in the UK. Chronically poor working conditions are known to impact employees' psychological and physiological health. The spread of the COVID-19 pandemic has affected both the mode and method of work in Social Care and Social Work. Through a series of cross-sectional online surveys, completed by a total of 4,950 UK Social Care and Social Workers, this study reports the changing working conditions and well-being of UK Social Care and Social Workers at two time points (phases) during the COVID-19 pandemic.FindingsAll working conditions and well-being measures were found to be significantly worse during Phase 2 (November?January 2021) than Phase 1 (May?July 2020), with worse psychological well-being than the UK average in Phase 2. Furthermore, our findings indicate that in January 2021, feelings about general well-being, control at work, and working conditions predicted worsened psychological well-being.ApplicationsOur findings highlight the importance of understanding and addressing the impact of the pandemic on the Social Care and Social Work workforce, thus highlighting that individuals, organizations, and governments need to develop mechanisms to support these employees during and beyond the pandemic.

17.
Health Expect ; 25(4): 1954-1966, 2022 08.
Article in English | MEDLINE | ID: covidwho-1895979

ABSTRACT

INTRODUCTION: COVID-19 has disproportionately affected people living with dementia and their carers. Its effects on health and social care systems necessitated a rapid-response approach to care planning and decision-making in this population, with reflexivity and responsiveness to changing individual and system needs at its core. Considering this, a decision-aid to help families of persons with dementia was developed. OBJECTIVES: To coproduce with people living with dementia, and the people who care for them, a decision-aid for family carers of people living with dementia, to support decisions during the COVID-19 pandemic and beyond. METHODS: Semi-structured interviews were undertaken in 2020 with: (1) staff from two English national end-of-life and supportive care organizations; and (2) people living with dementia and family carers. Simultaneously, a rapid review of current evidence on making decisions with older people at the end of life was undertaken. Evidence from these inputs was combined to shape the decision-aid through a series of workshops with key stakeholders, including our patient and public involvement group, which consisted of a person living with dementia and family carers; a group of clinical and academic experts and a group of policy and charity leads. RESULTS: The rapid review of existing evidence highlighted the need to consider both process and outcome elements of decision-making and their effects on people living with dementia and their families. The qualitative interviews discussed a wide range of topics, including trust, agency and confusion in making decisions in the context of COVID-19. The decision-aid primarily focussed on care moves, legal matters, carer wellbeing and help-seeking. CONCLUSIONS: Combining different sources and forms of evidence was a robust and systematic process that proved efficient and valuable in creating a novel decision-aid for family carers within the context of COVID-19. The output from this process is an evidence-based practical decision-aid coproduced with people living with dementia, family carers, clinical and academic experts and leading national dementia and palliative care organizations. PATIENT OR PUBLIC CONTRIBUTION: We worked with people living with dementia and family carers and other key stakeholders throughout this study, from study development and design to inclusion in stakeholder workshops and dissemination.


Subject(s)
COVID-19 , Dementia , Aged , Caregivers , Decision Making , Dementia/therapy , Humans , Pandemics
18.
Journal of Social Work ; : 14680173221083446, 2022.
Article in English | Sage | ID: covidwho-1794098

ABSTRACT

SummaryInternationally there has been much interest in the impact of the COVID-19 pandemic on the care and support of older people including those with needs arising from self-neglect and/or hoarding. During the pandemic English local authorities? legal duties remained to respond to concerns about harm about people with care and support needs living in the community. This paper reports interviews with 44 participants working for adult safeguarding/adult protective services (APS) in 31 local authorities recruited from all English regions. Interviews took place online in November-December 2020 as the pandemic's second UK wave was emerging. Analytic induction methods were used to develop themes.FindingsParticipants reported some of the variations in referrals to their services with more contact being received from community sources concerned about their neighbours? welfare. Participants provided accounts of the local organisation of adult safeguarding services during the pandemic, including in some areas the potential for offering early help to older people at risk of harm from self-neglect or hoarding behaviour. Online inter-agency meetings were positively received but were acknowledged to potentially exclude some older people.ApplicationsThis article reports observations from adult safeguarding practitioners about their services which may be of interest internationally and in renewing services that can sustain public interest in the welfare of their older citizens and in developing early help. The findings reflect those from children's services where online meetings are also predicted to enhance professional communications post-pandemic but similarly need to ensure effective engagement with service users and their families.

19.
Journal of Integrated Care ; 30(2):134-145, 2022.
Article in English | ProQuest Central | ID: covidwho-1784461

ABSTRACT

Purpose>A multiagency approach to supporting and enhancing child welfare lies at the heart of policies and practice in England and many other countries. The assumption is that if professionals together from different disciplines share their knowledge and skills this will lead to better outcomes for children and their families. The COVID-19 pandemic interrupted the “normal practice” of such arrangements. This research explored how the pandemic's disruption led to new ways of communicating and professional behaviour, while exploring the potential for longer-term impact in England and other jurisdictions.Design/methodology/approach>Case studies were conducted in 2020 in five English local authorities to explore how schools worked with Children's Social Care and other professionals during the COVID-19 period. It was supplemented by a survey of schools and discussions with and reflections from those with relevant experience in five other countries.Findings>Many schools played an extended role in supporting vulnerable and “in need” families during this period. Children's Social Care recognised their contributions and the improved communication achieved, although schools were divided over whether relationships had improved. Most communication and meetings were online;while benefits were noted there were concerns for families who were digitally disadvantaged.Originality/value>The work provides a contemporary picture of multiagency work during the 2020 pandemic and identifies factors which may shape this work in the future in England and internationally.

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