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1.
Sociol Health Illn ; 45(1): 54-69, 2023 01.
Article in English | MEDLINE | ID: mdl-36070188

ABSTRACT

The cost of social care, the work conditions experienced by care workers and the quality of care provided by residential homes for older people are all linked, yet we know very little about how this relationship works in practice. Drawing upon an ethnography of two differently priced residential care homes for older people in Southern England, I examine the implications of different financial regimes for care-giving practices. I show how the scheduling and allocation of resources-conveyed, for example, in formal routines and staffing levels-structure the care workers' time, tasks and activities in each setting. This acts to symbolically demarcate what, or who, is valued. I argue that the availability of resources facilitates and impedes the symbolic culture of care work, shapes care workers' ability to afford dignity to the individuals in their care and affects how care workers experience, and relate to, their labour. I conclude by discussing how current practices of funding and pricing social care have effects seeping beyond the practical and measurable, and into the realm of the symbolic.


Subject(s)
Homes for the Aged , Nursing Homes , Humans , Aged , England , Social Support , Anthropology, Cultural
2.
Dementia (London) ; 19(5): 1492-1508, 2020 Jul.
Article in English | MEDLINE | ID: mdl-30244597

ABSTRACT

With over two-thirds of people with dementia living in the community and one-third of those living alone, it is important to consider the future housing needs of this population, particularly as symptoms of cognitive impairment increase. Policy in England has focused on enabling people living with dementia to remain in their own homes for as long as possible, often with the support of a family carer. However, many people struggle to maintain an acceptable quality of life in their own homes as their dementia advances, often due to the design limitations of mainstream housing and the challenge of finding specialist domiciliary care that is affordable and of sufficient quality. Extra care housing offers a model that aims to support older people living in their own apartments, whilst also offering specialist person-centred care as and when it is needed. This paper reports on a longitudinal project that explored how extra care housing can respond to the changing social care needs of residents, including those living with dementia. Participants included residents and staff from four extra care housing schemes, one of which was a specialist dementia scheme, in two regions of England. Interviews were carried with 51 residents across 4 rounds at 5 month intervals between October 2015 and June 2017. Interviews were also carried out with 7 managers, 20 care staff and 2 local authority commissioners of housing for older people. Key factors included person-centred care and support, flexible commissioning and staffing, appropriate design of the environment and suitable location of the scheme within the wider community. The challenge of delivering services that addresses these issues during a period of reduced public spending is acknowledged. Further research is suggested to compare different approaches to supporting people with dementia, including integrated and separated accommodation, and different stages of dementia.


Subject(s)
Built Environment , Dementia/psychology , Housing , Independent Living , Social Support , Aged , England , Female , Humans , Longitudinal Studies , Male , Social Interaction
3.
Health Soc Care Community ; 28(2): 396-403, 2020 03.
Article in English | MEDLINE | ID: mdl-31631421

ABSTRACT

Extra care housing (ECH) has been lauded as an innovative model of housing with care for older people that promotes and supports independent living. The study used a qualitative design to explore how care is delivered in four extra care settings in England over 20 months during 2016-2017. This paper reports findings from semi-structured interviews with 20 care workers and seven managers. The article argues that, despite being heralded as a new model, care workers in ECH face similar organisational pressures as those working in more conventional settings and, in turn, the care which they are able to provide to residents mimics traditional forms of care.


Subject(s)
Homes for the Aged/organization & administration , Housing for the Elderly/organization & administration , Independent Living , Social Workers/statistics & numerical data , Aged , Aged, 80 and over , England , Female , Health Personnel , Home Care Services/organization & administration , Humans , Male , Qualitative Research
4.
Int J Qual Stud Health Well-being ; 14(1): 1593038, 2019 Dec.
Article in English | MEDLINE | ID: mdl-30935291

ABSTRACT

PURPOSE: The process of individual ageing in the context of a care environment is marked by continuity and change. It is shaped by individual, health-related factors as well as by diverse social and environmental factors, including characteristics of the places where older people live. The aim of this paper was to explore how longitudinal qualitative research, as a research method, could be used to explore older people's changing care needs. METHODS: The study used a longitudinal design to examine how the care and support needs of residents and their expectations of services developed over time and how these were influenced by changes in the organisation of their housing as well as in the make-up of the resident population. Residents were interviewed on four occasions over 20 months. RESULTS: The study highlighted the complex ways in which some participants proactively managed the care and support they received, which we argue would have been difficult to discern through other methods. CONCLUSION: The study adds to the growing evidence base that supports the use of qualitative longitudinal research; the approach enables the researcher to capture the diverse and mutable nature of older people's experiences at a time of profound change in their lives.


Subject(s)
Homes for the Aged , Housing , Long-Term Care , Aged , Aged, 80 and over , Female , Humans , Longitudinal Studies , Male , Middle Aged , Qualitative Research
5.
Sociol Health Illn ; 37(1): 112-26, 2015 Jan.
Article in English | MEDLINE | ID: mdl-25601068

ABSTRACT

Drawing on a case study conducted in a private residential care home, this article examines the emotional labour of care workers in relation to the moral construction of care and the practical experiences of work. An examination of the company's discursive attempts to construct, manage and demarcate its employees' emotional labour was carried out alongside an exploration of the carers' own interpretations of, and enrolment in, the care-giving role. The potential economic and emotional consequences of these occurrences were a key focus of the inquiry. The study found that carers, encouraged by the company, naturalised their emotional labour, and that this had contradictory consequences. On the one hand it justified the economic devaluation of the carer's work and left her vulnerable to emotional over-involvement and client aggression. On the other, it allowed the worker to defend the moral interests of those within her care and to see when those interests were in conflict with the economic motivations of her employer.


Subject(s)
Caregivers/psychology , Emotions , Morals , Professional-Patient Relations , Residential Facilities , Altruism , Humans , Interviews as Topic , Job Satisfaction
6.
Chem Commun (Camb) ; 49(77): 8698-700, 2013 Oct 07.
Article in English | MEDLINE | ID: mdl-23955276

ABSTRACT

We report the surface nucleated growth of self-assembled dipeptide films. The seeding-layer was a thin dipeptide film with a globular structure. Placing the seeding-layer in contact with dipeptide led to growth of fibres overnight. Active enzymes were incorporated into the gel by adding them to the growth solution.


Subject(s)
Dipeptides/chemistry , Gels/chemistry , Armoracia/enzymology , Enzymes, Immobilized/chemistry , Horseradish Peroxidase/chemistry , Surface Properties
7.
J Am Chem Soc ; 132(14): 5130-6, 2010 Apr 14.
Article in English | MEDLINE | ID: mdl-20307067

ABSTRACT

The dipeptide amphiphile Fmoc-Leu-Gly-OH has been induced to self-assemble into thin surface-supported hydrogel gel films and gap-spanning hydrogel membranes. The thickness can be closely controlled, giving films/membranes from tens of nanometers to millimeters thick. SEM and TEM have confirmed that the dipeptides self-assemble to form fibers, with the membranes resembling a dense "mat" of entangled fibers. The films and membranes were stable once formed. The films could be reversibly dried and collapsed, then reswollen to regain the gel structure.


Subject(s)
Dipeptides/chemical synthesis , Hydrogels/chemical synthesis , Membranes, Artificial , Dipeptides/chemistry , Hydrogels/chemistry , Particle Size , Surface Properties
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