Staff-user relationships

Although the proportion of older people using home care services has significantly increased in East Asian countries, the issue of the relationships between older people and home care workers in the East Asian context has received scant attention from scholars. This exploratory qualitative study aims to explore these relationships under the new Korean long-term care insurance system. Semi-structured in-depth interviews were conducted with 22 family carers and private-sector home care service providers (home care workers and provider managers).

The authors draw on their experience as a counsellor and counselling service manager working for the Dementia Care Trust, an organisation that specialises in providing counselling for carers in their home space. They look at the perceived strengths and weaknesses of counselling in the home, including client commitment, client and counsellor safety and boundaries. They also highlight the benefits of working within the clients context and environment.

Background: Individual assessment of needs has been recognised as the most appropriate way to allocate health and social care resources. These assessments, however, are often made by the staff or by a carer who acts as an advocate for the user themselves. Little is known about how these proxy measures compare to how individual patients perceive their own needs.

Aim: The aim of this study was to measure and compare ratings of need for older people with mental health problems by the older person themselves, their carer, and an appropriate staff member.

The Triangle of Care: Best Practice Guide on Acute Mental Health Care, which promotes the essential three-way relationship between professionals, service users, their carers and families is briefly discussed. The approach was developed by carers and staff who wanted to improve carer engagement in acute inpatient and home treatment services.

In 1999, the Stroke Association set up a project to promote home-based occupational therapy for patients who had had a stroke and been discharged home from hospital. As part of the service evaluation, focus groups for service users and carers were set up in two of the sites to consult users about the changes in their quality of life during the period of the home therapy. A total of 11 service users and 9 carers attended the groups, representing 30% of the service users and 27% of the carers involved in the project.

This article describes the development of a new service for people with dementia and their carers in a large post-industrial city in the north of England, UK. The service arose in response to the perceived inadequacies of existing respite care provision and has proved very successful in meeting the needs of people with dementia and their family carers, and in providing high levels of job satisfaction for staff. The success of the initiative can be understood using the Senses Framework and relationship-centred care as an analytic lens to identify key attributes of the service.

The increased presence and participation in Australian society of people with an intellectual disability provides challenges for the provision of primary health care. General practitioners (GPs) identify themselves as ill equipped to provide for this heterogeneous population. A major obstacle to the provision of appropriate health care is seen as inadequate communication between the GP and the person with an intellectual disability, who may or may not be accompanied by a carer or advocate.

User or carer involvement is often seen as intrinsically worth while; but if such involvement is a good thing in itself, it would not matter whether changes resulted from it. However, most people argue for user or carer involvement because they think some useful change will follow as a consequence. Being involved can benefit users or carers both personally (for example, by empowering them or increasing their social contacts) and practically (for example, by enabling them to earn money or learn new skills).