Social Care – Health and Wellbeing Centre for Innovative Ageing Centre for Innovative Ageing Research Portfolio Research Portfolio May 2013 1 The Centre for Innovative Ageing Vision Statement The Centre for Innovative Ageing aims to transform novel and challenging ideas into innovative, world-leading research that can positively impact on an ageing population; to anticipate and meet the requirements, opportunities and challenges of global ageing societies, academic communities, students and research beneficiaries. We endeavour to be a Centre of Excellence undertaking world-leading research with outstanding impact. We achieve our mission through the production of creative, impactful research on ageing that is world leading. We strive to create a sustained and empowering environment for researchers, academics and support staff; giving freedom to develop inter-disciplinary research and having intellectual space for creativity; with research recognised in terms of its contribution to the social sciences while raising awareness of ageing across other disciplinary areas. The Centre for Innovative Ageing is a place where research commissioners know that best quality research will be undertaken, and where people want to work. 1 Vision Statement 1 Centre Research Priorities 4 Introduction 5 Social Care, Health and Wellbeing 6 • • • • • Maintaining function and well-being in later life: A longitudinal cohort study All Wales Academic Social Care Research Collaboration (ASCC) – Research informed practice and practice informed research The role of older people’s support networks in health literacy and patterns of health and social care service use An evaluation of the impact of integrated health and social care delivery that promotes independence and wellbeing for older people Secondary prevention of stroke: The views and experiences of stroke survivors, carers and health practitioners Environments of Ageing • • • • • • • Going outdoors: Falls, ageing and resilience (Go Far) Extracare: Meeting the needs of fit and frail older people? Older Peoples Use of Unfamiliar Space (OPUS) Extracare: A cost effective care environment? To move or not to move? Residential relocation behaviour amongst older citizens in Wales Ageing in place: A French-British comparison of adaptations to housing environments The closure of care homes for older people in Wales: Prevalence, process and impact Community, Intergenerational and Family Relationships • • • • Inter, intra-generational and transnational caring in minority communities and inter, intra-generational and transnational caring in minority communities in Wales Grey and pleasant land? An interdisciplinary exploration of the connectivity of older people in rural civic society Intergenerational relationships and support networks of older South Asians: A comparison of the elders living in the UK, India and Bangladesh Migration, nutrition and ageing across the lifecourse in Bangladeshi families: A transnational perspective (MINA) Rights, Equality and Inclusion • • • • Elder abuse and independent advocacy: Developing research policy and practice in England Scoping study of complaints and advocacy in health and social care in Wales The effects of specific education and direct experience on implicit and explicit measures of ageism Provision of inclusive anti-discriminatory services to older lesbian, gay, bisexual identifying (LGB) people in residential care environments in Wales Death, Dying and Bereavement in an Ageing Society • End of life care for older people in Wales: Policy, practice and the effectiveness of the integrated care pathway for the last days of life Technology and its Facilitation • Care in business: Knowledge exchange project Future of Ageing • • Influencing the future of ageing Societal response to climate change 6 7 8 9 10 11 11 12 13 14 15 16 17 18 18 19 20 21 22 22 23 24 25 26 26 27 27 28 28 29 2 1 PhD Researchers 30 Older People & Ageing Research & Development Network (OPAN Cymru) 33 Post Graduate Programmes in Ageing Studies 35 Contact Us 36 3 1 Centre for Innovative Ageing Research Priorities The current research being conducted in the Centre for Innovative Ageing (CIA) falls into one of seven core strategic areas: Social Care, Health and Wellbeing Personalised care; social care information; ageing and disability; chronic conditions; mental health; life-limiting conditions; health promotion/education/literacy; health service utilisation; complimentary health; public health issues; integrated care provision Environments of Ageing Housing; supported living environments; design; social inclusion; transport; connectivity; ageing-in-place; place attachment; lighting; ageing in Wales; international disparities; architecture; migration; changing built environments; falls; rural/urban issues Community, Intergenerational and Family Relationships Social networks; support networks; intergenerational solidarity/conflict/ambivalence; loneliness; transnational relationships; social contagion; ethnicity; community cohesion Rights, Equality and Inclusion Human rights; social justice; equalities; participation; legal issues; attitudes; ageism; discrimination; advocacy; social inclusion/exclusion; empowerment; poverty; disadvantage Death, Dying and Bereavement in an Ageing Society Advanced care planning; bereavement support; carers and integrated care; choice, empowerment and decision-making; end-of-life care pathways; nurse/health care assistant education; space and place; spirituality Technology and its Facilitation Gerontechnology; assistive technologies; future-proofing; telecare and e-health; communication; education; Information Communication Technology (ICT); smart technology; user interface technology Future of Ageing Ageing with learning and physical disabilities; migrant populations; lifestyle – choices/consequences; sports; activities; consumerism; economics; arts; climate change 4 1 Introduction Population ageing is one of the most significant global issues over the coming decades. Locally, Wales has a higher percentage of the population over 65 than elsewhere in the UK, with nearly 1 in 4 over the age of 60. By 2025, for the first time in history 20% of the UK population will be over 65 and 5.5% over 80. Projections in Wales indicate that by 2031 more than one quarter (26%) of the population will be aged 65+. The increasing longevity of the global population provides new challenges which will need to be addressed to ensure that the quality of life of older people and their carers remains at a high standard. Ageing itself can be a time of opportunity, growth and development as the increasingly powerful role of the older person as a consumer is now widely recognised. For example, businesses need to identify how the ageing population will affect their workplace and market needs. ‘The reshaping of the age pyramid will reach into all corners of society. It offers fresh opportunities for businesses large and small ... new markets for products and services’ Foresight Ageing Population Panel 2000a Although biological changes do occur in later life, it is the interaction between biological, social and psychological factors that is of most relevance to older people’s well-being and lifestyle choices. With an international reputation, the Centre for Innovative Ageing (CIA) is at the forefront of interdisciplinary research into understanding how older people actively cope with and adjust to a range of factors. 60% of our research was rated as being of World-class or International quality RAE2008 The Centre achieves this by focusing its activity around the following objectives: • Engaging in world-class multi-disciplinary research to develop innovative solutions to the issues facing older people • Promoting and facilitating international collaboration between researchers, policy makers and practitioners • Communicating the findings of research in order to improve public awareness, practice and policy • Transferring and translating knowledge from research findings into potential applications through policies, interventions, services and products • Providing post-graduate educational and training facilities as well as professional courses. The centre has an applied focus and in particular has strong policy links at a national level with Westminster, the Welsh Government and the Older People’s Commissioner. In Wales, we have excellent links with business and industry and offer consultancy to SMEs as well as large companies. The Centre hosts the Older People and Ageing Research & Development Network (OPAN Cymru) and the Wales Stroke Research Interest Group, and maintains strong links to other thematic R&D Networks across Wales. Close collaborative links have also been forged with other centres in the UK (Sheffield, Kings College, Keele, Southampton, Brunel and Oxford), and internationally (Europe, Canada, USA, Australasia and India). 5 1 Social Care, Health and Wellbeing Social Care, Health and Wellbeing Maintaining Function and Well-being in Later Life: A Longitudinal Cohort Study Swansea Researchers: Prof. Vanessa Burholt (South Wales Lead), Carissa Philippart, Dr. Paul Nash, Prof. Judith Phillips Research Team: Prof. Bob Woods (Lead, Bangor), Prof. Linda Clare (Bangor), Dr. Gill Windle (Bangor), Dr. Cherie McCracken (Liverpool), Dr. Kate Bennett (Liverpool), Prof. Carol Brayne (Cambridge) Introduction Older people are living longer and form a greater proportion of the population that ever before. By 2025, for the first time in history 20% will be over 65 and 5.5% over 80. Each generation of older people differs from those that went before. They have different life experiences, expectations and views of the world. Their approaches to retirement, leisure, health, activity, nutrition and exercise differ from those of their parents’ generation, as do their ideas regarding how needs for care and support should be met, influenced perhaps by changes in families and society. Methodology This research will firstly repeat, as closely as possible, a survey of older people carried out in North Wales 15 years ago, in order to ask two specific questions: how have older people’s networks of social relationships changed in the face of great changes in social structures and families over this time period? And: has the extent of the changes in memory and thinking ability at a given aged reduced with general improvements in health, exercise and activity? This will involve interviewing 2500 people aged 65 and over twice, two years apart, so we can compare rates of change over time between cohorts. A further 2500 older people will be similarly interviewed twice in a different part of Wales, to develop a more varied composite picture. The combined sample of 5000 will enable us to look at a number of important issues, including: what makes some older people better able to cope with difficult life circumstances than others, to be resilient? Does being resilient help the person have greater well-being if changes in memory and thinking are experienced? There is some evidence that having a higher level of education, remaining active, physically and mentally, having a more active social life and being bilingual reduce the changes in memory and thinking, and perhaps dementia, in later life. This study will be able to examine which of these factors are associated with fewer changes in memory and thinking, initially and over a two year follow-up period. Some older people will also be asked to have a blood test, which will indicate the levels of nutrition, which similarly may protect against changes in memory and thinking, and also be related to levels of activity. This study benefits from the methods used having been tried and tested in previous research. This includes the procedures for identifying the older people to be approached from General Practitioner lists; procedures for training interviewers and carrying out the interviews; tests of memory and thinking; and the methods of recording, managing and analysing the large amount of data generated. The core of the data can be shared with an on-going study using the same procedures in 3 sites in England – giving a combined sample of 12,500 older people for providing estimates of health and levels of memory and thinking, and of mood. This study importantly adds consideration of aspects of personality such as resilience, a detailed analysis of networks and social relationships, evaluation of nutritional status, and the ability to study the effects of being bilingual on changes in memory and thinking in later life (up to two-thirds of older people in North Wales are bilingual). The study will provide more up-do-date information regarding ageing and older people, placing the individual in the context of their social relationships and of the wider communities in which they live. It will help governments and councils to plan more effectively for the future, and inform public awareness of the bigger picture of growing older today, drawing attention to possible ways of reducing risk factors and of developing resilience in the face of adversity. Funder: ESRC – RES-060-25-0060 Dates: 2009-2016 6 Social Care, Health and Wellbeing All Wales Academic Social Care Research Collaboration (ASCC) – Research informed practice and practice informed research Swansea Researchers: Prof. Judith Phillips (Lead), Nick Andrews Introduction The ASCC Project is an All Wales initiative being led by Swansea, Cardiff and Bangor Universities working in partnership with other HEIs and social care agencies (e.g. Care Council for Wales and Social Services Improvement Agency). The project commenced in late 2012 and is initially funded until April 2015. The two broad aims of the project (which build on the findings of the OPAN co-ordinated Huxley Report) are to support the development of evidence enriched practice and to increase the quality and capacity of social care research in Wales. The project will also build on the findings of related previous work undertaken by Professor Judith Phillips and Andrea Murray. Methodology Each of the three lead Universities are focusing on different aspects of the project, although there are some aspects which are common to all. • Swansea University has a lead on developing a distinctively Welsh model of developing evidence enriched practice (DEEP), working in partnership with a number of national and local agencies. On a national basis, this will include work with the Care Council for Wales (e.g. on their CPEL programme for Social Workers and Social Care Managers) and the Social Services Improvement Agency (e.g. their Sustainable Social Services in Wales programme), as well as Welsh Government in terms of supporting the development of evidence enriched policy. There will also be a strong emphasis on working closely with a small number of Local Authorities and social care provider agencies geographically close to Swansea University, developing a robust whole system approach based on the latest research evidence and good practice from elsewhere. For example, the project will be working with City & County of Swansea on exploring the development of community based prevention services and with Gwalia on the development of relationship centred support for people living with dementia in social care service settings. • Cardiff University has a lead on exploring the development and use of ICT based resources, including e-learning and social networking. This will include the identification of obstacles and opportunities. • Bangor University has a lead on the development and management of associated data sets, amongst other things. All three universities will also be working together to co-ordinate the ASCC Academy, which has been established to promote, develop and fund doctoral training within social care. Funder: National Institute of Social Care & Health Research (NISCHR) Dates: 2012-2015 7 1 Social Care, Health and Wellbeing The role of older people’s support networks in health literacy and patterns of health and social care service use Swansea researcher: Dr Michelle Edwards Introduction This project aims to extend Wenger’s (1989, 1990) research on support networks of older people in Wales by investigating variation in support network types and patterns of health and social care service use in 2012 for older people. This project will also focus on health literacy skills and practices within older people’s support networks, and aims to understand whether these determine their motivation and ability to engage with health and social care services. Edwards et al. (2012) found that health literacy was dispersed throughout social networks to support people in retrieving, processing and using information in order to manage their health and make health-related decisions. This project seeks to extend these findings by exploring the distribution of health literacy within different social network types (Wenger, 1989, 1990) and look at differences between those with physical and cognitive impairment, those with no impairments and those with specific chronic conditions (diabetes/depression). Methodology The project is a longitudinal study using mixed methods. Firstly, data from the Maintaining Function and Wellbeing in Later Life study (5,000 participants) will be analysed to examine the relationship between physical and cognitive impairment and health and social care service use of older people, to explore associations between network type and health and social care use, and examine whether support network type mediates the use of health and social care services for older people living in rural and urban areas of Wales. Secondly, serial qualitative interviews will be conducted with 120 participants to explore the distribution of health literacy in older people’s social networks. A Framework Approach (Ritchie and Spencer, 1994) will be used to analyse the qualitative data within the current policy climate and make recommendations for future policy. Funder: National Institute for Social Care and Health Research, Social Care Fellowship Award Dates: 2012-2015 8 1 Social Care, Health and Wellbeing An evaluation of the impact of integrated health and social care delivery that promotes independence and wellbeing for older people Swansea researcher: Dr. Susan Carnes Chichlowska, Academic Supervisor Swansea University, Mr. Christian Beech, Welsh Government Supervisor, Dr. Jamie Smith. Academic Lead, Prof. Vanessa Burholt. ) Introduction This project aims to evaluate the impact of new ways of delivering integrated health and social care to older people in Wales that promotes independent living and wellbeing. Integrated services have been defined as; a single system of needs assessment, commissioning, and/or service provision that aims to promote alignment and collaboration between the care and cure sectors (Ham, 2008). The driving force to restructure care delivery has been spearheaded by the Welsh Government in response to the challenging economic climate and the demographic population changes predicted for Wales. Integrating health and social care delivery is assumed to have the double benefit of being cost effective and necessary to provide a seamless and streamlined service for the end user. There is a growing body evidence of the cost effectiveness and the cost benefit of integrated care that report cost savings from as much as £2.65 for health care for every £1 spent on social care (English White Paper, July 2012). Other evaluations have been less conclusive, with results that do not suggest cost effectiveness when total input costs have been considered. Therefore, this project aims to specifically evaluate the impact of selected services for cost effectiveness, cost efficiency and cost benefit to the older service users that are in receipt of integrated health and social care in Wales. Methodology The project aims to construct an evaluation framework to guide the development of bespoke assessment tools that are fit for purpose for the many different services that offer integrated health and social care for older people. Initially a realistic evaluation (Pawson and Tilley, 2011) will be conducted on existing integrated services that are being delivered in Wales. Thirteen services were identified and reported on by the Social Services Innovation Agency (2011). These services will be revisited and follow-up semi-structured interviews will be conducted with the service representatives or service managers. These interviews will provide the data which will be considered against the realistic theory which is defined by the mechanisms, context and outcomes of each integrated service delivery model. The overall realistic evaluation will typically ask and define 'what works for whom and why and in what context?'. This information will be used to inform the development of an integrated health and social care evaluation framework. An initial pilot study to test the framework will be field tested in Bridgend. Integrated care team managers will work together to identify meaningful outcomes that will evaluate the impact of care delivery on the service user. Additional bespoke output measures will also be used to evaluate the cost and impact of service delivery. The service will develop a unique set of data that will form the basis of an evaluation assessment toolkit. Outcome and output measures and performance indicators will relate to the core indicators in the evaluation framework. The initial findings from the pilot project will be used to refine the framework and associated guidance for the construction of bespoke impact evaluation toolkits. The framework and guidance to develop a toolkit will then be used with three other identified projects in south and mid Wales. Conclusion The realistic evaluation will highlight the processes and outcomes of integrated care delivery. The evaluation framework will be developed and populated by national performance indicators, service output measures and service user outcome measures. Evaluating service user outcomes will give an understanding of the social benefit and impact of the new ways of delivering health and social care to older people. The knowledge transfer will contribute to shaping national policy and local services to deliver better outcomes, at lower cost. Funder: Welsh Government, Swansea University and the Technologies Strategy Board, A Knowledge Transfer Programme between the Welsh Government and Swansea University Dates: 2012-2014 9 1 Social Care, Health and Wellbeing Secondary Prevention of Stroke: The Views and Experiences of Stroke Survivors, Carers and Health Practitioners Swansea Researchers: Dr. Sue Lambert (Lead), Christine Stock, Prof. Joy Merrell, Dr. Katharine Daneski Introduction People who survive a first stroke are more likely to suffer another stroke compared to the general population. Little research has been undertaken in Wales to find out how stroke survivors and their carers understand and apply secondary prevention guidelines in their day-to-day lives. Methodology Mixed-methods were used to augment data collection resulting in triangulated output. A self-completion questionnaire was used to establish current knowledge about secondary prevention. Qualitative work followed using focus groups with stroke survivors and carers and one-to-one interviews with health workers. Results The findings revealed gaps in knowledge and lack of information provision affecting comprehension of secondary prevention. 78% of stroke survivors and carers surveyed thought that giving up smoking would have a major impact on preventing another stroke. The lowest rated answer was ‘taking a multi-vitamin every day’’ (10%). Stroke survivors’ and carers’ information-seeking behaviours varied enormously. The majority of stroke survivors and carers reported doing at least one thing themselves in order to find out how to prevent another stroke (87%, n=62). The most popular way to gather information was from leaflets: more than a third of stroke survivors and carers reported reading relevant leaflets. The focus groups discussed secondary prevention but also discussed topics prioritised by the participants themselves. Analysis revealed three key environments which influenced secondary prevention: the health environment, the lay social environment, and the internal emotional environment. The theory of salutogenesis informed the understanding of the experiences of the stroke survivors and carers. Conclusions Stroke survivors and carers need access to high quality secondary prevention advice and support post-stroke. Every opportunity to reinforce secondary prevention messages needs to be taken if the high incidence of stroke recurrence is to be reduced. The impact of a multidisciplinary team approach on secondary prevention was highlighted. Participants’ experiences within the health environment, for example their initial stroke illness encounter, impacted their ongoing relationships with health workers. In the lay social environment, family food culture and exercise habits impacted on adherence to secondary prevention recommendations. How the stroke survivors and carers coped emotionally with stroke influenced their ability to implement secondary prevention. The theory of salutogenesis may help practitioners to develop innovative interventions to enhance secondary prevention. Funder: Welsh Office for Research and Development - RFSSA07-3-004 10 1 Environments of Ageing Environments of Ageing Going Outdoors: Falls, Ageing & Resilience (Go Far) Swansea Researcher: Prof. Judith Phillips Research Team: Prof. Marcus Omerod – University of Salford (Lead) Introduction This study explored the features of the outdoor environment which shape older people’s resilience to falls. This aim was achieved through the following research objectives: 1. 2. 3. 4. To consider the role of the outdoor environment in shaping social and local geographical inequalities in health; To explore older people’s perceptions on and experiences of falling (and fear of falling) outdoors; To develop and test innovative methods, tools and techniques to evaluate the relationship between the person who falls (or who has a fear of falling) and the outdoor environment; To develop a clear road map for future, cross-disciplinary research that will be both robust and practicable, to address the most important issues related to ageing, falls and the outdoors. Getting outdoors is a key factor in preserving good physical, mental and social health in all age groups but particularly as people move into older age. In the UK alone, it is estimated that the ‘cost’ of sedentary behaviour is £8.3 billion per year to the economy. However, falls can lead to disability and decreased mobility, and fear of falling is a key inhibitor of getting outdoors for older people. Many of the environmental risk factors (pavement quality, dilapidation, kerb height) associated with outdoor falls appear to be preventable through better design and maintenance and through better understanding of how individuals perceive opportunities in the environment. Methodology The study involved seven institutions with the School of the Built Environment at the University of Salford. The University of Salford acted as the principle investigating institution with Professor Marcus Ormerod as the Lead investigator. Swansea University (Professor Judith Phillips) was involved in work package 2 which looked at: What do older people perceive as the key risk factors for falling in the outdoor environment? A target of 10 and a minimum of seven focus groups of 4-8 older people were conducted to explore dimensions of relevance of the outside environment in outdoor falls. Participants who had recently fallen outdoors were recruited from different geographic regions and in varying urban/suburban and more rural contexts. The desired sample was heterogeneous on four variables: age (65-74, 75-84, and 85+), gender (male / female), health status (healthy / active and frail / sedentary, and some with visual impairment), and location (from across the UK, urban / rural, and statutory / voluntary / private sectors). Framework analysis (Ritchie, Spencer, & O’Connor, 2003) was used to perform an inductive and thematic-style analysis of the data. From this work, it was identified what older people perceive to be key risk factors and issues that lead to outdoor falls, and recommendations have been made for preventing future outdoor falls. Funder: Medical Research Council (MRC) – Lifelong Health & Wellbeing; G1001872 Dates: 2011-2013 11 Environments of Ageing Extracare: Meeting the Needs of Fit & Frail Older People? Swansea Researchers: Prof. Vanessa Burholt (Lead), Dr. Paul Nash, Prof.Judith Phillips, Dr. Sarah Hillcoat-Nallétamby, Dr. Sherrill Evans, Prof. Ceri Phillips Research Team: Dr. Sinead O’Mahoney (Llandough Hospital) Introduction The key assumptions behind extracare developments are that they will enable older people to live for longer in their own homes, utilising a range of care and support services thus promoting their health and well-being. This research looked at the integration and management of care packages across three care environments; those of extracare, residential care and care in the community. The primary research question was ‘Does extracare accommodate the needs of both fit and frail older people, particularly those with cognitive impairments?’ Methodology A sample of 180 service users was drawn from three care environments and split between both North and South Wales. A questionnaire including measures of resilience, nutrition, loneliness and levels of physical activity were utilized in conjunction with physical grip strength and mobility measures. Following the questionnaire, 90 older people from the original sample were interviewed, using a semi-structured cognitive interview technique to gather subjective experiences on ageing and the care being received. Results Extracare provides for proportionally fewer frail older people than the other care environments. There are proportionally more physically frail older people in the community than in extracare, and a greater proportion of cognitively frail older people in residential care than in extracare. The care services provided within extracare facilities lack both breadth and depth. Extracare environments provide the conditions for increased social interaction which were particularly effective for older widows. However, there were no differences in the levels of loneliness between the three living environments: although social interactions are increased in extracare environments, the interactions do not necessarily lead to high quality and emotionally satisfying social relationships. The type of care environment is not predictive of quality of life (with two exceptions). Older people in residential care homes were least satisfied with control over financial matters, and extracare residents were least satisfied with access to personal care services. Conclusions Extracare should be defined clearly by the Welsh Assembly Government – there should be a gold standard so that it is clear to older people what they can demand/expect from these facilities either in the public or private sector. The unified assessment process needs to be re-examined and challenged especially with regard to the over-simplified outcome that older people with cognitive impairment ‘pose a risk to themselves or others’ and thus cannot live independently in the community. Examples of good practice should be provided to encourage care managers’ use of innovative care packages to help people remain independent in the community or in extracare schemes (if they should wish to do so). Although the development of a socially connected community within the facility may be an important facet for extracare home managers as they try to deliver the a range of facilities that promote participation, for those residents who have longterm friends in the community, support to facilitate visits or other forms of communication between them may be more important. Funder: Wales Office of Research & Development (WORD) - RFSC07-3-012 Dates: 2009-2011 12 1 Environments of Ageing Older People’s Use of Unfamiliar Spaces (OPUS) Swansea Researcher: Prof. Judith Phillips (Lead), Dr Mike Lewis Introduction As urban landscapes change through regeneration or decline, the use of space changes and previously familiar places may become unfamiliar. Unfamiliarity can lead to insecurity, disorientation, fear over personal safety, social exclusion and loss of independence. Enabling navigation and orientation in built environments is essential to facilitate 'ageing in place' and assist the increasing numbers of older people travelling the world as tourists. The aim of the project was to investigate the influences on someone’s ability to cope with unfamiliar environments; to examine the extent to which unfamiliar environments curtail autonomy and independence, and lead to social (and environmental) exclusion; to identify the characteristics of places that make them threatening or worrisome; to explore how technologies can assist in enabling older people to adapt to or ameliorate change in their environment and finally to engage with spatial planners in discussing forms of environmental design that facilitates older people’s use of space. Methodology Direct assessment of participant’s navigational ability was followed by questionnaires about familiar and unfamiliar town centres. Participants then watched and commented on a film of a route through an unfamiliar town during which time their heart rate was monitored to assess stress levels. A three day visit to the unfamiliar town was undertaken with eight participants and focus groups with local residents and spatial planners were conducted. Results Landmarks and distinctive buildings were more important than signage in navigating unfamiliar areas; however the meaning of space and memories attached to places was significant particularly in familiar spaces. Barriers exist in using landmarks to navigate unfamiliar places. Landmarks were important navigational aids but people had difficulty keeping them in view, particularly if these were upward cues in the visual field and there was a need to negotiate the immediate environment and attend to lower cues such as broken pavements and billboards. Sensory overload was experienced through too many cues and barriers in the environment. Shared space was often not sufficiently segregated and clear for the older visitor to negotiate. Conclusions Designing outdoor spaces that are pleasant and easily walkable as well as routes that are navigable is important in making the environment less worrisome. A variety of appropriate cues are necessary to assist navigation and provide a pleasant experience for older people. Such cues should be distinctive and include a variety of signage, appropriate postings, colours and background historical information. The meaning (as well as use) of space may change as people age. Preserving memories of spaces and places is important in relation to regeneration of towns and city areas. There are a number of barriers in relation to physical safety that are a concern for older people, particularly when they experience new environments. Many of these apply to all age groups and a focus on inclusive design is a key issue. However older people can add considerably more to the experience and ambience of a place through recording their collective memories of spaces and places enabling the unfamiliar to some to become 'familiar'. Funder: ESRC New Dynamics of Ageing Programme: RES-3 52-25-0003 Dates: 2008-2010 13 1 Environments of Ageing Extracare: A Cost Effective Care Environment? Swansea Researchers: Dr. Paul Nash (Lead), Prof. Ceri Phillips, Angela Farr Introduction Extracare has evolved to provide a living environment where older people can be supported in their own home from having no care requirements through to having higher level integrated complex care requirements. Little cost information exists regarding the overall benefits of this care environment over any other in fiscal terms. Using retrospective longitudinal information, this research compares and contrasts the utilisation of health and social services and their associated costs for those living in Extracare; in their own homes; in sheltered housing; and residential care settings. Making use of local authority ‘supporting people and adult social care’ information as well as information contained within the Secured Anonymised Information Linkage (SAIL) database at Swansea University, a pragmatic cohort of older people has been identified from Swansea and their use of health and social care services monitored. The SAIL database has provided access to health service utilisation by those in each of the care environments to assess the overall cost effectiveness. Methodology Researchers at Swansea University have been working in partnership with Swansea Local Authority. Currently, data on service use is being linked to participants unit cost data. A complete economic costing across health and social care services will be conducted to ascertain any cost benefit of different supported living environments relating to subsequent utilisation of NHS resources. Results The costing information can be used to identify the most cost effective environments for delivering different types of care package. Where more complex needs may be better supported in more intensive care environments such as residential care, more social interventions could be better delivered in extracare to aid the independence of the older adult. Results will be compared between environments and total economic cost will be calculated. Recommendations can be made in partnership with previous research on extracare conducted in the CIA regarding the delivery of complex and integrated care packages. Funder: SEWIC (South East Wales Improvement Collaborative) Dates: 2012-2013 14 1 Environments of Ageing To Move or Not to Move? Residential Relocation Behaviour Amongst Older Citizens in Wales Swansea Researcher: Dr. Sarah Hillcoat-Nallétamby (Lead) Research Team: Dr. Jim Ogg (Young Foundation, London) Introduction The project aimed to increase knowledge about the residential relocation behaviour of older people living in Wales and the decisions they make about whether to move or remain in familiar home and neighbourhood environments. This knowledge is needed in a policy context where promoting independent living, facilitating older people’s choice of where and in what types of accommodation they wish to live, and ensuring high quality housing environments for an increasingly large ageing population are key government priorities. Methodology Data from the 2004 Living in Wales survey (and its accompanying property survey) were analysed to identify two groups of older people aged 55 or more living in Wales - ‘movers’ who have moved within the past six years and ‘stay putters’ who have remained in their homes for six years or more. Descriptive statistics and logistic regression analysis were performed to: establish each groups’ socio-demographic profiles; assess whether ‘movers’ had a better quality of housing than ‘stay putters’ in terms of state of repair and neighbourhood environment; examine ‘movers’ motives for their recent decisions to relocate; identify the factors which have made some older people more likely than others to have moved in later life. Results Moving decreases with age (except around the age of 80+) and the majority of older people have not moved for more than two decades. ‘Movers’ are more likely than ‘stay putters’ to have been born outside Wales, to be living by themselves after the age of 75, in more modern and smaller properties, and to be ‘very satisfied’ with the state of repair of their homes. ‘Stay putters’ are more likely to be home owners and on average, have a more positive attitude towards their neighbourhood. Key reasons for moving related to housing (45%), personal and family reasons (24%) and neighbourhood (8%). Those most likely to have recently moved are: the ‘younger’ old, people born outside Wales, living in modern properties built after WWII, renting their accommodation, living in 1-bedroom accommodation and alone. Gender, illness or disability status, household income and work status (for those of pre-retirement age) do not appear to influence whether older people living in Wales will have moved. Conclusions Findings indicate the importance of distinguishing between the effects that moving in later life can have in terms of a person’s immediate living environment and the broader neighbourhood or community environments into which they move. Moving in later life because of housing environment needs suggests that if given more opportunities and appropriate information, older people would be in a better position to make more deliberated and planned choices about moving, to ensure that their housing environment ‘fits’ with their changing needs. Funder: The Office of the Chief Social Research Officer (OCSRO) for the National Surveys Secondary Analysis Programme, Welsh Assembly Government, Wales Dates: 2009-2011 15 1 Environments of Ageing Ageing in Place: A French-British Comparison of Adaptations to Housing Environments Swansea Researcher: Dr. Sarah Hillcoat-Nallétamby (Lead for Wales) Research Team: Dr. Jim Ogg, Sylvie Renaut, Prof. Catherine Bonvalet Introduction Taking France and Great Britain as comparative contexts and with a particular focus on Wales, this research project aimed to highlight housing policy provisions in each country relating to housing adaptations which had been designed to help older people live independently in their own homes. Methodology The project adopted a mixed-method approach involving analysis of survey data for the population of individuals aged 75+ in each country (2002 English Longitudinal Study on Ageing; Welsh 2004 Living in Wales survey; French 1999 survey Handicap, Incapacité, Dépendance); qualitative interviews with housing adaptation service providers, their older clients, and government-level policy makers concerned with housing; a critical analysis of strategic policy documents relating to housing and ageing policies. Results Older people in England, Wales and France share similar demographic profiles, although the proportions renting their accommodation from the social housing sector is lower in France. The overall trend in each country is a gradual increase in the proportions of households with adaptations (grab rails, adapted bathrooms) with increasing age, although the majority of older households do not have these facilities. Each country shares similar problems regarding the implementation of housing adaptations and improvements including: significant regional variations; implementation dependent on local-level service provider capacities to respond to demand; the degree of local authority commitment to promoting housing-related preventive-based measures. Each country also recognised certain issues relating to the provision of housing adaptation services, notably: service user difficulties in accessing information; complexities in the number and types of services offered, as well as in sources of funding or financial assistance; significant regional and local variations in service provisions; service providers’ difficulties in demonstrating the preventive value of housing adaptations and of obtaining funding support for preventive interventions (e.g. installing a walk-in shower before someone has an accident); acknowledgment by service users and providers that even minor adaptations can have a very positive, life-changing impact upon older people’s quality of life. Conclusion In each country context, the question of how to house an older population in decent and affordable accommodation seems only recently to have come to the fore, and presents a particular challenge in terms of adapting existing housing stock. Governments in each national context need to facilitate preventive approaches with regard to the provision of housing adaptations for older people. Funder: France’s Mission de la Recherche – MiRe/DRESS, Direction de la recherche, des études, de l’évaluationet des statistiques, Ministere de la Santé, de la Jeunesse et des Sports, Paris Dates : 2009-2011 16 1 Environments of Ageing The Closure of Care Homes for Older People in Wales: Prevalence, Process and Impact Swansea Researchers: Prof. Vanessa Burholt (Lead), Prof. Judith Phillips, Beth Winter, Christian Beech Research Team: Sarah Stone (Deputy Commissioner for Older People in Wales) Introduction In 2009 the Welsh Government (WG) developed guidelines entitled ‘Escalating concerns with, and closures of, care homes providing services for older adults’. The introduction of WG guidelines provided us with a timely opportunity to examine the way that care homes are closed. The research aimed to • Identify the rate of closure of care homes for older people, the types of homes closing and the reasons for closure from 1 June 2009 to 31 May 2010 • Examine the process surrounding the closure of care homes in 2010/11 especially with regard to adherence to/deviance from the guidance issued by the Welsh Assembly Government in the public and private sector • Explore the consequences for and the experiences of providers, key workers, older people, their relatives and carers during and after relocation because of the closure of a care home and in care homes that have been announced as ‘under threat’ of closure. Method This research used mixed methods including (i) secondary data analysis of CSSIW data, (ii) semi-structured telephone interviews with CSSIW inspectors and managers/owners of care homes that have closed, (iii) documentary analysis of minutes of meetings and (iv) case studies and in-depth interviews with providers, older residents, relatives and carers during the closure of care homes, and in care homes saved from closure. Results We found that the spatial distribution of care homes in the independent sector is problematic when one care provider has several care homes within a fairly small area (e.g. within one Local Authority), or has many care homes within a region. The vulnerability of the independent sector is further aggravated, in some circumstances, by a lack of financial stability. Based on our observations of the care home closure process and considering the WG guidelines for Escalating Concerns with and Closure of, Care Homes Providing Services for Adults, we recommended amendments to the document based on our results. Conclusions In terms of monitoring and reporting on care home closure in Wales, we recommend that CSSIW should undertake more in-depth analysis of the data on care home closures (or saving care homes from closure). We believe that the WG should legislate for the maximum proportion of care homes that a single independent provider can supply within a single local authority (or other geographically defined region). Furthermore, the financial health of an independent provider should become a factor that is taken into consideration before registration as a care home provider. We have made major changes to the Annexes of the Escalating Concerns with and Closure of, Care Homes Providing Services for Adults to ensure that the several stages of the process are separated from each other. We have described monitoring and proactive actions to prevent escalating concerns and home closure. We explain when a Joint Interagency Monitoring Panel (JIMP) should be established or take action during the ‘threat of closure’ and provide examples of the process that should be adopted during escalating concerns and the threat of Voluntary Closure of care homes. Finally we describe the process of care home closure for all sectors. These together provide much clearer guidance to the statutory agencies. Funder: Wales Office of Research and Development for Health and Social Care scheme: SC09/09 Dates: 2010-2011 17 1 Community, Intergenerational and Family Relationships Community, Intergenerational and Family Relationships 1 Inter, Intra-generational and Transnational Caring in Minority Communities & 2 Inter, Intra-generational and Transnational Caring in Minority Communities in Wales Swansea Researchers: Prof. Vanessa Burholt (Lead), Dr Christine Dobbs, Stefanie Doebler Research Team: Prof. Christina Victor (Lead) Brunel University (BU), Wendy Martin (BU) Introduction Evidence regarding the provision and receipt of informal care by older people in minority communities is partial: focusing upon individual communities thereby making explicit comparisons to identify similarities/differences between minority communities and the general population is challenging. Some communities are especially under-researched (Chinese most notably). Quantitative research has used a very narrow conceptualisation of care and has specifically excluded the transnational and/or intergenerational perspective and existing data do not enable us to provide a detailed commentary upon intra and inter-generational caring, nor do they address issues of the experience of the receipt of care. The study aims to map out the diverse and changing context of the provision and expectations of informal family care for older people living in black and ethnic minority communities, illustrate links with formal care provision and offer insights as to how this may (or may not) change for future generations of elders, and evaluate how different these issues are from those characteristic of the general population. The following objectives were identified: • What is the extent of informal family based care for older people amongst Britain’s minority communities, how does this vary across the major groups (Caribbean, African, Indian, Pakistani, Bangladeshi and Chinese) what are the links? • What are the patterns of inter-, intra-generational and transnational provision of care, and how does this vary across the major groups? • How do minority communities understand and conceptualise the notion of care and caring and how does this vary within and between generational, gender and minority groups? • Transferring and translating knowledge from research findings into potential applications through policies, interventions, services and products • How do older people from these groups experience the provision of informal care from the same and younger generation carers? What is the experience of older people in providing care across and between generations? What are the experiences of providing and/or receiving care transnationally? • How are family obligations and responsibilities for the provision of informal care negotiated across and within generation groups and transnationally, and how does this vary across the major groups? Methodology We have surveyed 100 people per ethnic (Caribbean, African, Chinese, Indian, Pakistani and Bangladeshi) and generational group (40-64 and 65+): with a total sample size of 1200 we will undertake in-depth semi-structured interviews with up to 10 participants each from our generational (ages 40-64 and 65+) and ethnic groups, a maximum of 120 interviews in England and Wales. This will capture transnational aspects of caring, the extent of norms based caring, and receipt of care, provide contemporary data on ‘family obligations’ with regard to caring and establish the relationship between formal and informal caring. 1 2 Funder: Leverhulme Trust & NISCHR Dates: 2010-2013 18 Community, Intergenerational and Family Relationships Grey and Pleasant Land?: An Interdisciplinary Exploration of the Connectivity of Older People in Rural Civic Society Swansea Researchers: Prof. Vanessa Burholt, Prof. Judith Phillips Research Team: Catherine Hennessey (Lead), University of Plymouth (UoP) Ray Jones (UoP), Andrew Phippen (UoP), Inocencio Maramba (UoP), Jill Pooler (UoP), George Giarchi (UoP), Fraser Reid (UoP), Robin Means, University of the West of England (UWE), Graham Parkhurst, (UWE), Iain Biggs (UWE), Nigel Curry (UWE), Charles Musselwhite (UWE), Simon Evans (UWE), Thomas Abba (UWE), Kip Jones, University of Bournemouth (UB), Kate Galvin (UB), Les Todres (UB), Rosie Read (UB), Yvette Staelens (UB), Peter Howard (UB), Liisa Rohumma (UB), Paul Milbourne, University of Cardiff, Lee-Ann Fenge (UB), Norah Keating, University of Alberta Introduction This project brings together an interdisciplinary team of gerontological researchers and rural experts from five universities in South West England and Wales to examine the connectivity of older people living in rural areas in civic society. At the heart of this is an exploration of their voluntary collective action around shared interests, purposes and values such as formal and informal associations and community groups. Growing older in contemporary rural Britain is experienced against a backdrop of issues such as incomer group pressures, minority group citizenship, gentrification and changes in land use, all of which have implications for ageing identities, attachment to place and participation in community life. Methodology The research programme employed methods and perspectives from across the arts and humanities, transport studies, the social and geographic sciences and informatics to examine key aspects of older people’s inclusion in and contributions to the life of their rural communities from a positive ageing paradigm, including a survey of 900 older people living in Wales and South West England. Results Members of the CIA used the data from GaPL to develop a multidimensional measure of place attachment for older people in rural areas. Using the measure of place attachment the team have empirically tested conceptual models based on the literature to identify the predictors of, and the pathways to, place attachment. In addition, data were used to develop a continuum of mobility from the physical to the ideational along which mobility can be perceived and experienced; each point offering consequent wellbeing benefits. Conclusions We have demonstrated empirically that there are distinct pathways to three kinds of connectivity between older people and the places in which they live: social attachment to place, aesthetic attachment to place and amenity/environment-oriented physical attachment. Understanding the processes by which connections are developed between older people and their rural communities provides us with an indication of potential threats to place attachment. The conceptualisation of mobilities suggests the connectivity of a community will depend on its connectivity opportunities, establishing means of connectivity and communicating and sharing those resources. Funder: ESRC grant number RES-353-25-001 Dates: 2008-2012 19 1 Community, Intergenerational and Family Relationships Intergenerational Relationships and Support Networks of Older South Asians: A Comparison of Elders Living in the UK, India and Bangladesh Swansea Researchers: Prof. Vanessa Burholt (Lead), Dr Christine Dobbs Introduction This study sought to further understanding of changes in patterns of social, individual and community life. It focused on the impact of migration on older members of Gujarati, Punjabi and Sylheti families living in the United Kingdom with regard to family solidarity, and care-giving within support networks. The study aimed to: • Explore the differences in intergenerational (parent/child) and intragenerational solidarity (siblings) between older Gujaratis, Punjabis and Sylhetis living in South Asia and the UK. • Explore gender differences in intergenerational (mother-child, father-child) and intragenerational (sister-sister, sisterbrother, brother-brother) solidarity between older Gujaratis, Punjabis and Sylhetis living in South Asia and the UK. • Adapt the Wenger (1989, 1994) network typology for application with older South Asian migrant groups to encompass both quantity of social resources and quality of relationships to provide a more diverse representation of network types. • Examine differences in network types between older Gujaratis, Punjabis and Sylhetis living in South Asia and the UK. • Explore the relationship between network types, loneliness, isolation and health. • Identify the most fragile or vulnerable network types. • Identify policy implications regarding provision and gaps in support provided to older South Asians in the UK and India. Methodology This project used data from the project Families and Migration: Older People from South Asia (2001-2003). The UK sample included 103 Gujaratis, 100 Punjabis and 100 Sylhetis living in Birmingham. In South Asia, 100 each of Gujaratis, Indian Punjabis and Sylhetis were included in the sample. We analysed relationship data for 2328 parent-child dyads, 734 sibling dyads, and 4648 network members. Using the data for parent-child and sibling dyads we used exploratory latent class analysis (LCA) to classify inter- and intragenerational relationship type according to five levels of intergenerational solidarity: structural solidarity (proximity); associational solidarity (frequency of contact); affectual solidarity (emotional closeness); and two measures of functional solidarity (giving help and receiving help). We examined the constitution of support networks and refined a list of 30 network generators to just seven questions about physical and emotional support and co-residence (co-resident children <15 years were excluded). Cluster analysis was used to identify support networks. Results We identified and compared three types of parent-child relationships (tight-knit; sociable; intimate but distant) and three types of sibling relationships (sociable, proximal-but-indifferent; detached) of older Gujarati, Punjabi and Sylhetis living in the UK with those living in South Asia. We found differences that may be a result of family change due to migration and settlement in the UK. We identified four types of support networks (multigenerational households: older integrated networks and younger family networks; family and friend integrated networks; restricted non-kin networks) and have determined that older Gujaratis, Punjabis and Sylhetis in the UK have different levels of family solidarity and provision of care to those in South Asia. Furthermore, we identified the networks that are most robust (family and friend integrated network) and those that are most vulnerable (restricted non-kin network) in terms of ill health, loneliness and social isolation. Conclusions We produced an adapted measure of support networks for use in a multi-cultural context and generated new knowledge about older South Asians’ support networks and relationships. Funder: ESRC RES-000-22-3312 Dates: 2009-2010 20 1 Community, Intergenerational and Family Relationships Migration, Nutrition and Ageing across the Lifecourse in Bangladeshi Families: A Transnational Perspective (MINA) Swansea Researchers: Prof. Joy Merrell, Jasmin Chowdury Research Team: Janice L. Thompson (Lead) (University of Birmingham), Barry Bogin (Loughborough University), Vanja Garaj (Brunel University), Michael Heinrich (University of London School of Pharmacy), Petra Meier (University of Sheffield) Introduction Bangladeshis are one of the recently migrated, major immigrant communities in the UK. As in the general population, nutrition plays a crucial role in the health status of the Bangladeshi population, who have poorer self-reported and measured health status indicated by higher rates of centralised obesity and chronic diseases. Little is known about how eating patterns and migration affect Bangladeshi women’s nutritional status and experiences of ageing. Project MINA explored Bangladeshi women’s nutritional status, food practices and experiences of ageing in Cardiff and Bangladesh. Methodology A participatory approach was taken involving trained community researchers, and mixed methods including anthropometry, heel bone density using ultrasound, questionnaires, in depth interviews, focus groups and photo-ethnography were employed. Purposive samples of 40 Bangladeshi women (aged 45+) who migrated to Cardiff, 37 of their daughters (aged 18-35) and 44 mothers and daughters in Bangladesh were recruited. Results A total of 121 women (aged 17 to 70 years) participated. Two thirds of Cardiff participants had lived in Cardiff for more than 21 years and migrated mainly to re-unite with their spouses and provide a better life for their children. Obesity was particularly high in Cardiff older mothers, with 65% having body mass index (BMI) values indicative of obesity compared to 27.3% of older mothers in Bangladesh. 42.5% of Cardiff daughters had BMI values indicative of obesity compared to 13.6% of daughters in Bangladesh. Frequency of consumption of savoury snacks and sweet foods was significantly higher in those born in the UK. Although many MINA participants recognised the importance of good nutrition, they were less inclined to alter food choices and cooking preparation methods unless they had been diagnosed with disease. Trying to make dietary changes was challenging in an environment of communal cooking and food consumption. Very low physical function was common in the Cardiff older mothers due to sedentary lifestyles, who also reported feeling socially isolated. Bilingual written, oral and web-based resources were information formats preferred by Cardiff mothers and daughters. The majority of mothers and daughters living in Cardiff expect to remain in the UK and some expressed concerns about their future care needs. Conclusions Our findings indicate that providing a social component in conjunction with a physical activity may promote engagement, particularly for older UK residing Bangladeshi women. There is a need for further culturally relevant health promotion and public health campaigns for the Bangladeshi community, provided through a range of media and incorporating oral Sylheti. Nutrition-related health promotion messages and materials need to focus more on portion sizes as opposed to the concept of the `Eatwell’ plate, which has limited relevance for communities who eat communally. In the UK it is daughters, as opposed to traditionally sons and daughters-in-law, who are increasingly assuming responsibility for caring for their elderly parents. Changes in family structures, wider employment opportunities for women and increased geographical mobility means that not all families may be able to care for their elderly parents. Planning and provision of healthcare and social services need to take account of the diverse care needs of this growing ageing Bangladeshi population. Funder: ESRC New Dynamics of Ageing Programme (RES-354-25-0002) Dates: 2008-2011 21 1 Rights, Equality and Inclusion Rights, Equality and Inclusion Elder Abuse and Independent Advocacy: Developing Research Policy & Practice in England Swansea Researcher: Andrew Dunning (Lead) Introduction There has been growing recognition of the need for independent advocacy to represent the rights, choices and interests of otherwise vulnerable older people in the UK. Advocacy is seen to complement the statutory Safeguarding agenda in preventing and protecting older people from abuse. However, the legislative status of advocacy is limited and provision remains fragile and fragmented. The author drew upon work undertaken as part of an exploratory research and development project initiated by the Older People’s Advocacy Alliance (OPAAL) UK in collaboration with Action on Elder Abuse and other partners. Advocacy in this context is defined as being ‘a one-to-one partnership between a trained, independent advocate and an older person who needs support in order to secure or exercise their rights, choices and interests’. Methodology A variety of methods and materials were employed in the project starting with a review of academic research, official reports and ‘grey’ literature. Questionnaires were completed by advocacy workers in 13 advocacy organisations. Group meetings and reflective practice sessions with advocacy workers were followed by telephone interviews with six advocacy organisations. Results The goals for intervention identified by the older person and the advocate were achieved in most cases although some advocacy schemes reported having an ambivalent relationship with statutory safeguarding bodies. There are significant challenges for advocates working in this field, which call for more guidance and support especially as the advocacy schemes reported working with people experiencing a range of types of abuse. Conclusions There is a need for more research to explore the advocacy process as well as outcomes and to source the direct views of older people themselves. Policy makers also need to make provision for advocacy for older people who fall outside the current statutory framework. Finally there is a need for advocacy practitioners to have greater opportunities for reflection, learning and support in working with elder abuse. Funder: Age Cymru Dates: 2013 22 Rights, Equality and Inclusion Scoping Study of Complaints and Advocacy in Health and Social Care in Wales Swansea Researchers: Dr Susan Lambert, Andrew Dunning Introduction This Scoping Study explored statutory complaints procedures and advocacy arrangements in local authorities, the NHS and care providers in Wales with the overall aim of setting out issues for the Older People’s Commissioner to consider. The study provided an overview of guidance and outcomes of complaints handling together with a discussion about developments and reforms that are underway to change complaints arrangements. It set out organisational structure of complaints arrangements and roles and responsibilities at national and local levels. Methodology Web-based search of national and local government and NHS policies and procedures, evidence of operation and outcomes; Telephone and face to face interviews with key informants in complaints and advocacy; electronic surveys with complaint officers in health and social care; secondary data analysis of research and policies. Results • • • • • Lack of robust, comparable data about older people aged over 60 years in complaints reports; Variations in practice particularly across health and social care; Variations in definitions of complaints and concerns; A requirement for tailor-made advocacy support for older people; The main reasons for complaints are staff attitudes and behavior, poor standards of care, care practices around personal care and communication Conclusions Participants in the study revealed a willingness to embrace change and to improve the quality of complaints arrangements. Gaps in the regulations include concerns about people who self-fund their own care at home or in a care setting. At present CSSIW does not regulate day care, nor new initiatives such as self-directed care. Extracare schemes are covered by domiciliary care and not care home regulations. People living in care homes do not have the same rights of tenure as people living in other forms of rented accommodation. On the whole, age is lacking in complaints monitoring data making it difficult to draw conclusions about the extent of complaints made by and on behalf of older people. Funder: Older People’s Commissioner for Wales Dates: 2010 23 1 Rights, Equality and Inclusion The Effects of Specific Education & Direct Experience on Implicit & Explicit Measures of Ageism Swansea Researcher: Dr. Paul Nash (Lead) Research Team: Prof. Ian-Stuart Hamilton (University of Glamorgan, UoG), Dr. Peter Mayer (UoG) Introduction It is known that people's expressed attitudes are often more 'politically correct' than their implicit attitudes. When age stereotypes have been acquired they are easily activated in the presence of older people, resulting in the generalisation of older people to the stereotyped schema held. It is the ageist attitudes held that have been shown to affect the treatment received and the way in which older people are treated. Explicit age attitudes have been shown to predict planned behaviour whereas implicit age attitudes predict unplanned behaviour and spontaneous reaction. Performance on measures of explicit and implicit attitudes in nurses and higher education students were compared in their first and second year of study. Methodology Explicit attitudes were measured using the Fraboni Scale of Ageism and implicit attitudes were measured using a bespoke ageing Implicit Association Test (IAT). The dependent variable for the explicit measure is the raw Fraboni scale score and for the implicit measure, the response latencies were calculated using the D-Measure IAT algorithm. Participants (N=74) were given the explicit measure first and instructed to circle the appropriate answers in silence before completing a computer based implicit measure. Results ANOVA results show a significant difference between the congruent and incongruent associations (F=10.55, p≤0.001) as well as between nursing and psychology students (f=44.495, p≤0.001). This data also illustrated a statistically significant difference between congruent and incongruent pairings when all student data were pooled (f=10.162, p≤0.002). The results show that there are distinct differences between congruent and incongruent associations demonstrating a preference towards younger images and thus a more ageist attitude. The change from entry to midpoint data could demonstrate a higher level of knowledge of ageing and a greater sense of self-monitoring on behalf of the nursing students as the explicit scores dropped. The increase in the gap between incongruent and congruent IAT pairings may highlight the need to review the training materials provided to nursing students. Results suggest that negative implicit attitudes which predict spontaneous behaviour are increasing in nursing when compared to the drop seen in those psychology / HE students not receiving specific age education. Conclusions There is no correlation between implicit and explicit measures of ageism which supported the supposition that they both measure distinct components of an individual’s attitude. There is no significant difference between nursing students, qualified nurses or general students on the explicit measure. The implicit trend indicates a sharp increase in negative attitudes following the commencement of undergraduate nursing and psychology courses where the explicit score remains stable. This suggests that current higher level education could result in higher levels of self-presentational bias thus mediating the responses on the explicit measure. The implicit measure is not susceptible to such conscious thought processes and as such is more reflective of underlying attitudes. The University of Glamorgan: Staff PhD Studentship research Dates: 2006-2010 24 1 Rights, Equality and Inclusion Provision of Inclusive and Anti-discriminatory Services to Older Lesbian, Gay, Bisexual-identifying (LGB) People in Residential Care Environments in Wales Swansea Researchers: Dr Paul Willis (Lead), Dr Christine Baker, Dr Sherrill Evans, Dr Tracey Maegusuku-Hewett, Dr Paul Nash, Dr Penny Miles, Michele Raithby Introduction This project sought to examine the translation and implementation of Welsh policy at a local level, specifically within the policy and practices of residential care environments for older people who identify as lesbian, gay and bisexual (LGB). Older LGB residents’ sexual health and social needs are often overlooked or not recognised in policy and practice. We explored how older LGBT people are included and supported in care environments in Wales. Care environments included Extracare, residential care settings and nursing homes including elderly mentally infirm (EMI) settings. The research question was: How are the sexual identities and relationships of older LGB residents perceived and supported in residential care environments in Wales? The research had the following aims: 1. To identify how the sexual identities and relationships of older LGB residents are supported by a) health and social care staff within care environments, b) organisational management, c) policy at provider and national levels; 2. To examine attitudes and perceptions of residential care staff towards a) older people’s sexual practices and b) older LGB residents and their sexual needs and relationships; 3. To identify the hopes, expectations and concerns of LGB adults (50+) about service provision in care environments. Methodology First, we wanted to know to what extent older LGB residents’ needs are included in Inspection Reports on care homes. Second, through established attitudinal measures on sexual practices and perceptions of older people, we wanted to examine how care staff view LGB residents and what good practice is in place for promoting their rights and interests. We used questionnaires and focus groups to gather staff perceptions across care homes in urban and rural sites based in North and South Wales. Third, policy makers and interest groups participated in focus groups to look at how older LGB residents are included in policy. Finally, we wanted to hear from older LGB people (aged 50+) through semi-structured interviews about their hopes and expectations for future residential care. Conclusions The findings will inform service providers about how they can provide inclusive and equal care to LGB residents. This information will help develop staff training and assist care environments in providing anti-discriminatory services in line with the Equality Act 2010. The outcomes of this project will also help assess the standard of care provided in a) respecting and promoting the sexual lives of residents, and b) meeting the relationship and support needs of LGB-identifying residents. Funder: National Institute for Social Care and Health Research (NISCHR) Dates: 2011-2013 25 1 Death, Dying and Bereavement Death, Dying and Bereavement End of Life Care for Older People in Wales: Policy, Practice and the Effectiveness of the Integrated Care Pathway for the Last Days of Life Swansea Researchers: Dr Christine Dobbs (Lead), Prof. Vanessa Burholt Research Team: Dr. Kate Bullen (Aberystwyth University) Introduction The level of care afforded to older people in the hospital setting has become an issue of grave and overall concern. When such patients are approaching end-of-life, they and their loved ones are particularly vulnerable and anxious, and may require psychological, social and spiritual support. The evidence-based Integrated Care Pathway seeks to facilitate the good death, and its roll-out to date reports success. But what of those who would benefit from the pathway but are not placed on it? What is the quality of their death, and how might this affect the grieving process of those left behind? Simultaneously, clinical staff are faced with immense challenges that counter-act patient-centred end-of-life care delivery. Key terms here are inter-professional and voluntary/statutory sector boundaries; poor communication; understaffing; the current NHS risk and tick-box culture. Which barriers prevent and which procedures enhance optimal practice? Methodology In order to begin to investigate these complex and intertwined issues, we conducted a three-phase qualitative study with four participant groups; (1) older people, (2) clinical staff, (3) spiritual mentors and (4) policy-makers and –influencers. In Phase I we conducted semi-structured, in-depth interviews with groups 1-3 (N=28; Analysis: IPA and Thematic Content Analysis). In Phase II we held Consultation Workshops with group 1 (N=14; Method: Nominal Group Technique). In Phase III we presented findings to group 4 (N=18) in the framework of Summative Consultation Workshops, where the groups were tasked with creating road-maps for change. Results Older people: In particular, the interaction between the older person and clinical staff was a ‘make-or-break’ area in how well the patient felt emotionally and socially. Further, it would appear that some older patients and loved ones have difficulties in placing themselves into the hospital hierarchy. There was a desire to comply to the rules, where these rules were implicit rather than explicit. Simultaneously, patient decision-making and –choice were perceived to be at odds with being the compliant patient. Clinical Staff: These individuals did the very best they could to provide the best social and emotional support to the older patient and loved ones. However and almost without exception, the barrier to providing better care or upholding care standards was identified as management, middle management in particular. .As well as pinpointing specific political and cultural changes needed, policy-makers and influencers urged for more common-sense and pragmatism in service design and delivery. Conclusion Our main conclusions are to: reconsider ‘patient-centred care’; start implementing ‘carer-centred care’; acknowledge the reality of rurality; recognise death as part of the life-course; use current resources wisely and invest wisely. Funder: Wales Office of Research and Development for Health and Social Care scheme: HA09/006 Dates: 2010-2012 26 Technology and its Facilitation Technology and its Facilitation ‘Care in Business’: Knowledge Exchange Project Swansea Researchers: Prof. Judith Phillips, Dr. Sarah Hillcoat-Nallétamby, Mark Allen Dr. Pavel Loskot, Dr.Henry Wang Introduction ‘Care in Business’ aimed to bring together stakeholders from academia, business and care-organisations with older people in order to create a vision of care and explore how new technologies and emerging trends in the ICT sector can be innovatively exploited to meet care needs. The theme of the knowledge exchange project was Assisted Living. Assisted living technology plays an increasingly important role in maintaining independence and quality of life for older people and is seen as part of a solution on the preventative social and health care agenda for policy makers. Of particular interest to the project was remote care where a carer who is constrained by working can maintain a caring role through the innovative use of ICT. Methodology Five seminar series held over an 18 month period enabled debate, discussion and knowledge exchange between key partners and experts. The seminars offered a unique opportunity for business, academia, social services, carer organisations and older people to pioneer new innovations within an increasingly important market. Some of the discussion topics: • • • Ageing and the ageing process; needs of older people and barriers in relation to ICT. Communication technologies to interconnect the care for person’s home environment, the carer’s business/work hub and other third party care settings such as care homes, GP surgeries and hospitals. User interactions; investigating social and technical aspects of assisted living interface solutions, drawing on expertise from user groups, suppliers and developers, and defining metrics and processes for assisted living system evaluations. Results Through the series of seminar events that took place, stakeholders developed a greater understanding of the gaps in research knowledge, the market potential for business, and the aspiration of carers and older people to be treated as active rather than passive consumers in both the design and consumption of products and services. Over 150 companies and organisations fed into the established network of stakeholders, with a number of product ideas being developed as a result of the inter-sector and inter-disciplinary collaboration. £3,529,525 of external funding levered in for new projects and a research paper is being developed about the interface between ageing and business. For information following the seminar events that took place, please visit: http://www.opanwales.org.uk/project_kep.htm The project follows from an A4B feasibility study 'Linking Ageing with Business', funded by the Welsh Assembly Government. The purpose of the Feasibility Study was to identify and quantify the market needs of businesses in Wales, in relation to opportunities presented by an older population. This includes the whole spectrum of business and industry, not just those addressing the health and disability needs of older people. The study focused on three key areas: increased opportunity in new markets with older people; the changing needs of an ageing workforce and older people as entrepreneurs. A summary of the report is available from the OPAN website www.opanwales.org Funder: Welsh Assembly Government Date: 2010-2012 27 Future of Ageing Future of Ageing Influencing the Future of Ageing Swansea Researchers: Prof. Judith Phillips (Lead), Christian Beech, Andrew Dunning Introduction Wales is at the forefront of major policy initiatives that acknowledge the importance of person-centred, community-level approaches that promote and maintain the independence of older people. A critical area in achieving these policy imperatives is the development of a portfolio of services, including a quality social work service, which will promote and maintain the independence of older people. Methodology A series of qualitative focus groups were conducted with older people aged 65 and over and a younger cohort aged between 45 and 65 and social work practitioners from across Rhondda Cynon Taff and Powys Council areas covering a range of relevant themes Results In general, people were unclear as to the role and purpose of social services beyond the anecdotal (and often unflattering) accounts found in the media concerning the failures of social services to protect vulnerable adults and children from harm. With regard to relying on social services to support increasing needs, participants reported that they feared introducing social services into the equation would actually inhibit their level of choice and sense of autonomy. A minority of the study participants had direct experience of social services either through arranging care for older relatives or having received limited support themselves following hospital discharge. Opinions therefore tended to be based on anecdotal accounts and experiences. Both cohorts acknowledged that people age in different ways and develop different needs. Social services therefore were not expected to provide services that would appeal to everyone. This was discussed in the context of younger generations having different expectations to their parent’s and grandparent’s generation regarding what support would be considered acceptable. Both cohorts focused on the availability of good health care as an essential component of successful ageing. Preventative services were viewed as predominantly health-related with social services providing a supplemental role to primary health care services. The discord and inconsistencies in the delivery of joint health and social services were of concern to both cohorts who sought reassurance that partnership working was being improved. Conclusions The prominent focus for participants was to maintain physical and mental health with an anticipation that changes would occur gradually, allowing time to make adjustments at one’s own pace. Both generations reported that only exceptional circumstances that could not be realistically managed through spousal, family or wider support networks would cause them to approach social services for help. Generally, older people would turn to primary health care services in the first instance with an expectation that social services would be coordinated as an allied profession to provide supplementary support to enable them and their family manage the situation as effectively as possible. From the results of this study, two main conclusions can be drawn. Firstly, community and social support networks should be encouraged that offer people further choice in how care needs may be met and managed. This entails ensuring easily accessible, community-specific information is available and local services are developed that may not be overtly associated with social services to counteract stigma and distrust. Secondly, the role of social services within the wider context of health and social care partnerships should be made more explicit, and how the choice and control older people may have in managing future health and social care needs be promoted. This is important in bringing strategies together that target all generations in raising awareness of ageing issues and the importance of forward planning for older age. Funder: Rhondda Cynon Taff and Powys County Council Dates: 2008-2010 28 Future of Ageing Societal Responses to Climate Change Swansea Researchers: Mark Allen, Prof. Judith Phillips, Prof. Mark Stallworthy This project is part of The Climate Change Consortium of Wales (C3W), a multi-disciplinary research programme across four Welsh Universities (Swansea, Cardiff, Aberystwyth and Bangor), seeking to improve understanding of the causes, nature, timing and consequences of climate change. The four universities are collaborating in order to: • • • • • develop the infrastructure for climate change research in Wales to world-class standards, create new interdisciplinary and multi-institutional research projects, build on the existing strengths to provide a critical mass of researchers and maximise the potential for collaboration across Wales, promote dissemination, educational and outreach activities that raise the international profile of climate-change research in Wales, contribute to the formulation of climate change policy within Wales, the UK and the wider international community. A key aspect of the C3W programme is understanding the human dimensions of climate change, in terms of perception and potential adaptation and mitigation responses. This project is focusing on the behaviour of individuals as citizens and consumers in the context of changing regulatory and market signals, with a particular focus on older people and young adults in Wales. A recent national survey showed that older and younger age groups are the least concerned about the effects of climate change, whilst older people are least likely to express a willingness to change their behaviour to help address climate change (Capstick et al. 2013. Public Perceptions of Climate Change in Wales. Summary findings of a survey of the Welsh public conducted during November and December 2012). As climate change mitigation or adaptation is unlikely to succeed without behaviour and lifestyle changes (Pidgeon et al. 2009, 2010), this project is seeking to better understand potential drivers of behavioural change. Funder: HEFCW via C3W Date: 2012-2014 29 1 PhD Researchers Christian Beech: [email protected] Supervisors: Vanessa Burholt; Judith Phillips Christian is a qualified social worker with extensive practice, managerial and strategic development experience in health and social care services for older people with complex needs. He is a founder member of ‘G8’; a UK network of gerontological social work academics who are committed to promoting social work with older people and the development of key professional perspectives and skills that would contribute to the wellbeing of older people and their families/carers. Christian is currently working on his PhD part-time which is focusing on multidisciplinary working between health and social care professionals, risk and older people with complex needs. Christian contributes to a range of teaching activities including the Masters in Ageing and has recently joined the BSc Social work programme at Swansea University on a teaching and scholarship contract. External Activities: th Older People’s Commissioner for Wales - Coordinator, Team Wales at International federation of Ageing’s 10 Global Conference, Melbourne, Australia. May 2010. G8 Network of Social Work Academics. 2010 - present British Society of Gerontology – Chair, Emerging Researchers in Ageing. 2009 – 2011 Older People’s Commissioner for Wales – A Review of Advocacy Arrangements in Care Homes for Older People in Wales. 2011 - 2012 Jodie Croxall: [email protected] Supervisors: Sarah Hillcoat-Nallétamby; Vanessa Burholt I have a BSc in Social Policy (awarded in 2006) from Swansea University. My PhD research focused on the bereavement needs of older people. Bereavement is a universal experience; only those who die young may escape the pain of losing somebody they love through death. Recent socio-demographic trends, particularly due to increased life expectancies and changing patterns of mortality, have made deaths outside the older age ranges relatively rare occurrences; consequently experiences of bereavement have become largely confined to the later stages of the life course. This trend will doubtless continue as populations age. In this study qualitative interviews using a semi-structured schedule were administered to two study populations; older bereaved individuals (n=10) and service providers (n=6). The interviews aimed to determine what support was available, who provided support and where there was unmet need. Analysis suggests that social isolation and loneliness are particularly dominant concerns amongst older bereaved people. Social change (e.g. increasing divorce, women in work etc.) affects the availability of informal support. Older people interviewed felt that they have particular unmet needs for support following bereavement, especially with practical matters (such as paperwork, funeral arrangements); functional support (such as transport, shopping, cleaning); emotional support (companionship, somebody to talk to) and empathetic support (shared bereavement experiences). Although increased longevity and population ageing mean that bereavement is increasingly likely to become a commonplace experience in later life, and despite significant research evidence indicating its determining effect upon wellbeing, addressing the needs of older bereaved people has remained largely at the periphery of the welfare agenda. Preliminary analysis points to the need for more formalised support for older people during bereavement. Simon Dinwiddy: [email protected] Supervisor: Judith Phillips I graduated from the University of Bath with a BSc Joint Hons Sociology and Psychology. I am currently a lecturer for the BSc. Hons Social Work and BA Hons Post Compulsory Education and Training. My research interest encompasses the personal and social factors that influence the acquisition, in later life, of the role of ‘carer’ for a partner, close friend or family member. The specific focus examines resistance to actions intended to support this aspect of the life course. Concerns regarding changes in an older person’s capacity to sustain the best interests of those for whom they care, can promote potentially oppressive intervention that embraces actions to overcome such resistance. At the time of writing, my literature search questions current social work paradigms; the role of underpinning theory; the language and discourse of care and the issue of problematizing the older person. I am refining my research topic to facilitate a focused study and credible methodology to explore these themes. 30 Ruth Hopkins: [email protected] Supervisors: Sarah Hillcoat Nallétamby; Vanessa Burholt I come from an Environmental Health background specialising in Public Health and Housing (construction, maintenance and adaptations). I was awarded an MSc in Public Health and Health Promotion from Swansea University in 2009. My dissertation looked into the effects grant aided housing repairs had had on older people’s quality of life. Whilst concluding that grant funded repairs had positively impacted on older people’s quality of life, issues remained around continued maintenance of their homes, heating, the suitability of their homes. As we age the home takes on greater importance in our lives and older people have expressed a preference to remain living in their homes as they age. Whilst processes are in place to meet medical needs, (the Health Service) and social care needs (Local Authorities and the Third Sector), policies and resources have tended to address needs in a two dimensional perspective, i.e. medical and social care needs. Older people' needs are however three-dimensional. To successfully age in place we must meet not only older peoples medical and social needs, but also their (what I shall term) ‘other’ needs. We are living in a digital age and this digital age is an ageing society. Information and communication technologies (ICT’s) have been available for some considerable time. The Internet, computers, tablets, mobile and smart phones, book readers, and gaming devices are now commonplace in people’s homes. Advances in digital technologies are also being developed to address medical needs. Distinguishing between the two technologies, assistive technologies addressing medical needs have been described generically as telegerontology, eHealth, telehealth, (this list is not exhaustive), and ICT’s is the term used to described internet and mobile network based communication technologies. A large body of research exists into the uses of eHealth technologies and older peoples uses and non-uses of ICT’s. However little research has been undertaken into ICT’s within the context of ageing in place. This research aims to investigate whether ICT’s can be a vehicle to facilitate ageing in place and meet older peoples ‘other’ needs. Deborah Morgan: [email protected] Supervisors: Vanessa Burholt; Stephen Drinkwater I have a BSc (Open) from the Open University taken primarily in health and social welfare and an MSc in Social Science Research Methods (Cardiff). My PhD project entitled ‘ The Transient Nature of Loneliness in Later Life :A longitudinal cohort study’ is a mixed method study that aims to explore this under researched aspect of loneliness . A large scale survey is currently being administered to a population based sample of individuals born before 1944, in two locations. The survey will be administered over two time points, two years apart in order to examine whether individuals become more or less lonely as they age, to ascertain which groups of older people are most or least likely to experience an improvement or deterioration in their levels of loneliness and to assess the risk of developing dementia for older people who are lonely. In addition qualitative interviews will be conducted with a smaller sample of older people who have experienced loneliness in order to explore the experience of transitions in loneliness in greater depth. Angharad Parr: [email protected] Supervisors: Judith Phuillips; Sarah Hillcoat-Nalletamby After graduating in 2011 with a BSc (Hons) in Psychology, I completed an MSc in Abnormal and Clinical Psychology (2012), both at Swansea University. My MSc project explored the relationship between death anxiety and age and afterlife belief group. Key to this project was the aim of exploring differences in death anxiety levels between younger (18-25) and older (65+) adults. My research interests include; death and dying, bereavement, spirituality, end of life care, lifespan development, particularly transitions in later life, dementia, stroke and rehabilitation, mental health, social work, social care and social policy. I have also accumulated a diverse and substantial range of skills and knowledge through my volunteering experience. Some of which have included; volunteering as a hospital discharge service volunteer for Age Cymru, a group assistant for Swansea Mind mental health charity and a communication support volunteer at the Stroke Association. In October 2012 I commenced a full-time PhD studentship, located within the Centre for Innovative Ageing, supervised by Professor Judith Phillips. The PhD involves researching ‘The role of social work with older people with complex needs in times of transition’, with the aim of contributing to the current evidence base regarding the role of social work with older people in the changing context of health and social care policy and practice in Wales. 31 1 Delyth Rees: [email protected] Supervisors: Sarah Hillcoat-Nalletamby; Paul Nash I hold a BA (hons) in English and History from Swansea University. I completed a MA in Gender and Culture in 2006, focussing on Arab women writers’ resistance to established cultural norms through their writing. In recent years, I have worked in the third sector developing services for family carers. My current research interests lie in the relationships between older couples where a significant care role exists for one partner. This converges at a micro level on power relations within relationships and the impact this has on the ability for older people to age effectively in place. This research will be framed within the context of the devolved health and social care services in Wales. At present, the focus of my literature review are the contradictory discourses surrounding ageing in place; feminist discussion on ageing and caring and current developments in social policy in Wales. I am honing specific research questions to adequately address this topic and intend to adopt a primarily qualitative methodological approach in the exploration of this subject. Matthew Roberts: [email protected] Supervisors: Vanessa Burholt; Mick Dennis Having obtained a first class (honours) in Criminology and Psychology from Swansea University I was successfully awarded a studentship within the Centre For Innovative Ageing at Swansea University. The focus of my PhD is the influence of modifiable lifestyle behaviours on cognitive function in individuals with previously diagnosed major health conditions. My PhD is part of a larger multi-centre study, known as The Cognitive Function and Ageing Study in Wales (CFAS Wales). CFAS Wales is longitudinal in nature and uses a unique sample of individuals over 65 years of age split between 65-74 years and 75 years and older. This yields data on older participants than is usual in epidemiological research. I am in my fourth year of full-time study and I am focusing on writing up. I employed quantitative methods for my thesis including moderation and mediation analysis to explore the data collected from CFAS Wales. I have participated in data collection for CFAS Wales which I found rewarding and which helped to develop my fieldwork research skills. Beth Winter: [email protected] Supervisors: Vanessa Burholt; Keith Halfacree After graduating from the University of Bristol with a BSc in Social Policy and MA in Housing Studies in 1999 I spent many years working as a practitioner in the field of housing and community development in the voluntary sector, before moving into policy and strategic positions in these areas. I have a keen interest in issues of disadvantage and social exclusion as well as service user participation and community development and in 2011 embarked on a PhD entitled, ‘Disadvantage and advantage among older people in rural communities: a multi-level and life-course perspective’. Using a mixed methods approach this PhD has three overarching aims to (1) empirically test and challenge the existing dimensions of disadvantage that have been conceptually developed to apply to older people in rural areas; (2) examine the impact of disadvantage on the lives of older people in rural communities in Wales especially with regard to well-being and perceptions of social cohesion; (3) examine the processes and pathways (cumulative advantage/disadvantage) that contribute to social inclusion/exclusion among older people in rural communities in Wales. It will explore the extent to which advantages/disadvantages accumulate through the life course, or are driven by cohort, age-related or other individual or structural change. The lessons learned from lives played out in different contexts, life stages and economic cycles will be applied to the current economic situation. Nicola Woodward: [email protected] Supervisors: Vanessa Burholt; Judith Phillips After graduating from The University of Leeds with a BA (Hons) in Sociology in 2009 I completed a MA in Research Methodology in the Social Sciences in The University of Liverpool. I carried out the MA part time and alongside this volunteered in the Information and Advice Centre at Age UK Wirral. For my Masters dissertation I worked with Age UK Wirral in evaluating their befriending service ‘Friendship Matters’. On completion of my Master’s degree I successfully gained an internship at Barnardo’s carrying out research looking at volunteer retention. My PhD ‘Transitions in informal care for older people’ is part of The Cognitive Function and Ageing Study (CFAS). I will be using quantitative analysis to explore the levels and sources of informal help for those living in the community in an urban and rural area, comparing those with cognitive impairment and those without. I will also be examining the changes in the sources of help between two cohorts (1993 and 2011) in North Wales. Finally I will be using qualitative analysis to examine the role of key caring relationships for older people and how these may change over time with increased cognitive and physical impairment. 32 1 Older People and Ageing Research & Development Network (OPAN Cymru) OPAN Cymru’s u’s vision is ‘To make Wales the best place in the UK to do ageing and stroke research and to ensure the effective coordination and promotion of the research’. research . In 2010 OPAN Cymru was awarded £1,342,988 by the National Institute for Social Care and Health Research to support this aim and to support the development of multi-disciplinary multi research proposals that may link research with policy-making policy and practice. OPAN objectives are to: • • • • • • Enhance the quality, volume and impact of ageing research Improve the integration gration of policy, practice and research Strengthen research collaborations across and within disciplines Improve the coordination of research across and within health, social care and clinical specialism's Promote a broader vision of ageing Increase the participation articipation of older people in the research process. Research Development Groups (RDG) RDGs aim to stimulate the development of collaborative research proposals to increase research activity, expertise and income across Wales. OPAN continues to develop a high quality research portfolio reflecting national priorities and current research strengths with externally funded studies in progress. Recent RDG research includes: • • • Research on Elder Mistreatment in Black and Minority Ethnic Communities Nanotechnologyy for an ageing population Justice and Older People Key Achievements Since its inception in 2003 OPAN Cymru has achieved a number of key successes: • • • • • • • • • • • A total portfolio value of approximately £30 million Over 90 funded studies on the portfolio Formed Research rch and Development Groups covering research priority areas Attracted commercial interest e.g. Welsh Assembly Knowledge Exchange partnership ‘Care in Business’ International research collaborations Worked closely with key policy makers through Welsh Government Government Task and Finish Groups and the OPAN Policy Forum Bridging the gap between research and practice by establishing research projects with practitioners Worked with and across sectors to enhance research e.g. Stroke Association award for the first infrastructure infrast research post in Wales Involvement of older people in all activities and as representatives at key UK /international events Won a substantial grant in partnership with another NISCHR network group NEURODEM Cymru Disseminate research findings, OPAN activities and relevant information via public Seminars, e.Newsbulletins and OPAN website. 33 1 Ongoing Aims The main activity for the coming years will be to improve prospects for collaborative work with academics throughout Wales and internationally where re innovative and exciting research development opportunities can develop and support and expertise are available to allow access to appropriate research funding streams. OPAN will ensure ongoing involvement of older people in all areas of its work to ensure ensure the relevance of OPANs research activities. It will continue to promote a broader vision of ageing in Wales that will challenge stereotypes and myths surrounding ageing. Research Development Group Themes Funder: Welsh sh Assembly Government’s National Institute for Social Care and Health Research 34 1 35 1 Contact Us If you would like to find out more about the Centre for Innovative Ageing, its research or its activities, then please contact: Prof. Vanessa Burholt, Director +44 (0)1792 602186 [email protected] Participatory research methods, intergenerational relationships, support and social relationships, rurality, attachment to place, housing and migration of older people (including ethnic minority elders) Centre For Innovative Ageing School of Human & Health Sciences, Swansea University, Singleton Park, Swansea, SA2 8PP Mark Allen +44 (0)1792 602819 Ageing and business, new technologies, climate change [email protected] Nick Andrews +44 (0)1792 606380 All Wales Academic Social Care Research Collaboration (ASCC) [email protected] Molly Barraclough OPAN administrator [email protected] +44 (0)1792 295687 Christian Beech +44 (0)1792 602513 Social work with older people and the Welsh cultural context [email protected] Dr. Susan Carnes Chichlowska +44 (0)1792 606397 [email protected] Mens' health and recovery from male specific cancers, end of life care and advanced care planning Maria Cheshire-Allen +44 (0)1792 295886 OPAN Research Portfolio Development Officer [email protected] Jodie Croxall +44 (0)1792 602037 [email protected] Social Support, Social Networks, Social Need, Social Exclusion, Contemporary Social Policy, Comparative Social Policy, Bereavement Dr Christine Dobbs +44 (0)1792 602952 [email protected] Bereavement, BME communities, the Dignity Agenda, Empowerment, End-of-Life care, Informal care giving, Intergenerational relation, Mixed-methods, Social networks Stefanie Doebler [email protected] Social capital and social support networks, gender, age and participation, ethnic and religious minorities in Germany and the UK, survey data analysis and quantitative methods Andrew Dunning +44 (0)1792 602563 [email protected] Social policy and ageing, citizenship, participation and advocacy, intergenerational relationships, evaluation and participatory research Dr Michelle Edwards +44 (0)1792 602019 [email protected] Health literacy, health education, health communication, long-term condition management, health care utilisation, social support Marie Gabe Medication monitoring and nursing care +44 (0)1792 518568 [email protected] Monika Hare +44 (0)1792 606425 [email protected] Ageing and end of life care in individuals with intellectual disabilities and/or dementia Dr Sarah Hillcoat-Nalletamby +44 (0)1792 295783 [email protected] Comparative social policy, housing, intergenerational relations and family ties, population ageing and policy, bereavement 36 1 Jayne Kinnear CFAS researcher +44 (0)1792 602048 [email protected] +44 (0)1792 602048 [email protected] Dr Deborah Kwan Intergenerational family relationships, food choice, nutritional aspects of ageing Dr Penny Leonard CFAS researcher +44 (0)1792 602048 [email protected] Carol Maddock OPAN co-ordinator +44 (0)1792 602048 [email protected] Prof. Joy Merrell +44 (0)1792 518575 [email protected] Promoting healthy ageing, ethnic minority health, ethnic elder mistreatment, nutrition and older people, intergenerational health promotion, community/primary care for older people Dr Penny Miles +44 (0)1792 513262 [email protected] LGBT (lesbian, gay, bisexual and transgender) Ageing and social care, LGBT rights and human rights, rights in theory vs rights in practice Dr Sarah Miles +44 (0)1792 606386 Perinatal mental health and the effects on older people [email protected] Dr Charles Musselwhite +44 (0)1792 518696 [email protected] Psychology applied to traffic and transport, how transport issues impact on the wellbeing of older people, technology, public policy and transport planning +44 (0)1792 602907 [email protected] Dr Paul Nash Psychological aspects of ageing, attitudes towards ageing, housing and healthcare provision, social networking, community inclusion, participatory approaches, ageing in place Carissa Philippart +44 (0)1792 602906 Cognitive Function and Ageing Study (CFAS) co-ordinator [email protected] Prof. Judith Phillips +44 (0)1792 602341 [email protected] Social aspects of ageing, social work, social care, carers in employment, housing and retirement communities, intergenerational networks, carework and older offenders Michele Raithby +44 (0)1792 602163 [email protected] Social work with older people, domiciliary services and care environments, social care needs of lesbian, gay, bisexual and transgender older people Emma Richards [email protected] Psychological aspects of ageing, psychological and medical treatments / interventions of dementia, alcohol and the risk of dementia, carer stress, information technology use and ageing and residential care homes Christine Stock Stroke & carers support +44 (0)1792 513269 [email protected] Angela White CIA administrator +44 (0)1792 606588 [email protected] Aelwyn Williams Health literacy +44 (0)1792 606386 [email protected] Dr Paul Willis LGBT ageing and social care +44 (0)1792 602966 [email protected] Beth Winter +44 (0)1792 602519 [email protected] OPAN +44 (0)1792 602048 [email protected] 37 1 1
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