AbstractThe growing numbers of older people in the UK has resulted in increased demand on existing and prospective health and social care services (Gray, A and Birrell, D 2013, p. 6). Intermediate care for older people has been an important aspect of a wide range of policy developments in the UK, developing from an awareness that hospital admission or a prolonged hospital stay is not necessarily an appropriate or effective intervention for older people (Glasby and Littlechild, 2000, p.110, Parker, 2005, p.9). Contemporary intermediate care policy and practice has developed within the context of research into the issues which impact on the outcomes for older people, including the concepts of caring (Fine, 2012), gender and caring (Clarke and Bennett, 2013) dependency (Fine and Glendinning, 2005), resilience (Netuveli, Wiggins, Montgomery, Hildon, Blane, 2008) and motivation (Shafizadeh, 2007). However, there is a paucity of evidence about the effectiveness or impact of intermediate care units in the UK (Roe and Beech, 2005, p. 62); most research focuses on the impact of NHS services and on disease specific services.
This research provides an original contribution to knowledge by exploring the impact of the Lodge, a small intermediate care unit, managed by social services in a unitary authority on the south coast of England. Previous research on intermediate care has focused overwhelmingly on NHS provisions or disease specific rehabilitation. This research is original in exploring both the outcomes of rehabilitation and the voices of older people admitted to the Lodge. The effectiveness of the Lodge was measured by comparing the Barthel scores of residents both pre and post the rehabilitation intervention; as well as whether a resident is discharged to the community as opposed to residential or hospital care. Eleven participants were interviewed using a narrative approach to explore older people’s perspectives of rehabilitation and motivation. From the results, the Lodge was effective in improving the Barthel scores of older people and in facilitating their discharge to the community. Older people were generally positive about the intervention but they were not always clear about the process of admission; nor did the older people appear to have a sense of their goals within the Lodge. Instead, their motivation to return home appeared to be based on the quality and interdependence of the relationships with their family as well as their formal and informal carers.
|Date of Award
|Kieron Hatton (Supervisor), Pete Shepherd (Supervisor) & Ruth Sander (Supervisor)