Social Inclusion: Transnational Organization of Labour, Mobility, and Senior Care in Central and Eastern Europe

Dear colleagues,

Social Inclusion has just released a new issue, fully open access, and all articles are free for you and others to read, download and share.

Transnational Organization of Labour, Mobility, and Senior Care in Central and Eastern Europe (2026, Volume 14)

Edited by Ewa Palenga-Möllenbeck, Dóra Gábriel, Olena Fedyuk and Kristine Krause

Complete issue: https://doi.org/10.17645/si.i533

Table of Contents:

Transnational Organization of Labour, Mobility, and Senior Care in Central and Eastern Europe
https://doi.org/10.17645/si.13078
By Ewa Palenga-Möllenbeck, Dóra Gábriel, Olena Fedyuk and Kristine Krause

Migrant Live‐In Care Workers in the Global Care Chain: Results From an Online Survey
https://doi.org/10.17645/si.11728
By Silvia Wojczewski, Simona Ďurišová, Sabine Pleschberger, Anna Ernst, Rojin Bagheri, Kathryn Hoffmann and Viktoria Adler

Selling Care Skills? The Multiple Meanings of Training for Polish Live‐In Care Workers in Germany
https://doi.org/10.17645/si.11909
By Roxana Fiebig-Spindler

The Invisible Hand of Care: A Typology of Brokerage Actors in Migrant Care Labour
https://doi.org/10.17645/si.11953
By Ewa Palenga-Möllenbeck, Ivanna Kyliushyk and Roxana Fiebig-Spindler

Care Extractivism Beyond Households: Migration and Care for Older People in the Post‐Yugoslav Semi‐Periphery
https://doi.org/10.17645/si.11975
By Majda Hrženjak

Caring Communities in Urban Hungary: A Civil Society Perspective
https://doi.org/10.17645/si.12023
By Dóra Gábriel, Bettina Török and Noémi Katona

Care Under Constraint: Unmet Care Needs Among Older Adults in Romania
https://doi.org/10.17645/si.12028
By Mihaela Hărăguș and Ionuț Földes

Skill Construction and Challenges of Professionalization in the Hungarian Home Care Market
https://doi.org/10.17645/si.12029
By Noemi Katona and Dóra Gábriel

The Right to Care and Support: From Care Theory to Human Rights Law
https://doi.org/10.17645/si.12056
By Maroš Matiaško

Senior Care in Wartime Ukraine: A Fragmented Continuum of Arrangements Inside an “Unpromising Sector”
https://doi.org/10.17645/si.12060
By Oksana Dutchak, Olena Fedyuk and Anna Oksiutovych

Bounded Transport, Mobility Justice, and Claims for Recognition Among Live‐in Care Workers
https://doi.org/10.17645/si.12191
By Petra Ezzedine

In Times of the Market and Community Shift: On Live‐In Care and Caring Communities
https://doi.org/10.17645/si.12295
By Brigitte Aulenbacher, Klaus Wegleitner, Jonas Hagedorn and Bernhard Emunds

Care Outsourcing From Germany to Central and Eastern Europe
https://doi.org/10.17645/si.12319
By Kristine Krause, Veronika Prieler, Hanna Horváth, Matouš Jelínek, Mariusz Sapieha, Zuzana Sekeráková Búriková, Petra Ezzeddine and Luise Schurian‐Dąbrowska

Imagining Care: Transnational Inequality and Older Age Prospects for Ukrainian Caregivers in Italy
https://doi.org/10.17645/si.12324
By Oksana Dutchak, Olena Fedyuk and Anna Oksiutovych

The Winding Road to Professionalisation: Care Work in Romanian Nursing Homes
https://doi.org/10.17645/si.12326
By Neda Deneva, Ionuț Földes, Denisa Ursu and Mihaela Hărăguş

The Limits of State Control in Regulating Live‐In Care Work in The Netherlands
https://doi.org/10.17645/si.12375
By Siënna Hernandez, Kristína Bartošová and Franca van Hooren

Home Care for Sale: Marketisation and Social Change
https://doi.org/10.17645/si.12737
By Attila Melegh

Kind regards,

Mariana Pires
Cogitatio Press, Portugal
si AT cogitatiopress.com
Social Inclusion
https://www.cogitatiopress.com/socialinclusion

My source: COMPLEXITY-PRIMARY-CARE list

Caring with Excellence, Care that Evolves: Filipinos in Care Anniversary Event 2026

Time & Location

17 Apr 2026, 14:00 – 23:00 BST

St Mary Abbots Centre, Vicarage Gate, London, W8 4HN

About the event

This engaging 2-panel session will delve into the inspiring journeys of Filipino nurses and nurse leaders who are making significant contributions in the social care sector. Participants will have the opportunity to hear firsthand accounts of challenges, triumphs, and the unique experiences that shape their careers. The session aims to highlight the vital role that Filipino nurses play in providing compassionate care and leadership in diverse settings.

Panel 1: Personal Journeys and Experiences of Award-Winning Filipinos

The first panel will feature a diverse group of nurses who will share their personal stories. Topics will include:

• Overcoming cultural and professional challenges
• Adapting to different healthcare environments
• Building resilience and community support

Panel 2: Transitioning to Social Care

The second panel will focus on the experiences of Filipino nurses who moved from the NHS to social care. Key discussions will revolve around:

• Developing skills in a care home setting
• Key tips for the career move
• Key learnings from the shift from acute to chronic care

Takeaways: A Practical Toolkit

Attendees will leave the session equipped with a practical toolkit designed to inspire and guide them in their own nursing careers. This toolkit will include:

• Resources for professional development
• Strategies for effective leadership in nursing
• Networking opportunities with fellow nurses and leaders

Join us for this enlightening session to celebrate the contributions of Filipino nurses in social care and to gain valuable insights that can enhance your own journey in the field. Sessions moderated by Filipinos in Care Founder Kier Dungo and Co-Founder Jay Trondillo.

Tickets and website: https://www.filipinosincare.org.uk/event-details/fic-anniversary-event

My source: RCN North West Multicultural Group

Occupational therapist Joël inspires elderly to get in motion ...

Or, "Excuse me. How many movements are there in that watch?"*

"Joël Kruisselbrink’s creativity in designing exercises and games inspires elderly people to keep moving and live life to the fullest.

Nursing home residents are often understimulated and have little motivation to exercise. As an exercise instructor, Joël Kruisselbrink knows better than anyone how important exercise is for the elderly. His passion for creating exercises and games enables older people to continue enjoying life while keeping them moving."

Brightvibes: Exercise is life: Joel’s exercises and games inspire older people to keep moving

Individual

|

      INTERPERSONAL    :     SCIENCES                   

HUMANISTIC  --------------------------------------  MECHANISTIC      

 SOCIOLOGY  :    POLITICAL 

|

Group

What do you think the impact is upon the resident's mental health and emotional well-being? Psycho-
-Social?	Standards & Quality of Care Policy

*Hodges' model: A tool to watch the complications of Care

My source: https://x.com/Rainmaker1973/status/1802268229361967404

BGS Report "Smarter data, better care: Empowering care homes to use data to transform quality of care"

 

"The British Geriatrics Society (BGS) hosted an event in London in September 2023 on ideas and practice around a minimum dataset for care homes. This report, which is based on presentations at the event and the debate that followed, makes 12 recommendations for the effective implementation and delivery of a national minimum dataset that we believe policy-makers and regulators should consider."

Below, I have related the report's 12 recommendations to Hodges' model:

 Individual
  |

     INTERPERSONAL    :     SCIENCES               

HUMANISTIC --------------------------------------  MECHANISTIC      

SOCIOLOGY  :   POLITICAL 

|

GROUP

my quality of life my quality of care care home residents research - how new Artificial Intelligence can be harnessed safely and ethically to extract optimum value^^ out of linked social care data

my quality of life my quality of care integration - a harmonised set of quality of life and quality of care indicators not just a process* (data gathering/entry) by care sector on behalf of others high-level of interoperability

resident's families (advocate) needs that cannot be met at home ^Government recognition of contribution of social care sector to society linking of information sources, preserving privacy but improving public's understanding of how such data can be used (benefits) combine learning from the DACHA study, evidence of the analytic power of data instruments like interRAI, and the lived experience of those working in our care sector

care home managers & frontline staff shared decision-making - commissioners, regulators and providers sector-wide conversation around the data that does and does not need to be known by different stakeholders Investment in a data-informed system for health care and social care - greater equity between the two^ sustained - longer term approach - reduce the data burden Government funding of dedicated in-home data coordinators - cost recognised from outset

4Ps in Hodges' model -

INTRA- INTERPERSONAL - purpose
SCIENCES - process
SOCIOLOGY - practice
POLITICAL - policy

^^Where does 'optimum value' lie in Hodges' model?
How are these reconciled?

Transforming the quality of care in care homes through better use of data.  https://www.bgs.org.uk/policy-and-media/transforming-the-quality-of-care-in-care-homes-through-better-use-of-data 

STUDY: Bailed out and burned out? The financial impact of COVID-19 on UK care homes for older people and their workforce

 Via CHPI:

This research is the product of a collaboration between Warwick Business School, University College London and the CHPI, funded by the Economic and Social Research Council. 

The two year study examined  the financial impacts of the pandemic on UK care homes for older people  and their staff. It is based on an analysis of hundreds of company accounts, interviews with care home staff and a survey of over 600 care home workers.

 

Key findings

1. Without £2 billion of government support, and care workers working longer and harder, the sector would almost certainly have collapsed financially during the first year of the pandemic. That emergency funding helped to stabilise care homes early in the pandemic. Some even increased payments to investors: a quarter of companies increased dividends, by 11%.  
2. Since the peak of the pandemic, the care home sector has faced a financial crisis due to the removal of government financial support despite continuing COVID outbreaks, workforce shortages and inflation.  
3. Government support focused on keeping care homes financially viable, with only a small proportion devoted directly to supporting staff who were working in extreme circumstances. As many as 4 in 10 care home staff reported financial problems related to working in care during the pandemic. 
4. The financial impacts on staff varied by ownership type and size. Staff experiences were more positive in not-for-profits and smaller organisations on a range of measures. 
5. Staff valued in-person support from colleagues, managers, and external professionals 

Recommendations

1. Improved contingency planning for the financial impacts of future pandemics and their consequences for staffing, including creating a standby emergency social care workforce.  
2. Sustained government support for care homes coping with the lasting impacts of pandemics. 
3. Public funding for care, including emergency support during pandemics, should take account of evidence showing varying outcomes by ownership type and should seek to promote forms of provision that offer both good care and good jobs.  
4. Government and employers should improve pay and conditions for care staff, in general and especially during pandemics (including recognition payments, enhanced sick pay and overtime rates).  
5. Government should work with employers topromote a better understanding of how care staff experience their working lives, for example through an annual national workforce survey and to ensure adequate personal, professional, and clinical support is accessible to social care staff, particularly during a pandemic.
   
   

Fotaki, M., Horton, A., Rowland, D., Ozdemir Kaya, D. & Gain, A. (2023) Bailed out and burned out? The financial impact of COVID-19 on UK care homes for older people and their workforce. Coventry: Warwick Business School.

Listen also ... BBC Radio 4 Today 0652.50 

https://www.bbc.co.uk/sounds/play/m001kx5m

August 2022 - Journal of Health Care for the Poor and Underserved

To JHCPU readers,

 

The August 2022 issue of the Journal of Health Care for the Poor and Underserved (JHCPU) has been released:

https://muse.jhu.edu/issue/48370

The Note from the Editor appears below. Following the link will bring you to the full table of contents.

With best wishes for the new academic year,

Ginny Brennan

 

Note from the Editor

Public Health and Politics

Positioned at the nexus of social science and health, the Journal's work is necessarily political. One of the many concerns in the U.S. as we approach the Fall of 2022 is the U.S. Supreme Court's June decision in Dobbs v. Jackson Women's Health Organization to overturn Roe v. Wade and with it the Constitutional guarantee of the right to abortion, abrogating women's moral autonomy over their reproductive health. In this issue, Frohwirth and colleagues consider another contested site in the reproductive health care landscape—contraception affected by abortion policy—as they assess the impact on women in Iowa of a 2017 reduction in Medicaid coverage of contraceptive care. Due to the new law, patients enrolled in the state family planning program could no longer access subsidized care at publicly funded clinics affiliated with abortion provision, and over 15,000 patients had to find to find a new family planning provider. The researchers learned in their qualitative study that high fees for visits and contraceptive methods, restrictive or inadequate insurance coverage, and access barriers such as long appointment wait times were the most common barriers to preferred contraceptive care, and these barriers compounded one another. Furthermore, barriers grew once the more restrictive Iowa Medicaid policy was in place. The authors conclude that policy changes supportive of contraceptive care would decrease vulnerability and increase reproductive autonomy.

Several papers in this issue bear on the construction of datasets or use datasets in new and sophisticated ways. We publish them aware of the fact that database construction is central to many highly political debates. Qato and colleagues introduce an intermediate-level variable—the nursing home—into an analysis of the distribution of COVID19 vaccination among nursing home residents. Looking at over 12,000 nursing homes in terms of the racial heterogeneity of the residents, the authors find that residents of the quantile of homes that were more predominantly non-Hispanic White were significantly more likely to be vaccinated (mean vaccinated 85.65%) than residents of the quantile that was least predominantly non-Hispanic White (mean vaccinated 72.74%). The authors of this short article conclude, "A higher proportion of White residents per facility was associated with higher resident COVID-19 vaccination rates reflecting continued disparities in quality of care during the pandemic."

While it is not construed formally as a variable, the construct of neighborhood in the paper by DiFiore and colleagues reveals significant patterns in the distribution of food insecurity. They assess food insecurity in relationship to perceived neighborhood safety, social cohesion, informal social control, and crime, adjusted for demographics, socioeconomic status, and neighborhood characteristics. The participants in the study were 300 mothers and female caregivers of Medicaid-enrolled two- to four-year old children in Philadelphia. Greater food security was associated with higher perceived neighborhood safety and social cohesion, and lower police-recorded violent crime rates. The evidence of this research suggests that the structural condition of living in a supportive neighborhood social environment may protect against food insecurity.

Kong and colleagues conducted COVID19/food security research, using longitudinal data to assess the interrelationships among food insecurity, mental health, and the COVID19 pandemic. They found that food insecurity was associated with stress, depression, and anxiety. They also found that these conditions improved over time during the pandemic among food-secure participants but worsened among food-insecure participants. The pandemic appears to worsen the already vicious cycle connecting food insecurity and mental health.

Two papers based on the Youth Risk Behavior Survey (YRBS) argue for enriched variables for coding race and ethnicity. Jones and Satter analyze mental health outcomes based on race and ethnicity and, in doing so, they observe that over 80% of respondents to the YRBS who self-identified as American Indian/Alaska Native also self-identified as Hispanic. American Indians/Alaska Natives are often multi-racial and of Hispanic/Latino ethnicity, and therefore outcomes differ widely depending on whether one examines American Indian/Alaska Native alone or in combination with other racial/ethnic variables. Also using the YRBSS, Braun and colleagues assessed tobacco and alcohol use and adolescent sexual practices among Black, bi/multi-racial, and White adolescents. They find that results differed across all three groups, leading them to conclude that nuanced racial categories are called for.

It is our hope that these and the many other papers in this quarter's issue—through their attention to social, scientific, and political decisions affecting health and health care—will serve to advance health justice, either through or in spite of the political process.

Virginia M. Brennan, PhD, MA

Editor, JHCPU

Associate Professor, Meharry Medical College

My source:
Spiritof1848 Listserv WWW.SPIRITOF1848.ORG #Spiritof1848

Social care [ Not... ]

 INDIVIDUAL
|

   INTERPERSONAL    :     SCIENCES               

HUMANISTIC --------------------------------------  MECHANISTIC      

SOCIOLOGY  :   POLITICAL 

|

GROUP

	"No minister, a “protective ring” was not thrown around care homes"

 

McKee M. No minister, a “protective ring” was not thrown around care homes BMJ 2022; 377, :o1116 doi:10.1136/bmj.o1116

Two papers and a Conference

However much I try to multitask the result is illusory. Writing projects are many and the status of most is stalled*. Even those 'active' such as the SDG paper that combines Hodges' model, public health, specifically nutrition is on a sister journal and still awaiting word from the reviewers and editorial team. Where the paper remains active for me is that since last summer I've had the assistance of a co-author. This really does make a difference.

 Another paper I've posted about is the two-part draft [4400 Words / 46 Refs :: 4700 Words / 37 Refs] on:

• Threshold Concepts
• Hodges' model 
• Liberty Protection Safeguarding (Deprivation of Liberty Safeguarding - DoLS)
• Residential Care and Nursing Homes
  

Before the renewed focus on the SDG effort, the TC paper benefited from feedback (which will be acknowledged). Putting it down (yet again), it seemed a much more complete draft. Now, as the themes suggest, post-Covid, another revision-pass is merited. In compensation, as I find with Hodges' model and  each new year, the two-part paper's focus is even more relevant.

Next week I will once again share Hodges' model with a community of practice. Postponed from July 2020:

TC2020: 8TH BIENNIAL THRESHOLD CONCEPTS CONFERENCE, 2021

I wish I had data to back up and support the paper. I have routinely used Hodges' model implicitly in this care context as a community mental health nurse. Once again the work is descriptive. Before COVID struck, I was planning to address this and will as soon as possible. Now, I've sixteen slides to complete.

*Don't mention the website!

Anticipatory Prescribing as part of Anticipatory Care

This post is derived from a selection of the main concepts found within three papers (references listed below) on 'anticipatory prescribing'. Some explanation may assist. I have duplicated 1. What is current practice? across the domains to suggest that the question needs to be answered for each of the care (knowledge) domains. The same principle applies to the repetition of the attitudinal questions at the individual and group (sociological) level. Person-centredness demands that the patient's views are paramount plus the aggregated responses of the group as a whole.

Perhaps there is a 'drug TIME' too, which operates across all the domains once more, and each variously weighted objectively and subjectively? The concept of control and assessment of control is also critical.

I've placed GP decision-making across both 'individual' domains described as it is as a 'process' and for the patient as 'bedside manner', as also reflected in the GP and healthcare professional's communication with the family.

Clinical effectiveness and observations are likewise span the interpersonal and sciences domains. This is to denote the need to achieve and sustain parity of esteem and integrate physical and mental health care - pastoral and spiritual also.

'Cost' is anchored in the political domain, but clearly there are much wider economic ramifications, both in quality of life, quality of death and the way 'cost' is determined, measured, analysed, evaluated and reported.

For me nursing, medicine, healthcare are most effective when they are anticipatory. Observation, reflection and critical thinking are key. In a way for an individual to be health literate is a preparation for self-care. Although clearly in a general sense of health and well-being; not necessarily being literate with respect to a long-term medical condition.

Hodges' model is an idealisation and the detail is obviously described in the papers listed. The intention below is for readers to gain an appreciation of anticipatory prescribing and the application and scope of Hodges' model.

 Taking a larger perspective anticipatory prescribing is part of anticipatory care.

@GeriSoc https://twitter.com/GeriSoc/status/1374716732120645632?s=20

individual

|

INTERPERSONAL : SCIENCES

humanistic ----------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

|

group

Anticipatory Prescribing Reassurance for patient, family &  friends clinical effectiveness subjective TIME observation agitation, distress (mood, anxiety, orientation, communication, identity - self, fear, understanding, mental capacity...) The patient's spiritual well-being needs are met*. 1. What is current practice? 2. What are the attitudes of patients? 3. What are the attitudes of family carers? 4. What are the attitudes of community healthcare professionals? [as individuals] GPs’ discussion with patients (Advanced care planning - choices) 5. What is its impact on patient comfort and symptom control?

Anticipatory Prescribing Physical access to medication and treatment is assured. clinical effectiveness objective TIME observation remote anticipatory prescribing increased 24 hours availability (out-of-hours) The intervention seeks to improve [my] symptom control pain, nausea and vomiting, agitation, and respiratory secretions. The Covid-19 pandemic has accelerated the practice of Anticipatory Prescribing; more terminally ill patients are having end-of-life care at home and in care homes. 1. What is current practice? New routes of administration injection, oral, sublingual, or rectal 5. What is its impact on patient comfort and symptom control? GPs’ decision-making processes Research: Systematic review and narrative synthesis Semi-structured interviews Web-based survey

An important intervention in supporting patients and families who wish to have last days of life care at home. 1. What is current practice? 2. What are the attitudes of patients? 3. What are the attitudes of family carers? 4. What are the attitudes of community healthcare professionals? [collectively] 5. What is its impact on patient comfort and symptom control? Patient and families’ well-being throughout the end-of-life journey *There is concord and respect regards patient's spiritual well-being needs. GPs’ discussion with family family caregiver administration

The Independent Review of the Liverpool Care Pathway found that the use of Anticipatory Prescribing without adequate explanation or justification led to families being concerned about over-sedation and the medication hastening death. 1. What is current practice? 5. What is its impact on patient comfort and symptom control? 6. Is it cost-effective? Revise pharmaceutical regulations to permit repurposing of anticipatory prescribing medications in care homes, wider community drug access, and recycling unused medications returned to pharmacies. Address stock shortages.

Bowers B, Ryan R, Kuhn I, Barclay S (2019) Anticipatory prescribing of injectable medications for adults at the end of life in the community: A systematic literature review and narrative synthesis. Palliative Medicine 33(2): 160-177 https://doi.org/10.1177/0269216318815796

Antunes B, Bowers B, Winterburn I, Kelly MP, Brodrick R, Pollock K, Majumder M, Spathis A, Lawrie I, George R, Ryan R, Barclay S. (2020) Anticipatory prescribing in community end-of-life care in the UK and Ireland during the COVID-19 pandemic: online survey. BMJ Supportive & Palliative Care; http://dx.doi.org/10.1136/bmjspcare-2020-002394

Bowers B, Barclay SS, Pollock K, Barclay S (2020) General Practitioners’ decisions about prescribing end-of-life anticipatory medications: a qualitative study. British Journal of General Practice; 70(699) e731-739 https://doi.org/10.3399/bjgp20X712625 

 

National Day of Arts in Care Homes

 

 

Not long to go now until the second National Day of Arts in Care Homes, which takes place on Thursday 24 September.

During lockdown, we have seen a wealth of amazing activities and projects take place in care homes across the UK, including corridor choirs, garden concerts, socially distanced art sessions, online ceramics tutorials, live streamed concerts and dance, pen pal projects and postal art initiatives. Care settings have used the arts to raise morale, keep residents and staff stimulated, keep in touch with friends and loved ones, express worries and fears and also to celebrate birthdays and other occasions. 

Please show your support for the provision of arts activities in care homes on 24 September by organising an event, sharing stories and spreading the word.

 

Continued...

Inverse Care Law ... at Social Care's Door

Since 2015 I've had four 'conversations' with the doctors at A&E upon mum's attendance and subsequent admission on a couple of occasions. Initially, I was surprised if not shocked by the speed with which the 'conversation' followed on treatment, the extent of this and the question of resus. The further interactions were still emotionally jarring, even when expected and telegraphed. I also understand: to an extent. Repeated chest infection or urine infection had resulted in confusion, delirium that varied. on one occasion, at the nursing home there was also suddenly talk of a diagnosis of dementia, which prompted social services to wonder, like family and staff, where exactly this diagnosis had come from and investigate. (Another post?)

Mum has been very poorly, most recently in November. What surprised and shocked was the 'conversation' at the end of the bed when I knew mum - with mental capacity at that time was most likely listening. The primacy of person-centredness seemed to be by-passed. I suggested the doctor ask mum since once hydrated she would be fine. There has been a sense of a script being followed with some pressure - urgency behind it, if not a 'prescription'. I empathised with the doctors, often FY1 FY2; such matters are never easy. Now amid COVID-19 there is alarm as social care are challenged with taking on a new role, for which they are ill-equipped. 

In health care you are always conscious of the inverse care law, it seems there is another care law in operation that gives cause to worry for those who cannot advocate for themselves or have no independent advocate. Perhaps there is another inverse law that runs concurrently concerning ethics. Triage, is real. Objectively, as a nurse you think "Am I being selfish?". But, as eldest son - absolutely not. These conversations, and the future aside, the doctors and team as a whole have worked (absolute) wonders for which mum and the family will always be grateful.

Be Well, Be Safe All.

 

individual

|

INTERPERSONAL : SCIENCES

humanistic ----------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

|

group - population

"There should be no wrong door and every  service should reverse the ...	... Inverse Care Law, which simply states those people in need of health and social care the most  get them the least."
https://www.smithsltd.co.uk/doors/composite	By MrPanyGoff - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=19702555

A comment at The King’s Fund, by Lord Victor Adebowale.

Partnership Working, Time to Talk, Drink and Drugs News, October 2018, pp.10-11
https://drinkanddrugsnews.com/wp-content/uploads/2018/10/DDN-October-2018.pdf

If anyone has a photo of a red door at a care or nursing home that I can display above please let me know.

Social Care: in the round and square c/o King's Fund

Simon Bottery's Long Read -

What’s your problem, social care? The eight key areas for reform

- and listed below, have been mapped to Hodges' model. The full article and comments are well worth reading and may help readers discern the relationships between the key areas identified.

1. Means testing: it’s not like the NHS 
2. Catastrophic costs: selling homes to pay for care 
3. Unmet need: people going without the care and support they need 
4. Quality of care: 15-minute care visits and neglect 
5. Workforce pay and conditions: underpaid, overworked staff 
6. Market fragility: care home companies going out of business 
7. Disjointed care: delayed transfers of care and lack of integration with health 
8. The postcode lottery: unwarranted variation in access and performance

I have associated each with the respective knowledge (care) domain in which they are placed:

individual

|

INTERPERSONAL : SCIENCES

humanistic ----------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

|

group - population

1. Parity of Esteem in Means Testing 2. (Catastrophic) Cost to me, anxiety, depression, stress 3. Unmet need (mental health, counselling ...) 4. Quality of Care (Mental Health, Well-Being..) 5. Workforce (values, person-centred, self-esteem, job-well-done, BE the Difference?) 6. Market fragility (attractiveness as career pathway, having a leader) 7. Disjointed care (number of carers, lived experience...) 8. Postcode (I thought this had been addressed?) (postcode? - a remote 'thing' outside through the window and (summer) garden]

1. Parity of Esteem in Means Testing 2. (Catastrophic) Cost to NHS - innovation, change, prevention, transformation 3. Unmet need (physical, access ...) 4. Quality of Care (Time, Logistics) 5. Workforce (tasks, scheduling, physically reasonable?) 6. Market fragility (scale, bed occupancy, local demographics...) 7. Disjointed care (geography, transfers, A&E admissions...) 8. Postcode ('literally') North, West, East, South, Regions, London, Urban, Rural ...

1. What is your Parity across 2. (Catastrophic) Cost to my family. 3. Unmet need (socialising, access, carer ..) 4. Quality of Care (Relationships, Belonging, Communication, Family Groups..) 5. Workforce (job satisfaction, status, social worth ..) 6. Market fragility (Public perception, marketing, negativity bias - local news, time for outreach, intergenerational engagement...) 7. Disjointed care (input of family, local provisions, self-funding - budgets...) 8. Postcode (pre-social care, pre-lottery?)

Means (let's Test that.) here too?  2. (Catastrophic) Cost to the State? 3. Unmet need (my choices, informal carer ...)  4. Quality of Care (Value for £, Measures, Inspection, safety..) 5. Workforce (pay and conditions, minimum wage?, Unions, contracts, training, BREXIT ..) 6. Market fragility (FUNDING settlements, estate, investment, staff turnover, Qualified staff, commercial history, profit, governance..) 7. Disjointed care (commissioning, ...) 8. Postcode (local policy, funding, protocols ..)

An update papers, Hodges' model, website...

Here is an update on writing projects ...

WEBSITE - DRUPAL:

A few months ago I decided to cancel the web hosting. The same provider and for the second time. Lack of progress is nothing to do with them. Despite best intentions, the account was essentially redundant, apart from one occasion when I was ready to start transfer of a site including Brian Hodges' lecture notes, as part of what would be an archive. I still have the pages - HTML all ready to 'go' - somewhere... The host company were very good, offering to take me through the process. I will git back on the horse. The journey is still very enjoyable, even if frustrating.

Last weekend at the Northwest (England) Drupal User Group - NWDUG Unconference in Manchester, I gave an eleven slide presentation on the ultimate in vapour ware. Even with no site the day was very useful, the community great. At month end I will be following online DrupalCon Amsterdam. Really disappointed not to be there, but the currency situation nails it, on top of my not having earned the trip.

As posted last Tuesday -

Book: "The Empty Space"

- I've been crossing the Pennines and enjoyed visits to see Mr Hodges at his home. It would be marvellous to get to a point were I can 'demonstrate' some progress on the web front. The Drupal community continue to try to improve the migration and update processes. This can certainly help me. A Drupal developer questioned me a while ago if I'm being too loyal. Is Drupal the right tool? I am considering this ...

PAPERS:

As to papers I'm determined to try to clear the desks of draft papers. I'm not duty-bound to write, just learning-bound. In May a journal editor invited me to write about Hodges' model. The brief was more specific, write about the model but not in general terms. I was directed to relate the model to at least two public health themes.*

Trying to put a map on the map is challenging.
Everyone wants data, evidence, findings, method ...

Last month I arrived at a final draft and am now advised to answer my own queries and then submit. So sounds positive thus far. I really will diligently check the submission requirements.

The other paper is a bit of a saga, having started before the Part 1 - MRES studies at Lancaster in 2014. The paper overall concerns Hodges' model, threshold concepts and deprivation of liberty safeguarding. It is now in two-parts, feedback on part one has been favourable but still seeking people with time to read and critique- so hopefully on-track with this too.

*Public mental health is always also implied as far as I am concerned.

Distant Constellation: @HOME

individual

|

INTERPERSONAL : SCIENCES

humanistic ----------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

|

group

"Distant	CONSTELLATION"
	@ HOME  (preferably!)

https://grasshopperfilm.com/film/distant-constellation/

Care with a Smile: For a Smile in Care Homes

individual

|

INTERPERSONAL : SCIENCES

humanistic --------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

|

group

Self-esteem, self-image anxiety, worry, depression Able to express needs communication Ability to ask, remind, argue - self-advocate Challenging behaviours, agitation, aggression Irritability, poor sleep reduced attention and concentration Observation of staff - pain? Loss of dentures, memory

Changes in gums, gum disease, weight loss cleaning teeth, false dentures, fit, marking dentures, care plans Access to toothbrush, toothpaste, mouth wash, Oral hygiene Sugar – sweets (one of few pleasures?) Risk of thrush and other infections (cardiac?) Mobility of the resident Appearance and sense of well-being Pain of toothache, analgesia – tiredness Avoiding eating and drinking properly Access to dental surgery Changes with speech Equipment challenges of remote care, technology changes Mobile clinics

Responding to expressed distress - whether explicit or implicit (listening - caring) Confidence. Isolation Avoiding other people. Having friends and family to advocate for dental care Impatience with others, argumentative, shouting Family expectations

Guidelines Commissioning of dental care in the residential / nursing home sectors Local authorities, Health, CQC Asessment - Evaluation Referral process Staff  awareness and knowledge The nursing home make the referral? The family must make the referral? Payment National standards Domiciliary visits paid in advance. Dental service packs packs circulated to residential and nursing homes across a Region. Global access to Dental care?

"Welcome (nursing) home?"

Sometimes people residing in nursing and residential care facilities become so ill they need to go into hospital. In community mental health terms this can mean that an individual's behaviour can be so disturbed they need specialist assessment and care. It is essential to ensure they can have the best quality of life that their circumstances can provide, without resort to 'care by medication'.

The job means listening to people in care asking to go home. Staff need to be skilled and sensitive in how they respond to such requests, especially when they are repeated time after time. Family members can really struggle with this; should they visit? It is amazing how things can change though...

Quite a while ago I visited a care home and had arrived a bit early. As I turned-up the lady I'd called to see had just returned back from a stay in hospital. It was remarkable to see her recognise the home as home. She responded warmly to the nurse in charge, the many greetings and reassurances offered plus the familiar surroundings. As we accompanied this lady through to her room, it made our day (my week) to hear the deep sigh of relief when the door to her room was opened.

She said, "Oh, it's good to be back."

Walking over to the side of her bed, this highly trained life-trooper stopped.

Sometimes when a tree falls in the forest and someone IS there, there is no sound - just emotion.

Suddenly this lady made like a falling pine in Grizedale forest. In slow motion she fell sideways to greet her bed with another sigh - satisfaction and rest. The home manager and I just looked at each other....

Close call that - just missing the wall - but so good to be 'home' at last.

Image source: http://www.english-lakes.com/grizedale_forest.html