Empowerment

Much confusion still surrounds the concept of empowerment and how it is to be translated into practice within the context of community care for service users and carers. A major limitation has been the tendency to treat empowerment as synonymous with participation in decision-making with little attention given to the ‘ecological’ model of empowerment where linkages have been found between community participation and measures of psychological empowerment.

Carers are seen as legitimate stakeholders in wider policy processes and increasingly as ‘co-producers’ and key providers of care. Mental health carers, however, especially those caring for relatives subject to compulsory care and treatment, often feel overlooked and marginalised, caring in complex circumstances with little or no professional support. The Mental Health (Care & Treatment) (Scotland) Act 2003 (MHCT Act) implemented in 2005 aspired to change this for the better.

Understanding how long-term illness affects quality of life for patients and families is central to providing individualised, patient-focused care in the community, as Leire Ambrosio and colleagues explain

The study's rationale: Most people diagnosed with multiple sclerosis (MS) choose to live at home without known consequences for their children.

Aims and objectives: To study the personal experience of being a young caregiver of a chronically ill parent diagnosed with MS.

Methodological design and justification: Phenomenology was the methodological approach of the study since it gives an inside information of the lived experience.

Looks at what user consultation and empowerment mean to service users and carers themselves.

Traditionally viewed as in opposition to palliative care, newer ideas about ‘health-promoting palliative care’ increasingly infuse the practices and philosophies of healthcare professionals, often invoking ideals of empowerment and participation in care and decision-making. The general tendency is to assume that empowerment, participation, and self-care are universally beneficial for and welcomed by all individuals. But does this assumption hold for everyone, and do we fully understand the implications of health-promoting palliative care for family caregivers in particular?

Suffolk's HSJ Award-nominated People Project aims to empower service users and carers. Participants attend workshops on subjects including getting heard. The project has secured a new round of funding to take it through to August 2006.

The Valuing People White Paper (Department of Health, 2001) requires services to secure a plan for all service-users with learning disabilities living with older carers and promises them and their families more choice and control over how and where they live. This paper examines the views of the older carers (aged over seventy) of sixty-two adults with a learning disability about planning for the future. Fifty-six took part in interviews in their own homes and six completed a questionnaire.

I argue that it is appropriate for adult recipients of personal care to feel and express gratitude whenever care providers are inspired partly by benevolence, and deliver a real benefit in a manner that conveys respect for the recipient. My focus on gratitude is consistent with important aspects of feminist ethics of care, including its attention to the particularities and vulnerabilities of caregivers and care recipients, and its concern with how relations of care are shaped by social hierarchies and public institutions.

The term leadership has been often applicable within the work domain, where development programmes are aimed at managers and lead organisations. However the government has recognised that changes in public services require the collaboration of many stakeholders working together in partnership and has placed at the core of its policies the need to include users and carers.