Service provision

This chapter opens with the movement to long-term care benefits in Germany in 1994 with a two-tiered system of employment-related, contribution-based long-term care insurance (LTCI) and a last resort of tax-funded social assistance. The goals were to reduce the financial burden on the states and municipalities, lessen poverty for care clients, increase long-term care services, expand home- and community-based services and support informal caring, and to prevent or delay institutionalisation.

This study, funded by The True Colours Trust in association with The Princess Royal Trust for Carers, investigates the experiences, needs and service responses to the 290,000 young adult carers aged 16-24 in the UK today.

The author examines the pressures that may be experienced by carers in the community and discusses ways in which nurses can help to address these problems. 

This report presents results of projections of use and supply of long-term care for older persons in four countries representative of different long-term care systems: Germany, the Netherlands, Spain and Poland. Using a standardised methodology, the projections show that between 2010 and 2060, the numbers of users of residential care, formal home care and informal care are projected to increase in all countries, but at different rates. The results also indicate that if current patterns of care use and supply prevail, supply of informal and formal care is likely to fall behind demand.

This small-scale survey explored how effectively young carers were identified by councils and their partners. It also examined the assessment and delivery of services for young carers and their families. It drew on evidence from visits to eight council areas, focus groups with young carers and meetings with those who provide young carer support services

Stroke patients, and their carers can have many questions about the mental and physical effects of the condition, hospital procedures and treatments, and prospects for the future. This paper discusses issues involved in giving information to patients-some of whom may be experiencing serious communication problems - as well as those looking after them, and offers solutions. 

This article reviews current policies and their impact on carers' lives, and highlights the potential limitations of a more personalised approach to care. Using some key research findings and illustrative case studies, the article argues that we should build on the achievements of the personalisation reforms, but not limit our ambition to offering individuals more choice and control over their services. Instead, there should be a focus on individuals achieving ordinary life chances and families achieving emotional and financial sustainability.

Respite care or ‘short breaks’ are currently heavily promoted as services to support older people and their carers. However, uptake of such services can be limited and there is a need to design models which are more flexible and responsive, and also reflect the ethos of personcentred care, which is currently one of the main drivers of health and social care policy in the UK. This paper describes the rationale for, and the philosophy behind, a new service for people with dementia and their carers recently established in Sheffield which provides respite care in the person's own home.

BACKGROUND: Mental health services are required to take account of the needs of carers, yet little is known about how services affect carers.

AIMS: This paper explores the relationship between the user's mental health problems, the services received and the impact of caring on carers.

METHODS: Sixty-four carers were interviewed, measuring their experiences of care-giving, carer stress and the service user's level of impairment. A robust, composite measure of user severity was derived.

The present paper provides an overview of the application of the key ethical issues which arose in an EU-funded research, technology and development project, Assisting Carers using Telematics Interventions to meet Older Persons' Needs (ACTION). The primary aim of the ACTION project was to support frail older people and their family carers in their own homes across England, Northern Ireland, the Republic of Ireland, Sweden and Portugal via the use of user-friendly information and communication technology.