Managing the Care Home Closure Process: Care Managers' Experiences and Views

This paper reports case study research that set out to identifywhat care managers do during independent care home closures.Little research has focused on the way in which care homes forolder people are closed in England, or what those involved thinkabout the process. This paper reports the activities and viewsof care managers directly involved in helping older people relocatefrom care homes that were closed by their owners. During suchclosures, residents and their families have no choice but tomove, usually to a deadline, and with little control over theprocess. Care managers have a responsibility to help arrangealternative care for those current residents who are publiclyfunded, and to offer information and support to those fundingtheir own care (the ‘self-funded’). Closure relatedactivities could involve considerable staff time. Care managementarrangements, including the organization of teams and provisionof needs assessments, varied across authorities. The care managersdescribed drawing on emotional counselling and inter-personalskills, as well as practitioner knowledge and experience, particularlywhen offering support and advice about finding appropriate newhomes. Tensions between aims, constraints on their actions andviews of good practice are identified.     

Evaluating Risk Communications: Completing and Correcting Mental Models of Hazardous Processes, Part II

We propose a decision-analytic framework, called the mental models approach , for evaluating the impact of risk communications. It employs multiple evaluation methods, including think-aloud protocol analysis, problem solving, and a true-false test that allows respondents to express uncertainty about their answers. The approach is illustrated in empirical comparisons of three brochures about indoor radon.     

An Integrational Model of Quality of Life in Older Age. Results from the ESRC/MRC HSRC Quality of Life Survey in Britain

This paper is based on the results of anational survey of the quality of life of 999randomly sampled people aged 65 and over,living at home in Britain. The survey wassemi-structured, and a sample of surveyrespondents was followed up and interviewedin-depth in order to explore their perceptionsof quality of life in full. Comparisons aremade here between the results of (i) ahierarchical multiple regression model basedon theoretically derived indicators of survey respondents' ratings of their overall quality of life, with (ii) the samerespondents' own definitions of quality oflife, categorised from their responses toopen ended survey questions, and (iii) theviews of a sub-sample of these survey respondents who were subsequently interviewed in greater depth. Respondents were asked theopen ended questions on quality of life at theoutset of the survey interview in order toprevent any respondent bias from thestructured measures used.The core components, and the central planks,of quality of life, which were consistentlyemphasised by the three approaches, were psychological characteristics and outlook,health and functional status, personal andneighbourhood social capital. The lay modelsalso emphasised the importance of financialcircumstances and independence, which need tobe incorporated into a definition of broader quality of life.     

Cross national study of perceived service quality in long-term care facilities

This cross-national study of 306 nursing home residents in the United States and the United Kingdom examines the similarities and differences in their evaluation of service quality. Service quality was defined as the differences between expectations about the service and actual perceptions of the service delivered in terms of five dimensions: tangibles, assurance, empathy, reliability and responsiveness. The SERVQUAL instrument was used to measure service quality. The two groups differed in their expectations for quality and their perceptions of service quality: US residents' ratings were lower in all respects.     

Policy assignment in the European union

EMU will see a re‐allocation of responsibility between different tiers of government for different elements of economic policy, yet policy assignment in the EU often reflects political compromises rather than dispassionate analysis or principles. This article explores the arguments for assigning responsibility for economic policy to different tiers of government in the EU. In the light of these arguments, the case for re‐assigning policy for prudential supervision of credit institutions, regulation of utilities and industrial policy is examined. This leads to the conclusion that closer economic integration will require potentially substantial changes in the assignment of policy.     

Thinking empathically: The video laboratory as an integrative resource

The use of video taped, simulated interviews is an effective means of addressing the dynamics of affect in clinical practice. This mode of training, grounded in ego and self psychological concepts, is instrumental in identifying, understanding and integrating feelings—the goal of which is to help trainees think empathically. The theoretical framework and structure of the laboratory mode are presented; examples of the teaching/learning process are also discussed.     

Work and rest in the long-distance road transport industry in Australia

To date management of fatigue in professional drivers has largely focused on strategies that limit the amount of time spent on the job. These approaches have, however, not taken into account the well-documented effect of time of day. Consequently, the likely impact of the pattern and timing of work and rest has received little attention. The results revealed that the group of drivers who did the shortest trips and worked the shortest weekly hours were the lowest reporters of fatigue, although longer hours were not always associated with the highest reporting of fatigue. In contrast, the shortest working hours were associated with earliest onset of fatigue. For all drivers, the influence of circadian rhythms was evident in the occurrence of fatigue, with better management of the problem evident among drivers who were able to arrange the timing of rest to more closely coincide with periods of fatigue. Thus, time of day appeared to be a more important influence in determining effective rest than did period of work. These findings raise questions about the validity of the assumption underlying work hour regulations for long-distance drivers which, currently, are universally based on duration of work.