Showing posts with label quality of life. Show all posts
Showing posts with label quality of life. Show all posts

Friday, 10 October 2014

WMHD II c/o LSE: Investing in crisis care for people with schizophrenia makes moral and economic sense

“When someone has a mental health crisis, it is distressing and frightening for them as well as the people around them. Urgent and compassionate care in a safe place is essential – a police cell should never need to be used because mental health services are not available. For me, crisis care is the most stark example of the lack of equality between mental and physical health.” 
(The Rt Hon Norman Lamb MP, Care and Support Minister)
There is a strong moral and economic case for investing in innovative approaches that support people with schizophrenia to live independently in the community. Crisis resolution and home treatment teams and crisis houses can help reduce the need for expensive hospital admissions with some studies suggesting that the costs of care can be reduced by up to 30% through these service models. There is a clear potential for Clinical Commissioning Groups to make better use of their resources by investing in home treatment teams and crisis houses as approaches to crisis resolution.
My source: The London School of Economics and Political Science, Health and Social Care blog email

Hodges' model in recovery ...
Jones P. (2014) Using a conceptual framework to explore the dimensions of recovery and their relationship to service user choice and self-determination. International Journal of Person Centered Medicine. Vol 3, No 4, (2013) pp.305-311.

Tuesday, 3 June 2014

Never give up on someone ...

individual
INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
group

Never give up on someone with Mental Illness – 

when 'I' is replaced with -





'We' 
'illness' becomes 'Wellness'







Thanks to colleague Julie Draper - apparently this is doing the rounds on Facebook and elsewhere.

Friday, 18 April 2014

[ Exclusive* preview ] Wrinkles


individual, dignity, person, memories, identity,
security, communication, perception, meaning, friends,
belonging, mood, orientation ...


demographics, evidence based care, medication, treatments, physical environment ....
policy, standards, inspection, training, organisation, safety, governance, management culture, leadership ...

Link:
http://www.arrugaslapelicula.com/

*Person centered?

Sunday, 23 March 2014

Sensing Spaces: Care architecture - memories of choice

Good architecture is often invisible,
but it allows whatever is happening in that space to
be the best experience possible.

Pezo von Ellrichshausen


Good architecture may have something in common with good health; it is something that can be taken for granted. When things go awry and are wrong then architecture and health suddenly impose upon us, a major intrusion.

As I may have mentioned before, in the past I've been asked how I've managed entering such and such care facility for so long. Within health there is recognition of heartsink patients. There are still heartsink buildings too. Not purpose built, seemingly either all narrow dark corridors, interrupted when doors let in shafts of light and assault dignity and privacy; or large 'lounges' that still invite armchairs to be flung against walls.

Architecture like this is not invisible. Walls are walls, blanc, flat and solid. Pictures removed due to safety concerns. Two holes and exposed plaster testify to what? Now, after six months....?

Even for the confused there are few potential found spaces, spaces to sit, stand, be; spaces towards which some personal impetus might have a person gravitate. A space of relative quite, looking out on some-thing relaxing even if not a small garden feature.

"Where's Joan, her friend's here to see her?"
"It's OK, I know where she'll be."

Royal Academy: Sensing Spaces
Education guide



 


Friday, 14 March 2014

So many gardens: Press Release [ now ]

It had to happen. Twice over.

The irony that just as so many homes with older people living in them have gardens that are in a state of neglect, so too do many nursing and care homes.

Of course this is a sign in those domestics homes of reduced abilities.

In the residential care and nursing homes, garden neglect is reassuring.
A $ure sign that the love and spending is on the blooms inside?

Friday, 7 March 2014

Living with Practical Realities, 1978: Courtesy the Artist © Stephen Willats

Within Intermediate Support, Older Adults we are short-staffed at present. I was asked to work this Saturday - tomorrow - but was able to take Wednesday off. This helpfully coincided with a half-day event in Liverpool - Developing (research) proposals for Research for Patient Benefit (RfPB).

In the afternoon I took two hours (with reading to do also) at the Tate, this included:

Keywords: Art, Culture and Society in 1980s Britain

The exhibition included the three photographs displayed below by Stephen Willats. They are usually presented side-by-side. Since the 1970s and 80s the photographs made me wonder about social policy, social care, change and progress.

I was also prompted to recall a visit to a pensioner's club with my nan (maternal grandmother as we called her) in Liverpool in 1969-70.
[Clicking on the photos provides a more legible copy, or see collection link below ].

INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
individual

?




group - population

Image source:
Stephen Willats
Living with Practical Realities, 1978
Photographs
Letraset, gouache and ink on card
3 panels, each 109 x 76 cm

Collection: Tate London

Courtesy the Artist
© Stephen Willats

Thursday, 27 February 2014

Rare Disease Day 28 February 2014



INTERPERSONAL : SCIENCES
humanistic ------------------------------------------- mechanistic
SOCIOLOGY : POLITICAL
I am honored to stand, in her graceful place, and shine a light on a delicate group of individuals who, nevertheless, in sheer numbers are a force to be reckoned with.
Thank you,

Sean Hepburn Ferrer
A disease or disorder is defined as rare in Europe when it affects fewer than 1 in 2000.
A disease or disorder is defined as rare in the USA when it affects fewer than 200,000 Americans at any given time. One rare disease may affect only a handful of patients in the EU (European Union), and another touch as many as 245,000. In the EU, as many as 30 million people alone may be affected by one of over 6000 rare diseases existing.
  • 80% of rare diseases have identified genetic origins whilst others are the result of infections (bacterial or viral), allergies and environmental causes, or are degenerative and proliferative.
  • 50% of rare diseases touch children.
In the words of Audrey Hepburn,

We cannot save everyone… but the knowledge that someone is coming to their rescue… that we care as a society is ultimately as important…”.

It is in this spirit that we invite you, alongside Sean Hepburn Ferrer, to Join Together for Better Care.
group - population

Winwick Hospital remembered

Image source: Metro

Sunday, 23 February 2014

18th Annual International Philosophy of Nursing Conference

in association with the International Philosophy of Nursing Society
(IPONS)

September 8th, 9th and 10th, 2014

Hosted by the School of Health Sciences, University of Nottingham, England, UK

Brave new world?
Health, technology and evidence based practice

Nurses have seen some fundamental changes in the way that healthcare is delivered. Body care is at the centre of nursing practice but the nature of that care has been extended beyond the personal, human-to-human contact, and is increasingly refracted through the medium of technological/scientific interventions. The way that these technologies interact with the human dimension does, and should, require critical analysis.This is particularly the case for nurses who are increasingly expected to adopt methods and approaches that change the nature of the nurse patient relationship.  Added to this is the way that clinicians/academics/researchers interact with health care issues, locally as well as globally.

There is an established debate and tension within the evidence based practice literature that illustrates a deep ambivalence about how a holistic approach to clinical practice relates to, enhances, or is undermined by the new health technologies. These include care pathways, systematic reviews of knowledge, the enabling/disabling effects of technology and the putative implication that there is an empiricist and dehumanising process involved in these developments. For example, what happens to the complexity of ethical debates when they are shaped in the form of arguments based on literature reviews? These may wittingly or unwittingly serve as a means of translating complex moral issues into usable clinical regimes that partially mimic meta-analyses. Furthermore we may ask what place narrative knowledge and qualitative experiences may have in this new world of implementation technologies? And how do the new interventions of telemedicine and other policy drivers that emphasise the “hospital-at-home” impact on the ways that nurses carry out health care?

This conference intends to examine these and other issues related to ‘Health, technology, and evidence-based practice’.


CONFERENCE DETAILS

Details of the Conference can now be found at the following link:
http://www.nottingham.ac.uk/conference/fac-mhs/healthsciences/aipnursingconference/index.aspx

These details include the list of Keynote speakers; the venue; a Call for Abstracts; conference registration and accommodation, and transportation. Abstracts of the Keynote speakers and the full Conference Programme will be available soon on the above link.

Any specific queries should be addressed to Dr Stuart Nairn
stuart.nairn AT nottingham.ac.uk


other IPONS posts on W2tQ

Saturday, 7 December 2013

Reading and writing the minutia of locked doors and windows (still a draught)

Couples, married or not, partners are the cards that frequently, if not by definition, lean on each other beyond the pale, to the n-th degree. Witness so many lessons of what love really is.

They bend and flex. Tested by history, timelines entwined, ties-that-bind, trying to persist in the hear and how.

Their psychological union is challenged as memories become eroded and physically frailty takes hold. Usually; mostly, on the one.

Eventually things, established relationships break and one or the other - should we say: finds themselves in - residential care.

Courtship enables us to become socialised to and with each other and respective families and in some instances other cultures and beliefs.

In this crucial transition sometimes there is learning through experience as respite care is sought.

In other cases health services wonder how this relationship has survived for so long. A crisis is a precipice for change. A chaotic invitation. Radical.

A sudden shift from what was home to a new world of corridors, r, ro, roo, room, rooms; my room? New noises and smells and altered routines and jumbled faces, touches, days and nights

The dolls of childhood are left behind, but may be picked up again literally as an emotional comforter. If not this then perhaps a ‘paper clad dol’ that is bound to be - ‘deprivation of liberty’.

In this new home, this person walks the corridor and inspects the minutia of the doors and windows. Staff pass by(e) waving by their walk - "so-busy-look-no-hands" while trying to be butterflies.

Butterflies that cannot say which way is ‘out’.

They are they. Difficult to follow with eye, head and a hand to catch. The individual recognises the whole of the comings and goings, the main thoroughfare. The strategic point, the nexus of comings and goings.

Something's not right though! I need to be somewhere else.

Sadly (or Usually), there is no going back.

Is there a pattern to this confused-coming-to-terms-with?

From asking repeatedly about being elsewhere, especially with the setting of the sun is there a shift in attempted reasoning? So correct, so responsible all those decades ago. Perhaps even months ago...

If no one will listen to me then perhaps if I have my wife/husband with me then they will see the importance of my cause, my mission.

See look - I have my wife, husband, partner with me now: we really need to go!

Can the residential care home support this person? Can they meet their care needs? They say they are ‘struggling’. Will they need to move – again?

How do they work through this transition? What do we know of how individuals negotiate this transition in their lives? How can we try to understand?

How do they make sense of what has happened, and where they now find themselves? Will their level of distress, agitation gradually extinguish as with their efforts to leave?

As they look to the windows, seek to traverse the doorway, cross the foreign threshold and venture to that somewhere that is not here, we know one thing.

Person centredness lies in the minutia of the life once lived through those locked doors and windows.

We can ‘open’ the doors and windows by travelling with them, together, sharing that journey, the sense of those times and upon returning help them adjust to this new listen and how. Clearly, deprivation of liberty is not a punishment here, yet it demands compensation by provision of high quality personalised care.

Wednesday, 30 October 2013

TEDMED Great Challenges Google+ Hangout: Unraveling Dementia 31st Oct

Unraveling Dementia: The Race to Find Answers

Thursday, October 31st, 2PM EDT

Recent advances in research are describing more of what we need to know to prevent or treat Alzheimer's and dementia. Projects like the BRAIN Initiativedescribed at TEDMED 2013 by Dr. Rafael Yuste, and new medication discoveries, drive our opportunities to best understand dementia and imagine a future without it. Join our online conversation to talk about the latest breakthroughs in dementia, including research that has identified early lifestyle changes you can make to reduce your risk. 
 
Tweet questions and comments to #GreatChallenges and we’ll address them on air.  Join Us!

http://tedmed.com/greatchallenges?ref=live-events

Tuesday, 8 October 2013

Zero, One, Fifteen, (Thirty, Sixty...?)

SOCIETY
care-S S-cares
context: UK news media 15 minute carer visits to elderly clients

INTERPERSONAL : SCIENCES
SOCIOLOGY : POLITICAL
individual
Reflecting on Social Care with Hodges' model
The one, self, me, a person. Carers: ethics (and common sense? when is 15 minutes of 'fame' enough?), demonstration of rapport, empathy, dignity, loneliness, independence. Carer stress. Job satisfaction. Staff knowledge and skills. Observation. Mental state. Mood. Choices - personal preferences. Personal - carer's values. Cognition - Re-cognition. Case review. Individualized care? Expressed concerns (wither...?) theory: task vs. person-centered care
mechanistic aspects of care, travel, geography, arrival, tasks, plan, recording, constraints - esp. time, practical problems encountered. Number of carers involved. Safety. Protective clothing. Seasonal factors. Evidence base? Best practice? Relapse rates? Telecare role? Physical mobility - movement. Systems, processes, logistics and scheduling. Degrees of freedom - flexibility. Data, information, datasets. Admissions - depth of data?
practice: task vs. person-centered care
Caring relationship building, trust - very personal - intimate care, subjective: time with someone I like / don't like? Relatives experience. Social care infrastructure - community centers. Ability to go out shopping with a carer. Media: BBC 2 Newsnight 7/10/13; The Times; C4 News. Social contact. Social mores (time?)
Policy, professionalism, recording, outcome measures. Agreement - care plan. Care reviews. Ban on 15 minute visits? Management. Standards. Supervision. Zero hour contracts. Pay and conditions. Staff turnover. Vulnerable adults. Personal development, training. Risk of organization's reputations being damaged. Corporate responsibility, values. 'Value for money'. New commissioning systems. Advocacy (position significant). Whistleblowing. 'Francis effect' increase in nursing posts. HSJ, 25 Oct 2013, p.6. 'Funded establishment'.

group - population

Discount the contract, you can then 'discount' the individual worker and the client.
Care Relationship = Care Transaction

Wikipedia: "15 minutes of fame"

Tuesday, 6 August 2013

A New Dynamic of Ageing: The NDA Programme & Age UK research showcase of the decade

London, The Business Design Centre, 52 Upper Street, Greater London N1 0QH

You’ll know that the UK population is ageing. You’ll know that there is significant work to be done to be better prepared for ageing in our society. So it’s crucial that all of us who work in and for later life use latest evidence on ageing to support those preparations. The New Dynamics of Ageing (NDA) Programme and Age UK are proud to provide a unique opportunity to present that evidence at our joint event, held on Monday 21 October, at the stylish Business Design Centre, Islington, London.

This is the ageing research showcase of the decade, presenting the most comprehensive selection of state-of-the-art ageing research ever seen in the UK. This includes active ageing, quality of life, independence, dignity, money, work, environments, participation and connectivity to name a few. Throughout the day, you can hear from high profile speakers, pick up latest knowledge through our themed sessions, interact with exhibits in our innovative marketplace and meet the researchers. It will also be your chance to network with a wide range of colleagues from the public, private and charity sectors.

http://www.newdynamics.group.shef.ac.uk/showcase.html

Hope to see you there! PJ

Wednesday, 10 July 2013

Computer-based 'avatar' therapy promising for persecutory auditory hallucinations

A study in the British Journal of Psychiatry has reported symptom reductions among patients hearing voices, who developed computerised 'avatars' of the voices and then engaged in dialogue with them. When compared with treatment as usual during a randomised trial, the therapy group showed mean reductions in scores for auditory hallucinations and for the omnipotence and malevolence of the voices. The researchers conclude: 'Patients who are able to sustain a dialogue with their persecutor feel much more in control.'
BJP June 2013, 202:428-433
Source:
http://www.mental-health-forum.co.uk/news-blog.html

In addition see and listen to:

BBC Radio 4: http://www.bbc.co.uk/news/health-23141916

Tuesday, 2 July 2013

Living in the Memory Room: BBC Radio 4

Some people have no choice - they must become time travellers ....
There are 800,000 dementia sufferers in the UK. Kim Normanton presents a personal programme about memory and dementia, inspired by her mother's illness. She explores a new approach to treatment - recreating the past.

As her mother's memory of recent events was destroyed ... more

Sunday, 30 June 2013

ForAge International Conference, Budapest 30 Sept - 1 Oct 2013

The Future of Learning for Older People in Europe
Learning from Experience    
30 September – 1 October 2013
Budapest, Hungary


To coincide with the United Nations International Day of Older People on 1 October, the ForAge Grundtvig Multilateral Network is holding a Pan-European Conference to examine trends and developments in learning in later-life and what can be learned from the experience of European initiatives in this field. The programme includes the following topics:
  • The context for later-life learning in 21st Century Europe and the role of ForAge
  • Improving the quality of training of those trying to reach potential older learners
  • The benefits of later-life learning and the supporting evidence
  • Experiences of other European networks as information sources and influencers as well as providing expert opinion about future actions
  • Perspectives from international adult education organisations
  • Emerging issues and the further development of later-life learning
  • Older learners’ perspectives
  • Oral and poster presentations of European Projects on later-life learning

Keynote speakers include:
  • Hungarian Ministry of Human Resources, Department of Social Affairs 
  • Professor Dr László Iván, President of the Hungarian Academy of Elder People
  • Dr Alan Tuckett OBE, President of the International Council for Adult Education (ICAE)
  • Dr Michael Sommer, Infonet coordinator, Akademie Klausenhof, Germany
  • Professor Franz Kolland, University of Vienna, Austria
More details.

Monday, 17 June 2013

Walking the line of signs of movement in fresh air ...


P Being mobile and active is one
H of the most important
Y factors in longevity
S and quality of life.
I  A model of activity in residential
C and nursing home care should be a right.
O I often enquire about
-
P the possibility of residents who
O tend to become
L agitated at a certain time of
I of the day, to be taken, or assisted to
T have a walk, or at least
I  feel the fresh
C air on their faces.
A This can make a real
L difference, as Nature's natural sedative.


Prompted by a question posed by Jackie Pool on LinkedIn:
Supporting individuals through activity - a positive role for carers?

Jackie's description of an everyday indoor activity being used to promote movement and mobility flags a real issue. Access to the outdoors is still very difficult for many residents on units that are located upstairs.

Residential homes should (must) have sufficient staff to facilitate a full range of activities. This month in the Northern hemisphere it is summer: outside.

In terms of taking people out, staff often look at me and I them, as together we acknowledge the constraints that frequently operate. I've walked outside with residents myself a great opportunity to assess and engage. Staff know the benefits of movement and activity. This helps us all to get out-side of our-selves. The gift it that this diversion of sun and air (and rain) can reach through confusion and agitation, even if only for a short period of time. Hence it can be acutely frustrating when this basic need can not be fulfilled. Holding on to life's essential repertoire is vital.

Wednesday, 12 June 2013

£150k NHS Innovation Challenge Prize for Dementia in collaboration with Janssen Healthcare Innovation

We would like to draw your attention to the following information. Please circulate as appropriate. Thank you.
 
NHS Innovation Challenge Prize for Dementia in collaboration with Janssen Healthcare Innovation
 
Prize fund: up to £150k
 
If you are working in partnership to deliver integrated care that’s making a difference to the lives of people with dementia, their carers and families – then enter the challenge and share your best practice.
 
Closing date: 4 September 2013
 
For more details please see: http://www.nhschallengeprizes.org/
-------------------------------------------------------------------------
 
Regards,

Irina Johnston
CHAIN Administrative Assistant
 
If you wish to publicise information on the CHAIN Network please email your request to: enquiries@chain-network.org.uk
 
CHAIN - Contact, Help, Advice and Information Network – is an online international network for people working in health and social care. For more information on CHAIN and joining the network please visit website: http://chain.ulcc.ac.uk/chain/index.html

Saturday, 8 June 2013

New Scientist: Article on Cotard's syndrome [ and Hodges' model ]

Nine years ago, Graham woke up and discovered he was dead.

He was in the grip of Cotard's syndrome. People with this rare condition believe that they, or parts of their body, no longer exist.

... more
INTERPERSONAL : SCIENCES
SOCIOLOGY : POLITICAL

individual
Cotard's syndrome
Belief    "I am dead"   delusion (or?)
depression      self                                   suicide
 "I have no brain"    theory of mind         consc
psychotherapy           
                senses - taste smell
PET - positron emission tomography
ICD 11 - classification?
 attempts               'default network mode'
iousness          body (parts)        brain function
frontal and parietal lobes  anaesthesia
 low metabolic activity   physiology 
social impact, family, friends, carers
sense making  social understanding
stigma      interview
Jules Cotard (1840–1889), a French neurologist
media      unemployment
quality of life   autonomy   control
research funding      access to treatment
specialist services     referral processes
group - population


Source: New Scientist, 1 June 2013.
Mindscapes: First interview with a dead man

Wikipedia: Cotard delusion