Orellana Katharine, Manthorpe Jill, Tinker Anthea
King's College London, England.
J Soc Work (Lond). 2021 Nov;21(6):1315-1338. doi: 10.1177/1468017320952255. Epub 2020 Aug 30.
Day centres are a substantial element of community-based support for older people in many countries. However, assumptions that they are an outdated or costly service model have resulted in many centre closures in England. The perspectives of 42 people attending, providing, making referrals to or purchasing places at four diverse day centres for older people were collected in interviews. Using these data, we explore day centres' relevance to social workers' efforts to promote person-centred support for older people enabling them to maintain or improve their well-being. These are explored from the perspectives of choice, control and person-centredness and local authority responsibilities for shaping the care market under the Care Act 2014.
Attenders highly valued centres' congregate nature and the continuity they offered which contributed to the development of person-centred relationships. Attenders exercised choice in attending day centres. Social work staff were more positive about day centres' relevance to personalisation than those responsible for making decisions about the shape of local care services.
With social isolation recognised as a serious risk of old age, the value of togetherness in group environments may need highlighting. Enactment of personalisation policies need not necessarily lead to individualisation; day centres may be community-based assets for some. Those shaping the care market may be encouraged to acknowledge wider outcomes, and frontline social workers may benefit from hearing positive experiences that may help in the development of effective care plans for older people who would like to benefit from day centre participation.
在许多国家，日间护理中心是为老年人提供社区支持的重要组成部分。然而，认为它们是过时或成本高昂的服务模式的假设导致了英格兰许多日间护理中心的关闭。通过访谈收集了42位在四个不同的老年人日间护理中心接受服务、提供服务、进行转介或购买服务名额的人员的观点。利用这些数据，我们探讨日间护理中心与社会工作者为促进以个人为中心的老年人支持所做努力的相关性，使老年人能够维持或改善其幸福感。从选择、控制权和以个人为中心以及地方当局在2014年《护理法案》下塑造护理市场的责任等角度对这些问题进行了探讨。
服务使用者高度重视日间护理中心的集中性质及其提供的连续性，这有助于建立以个人为中心的关系。服务使用者在选择参加日间护理中心方面有自主权。与负责决定当地护理服务形式的人员相比，社会工作者对日间护理中心与个性化的相关性更为积极。
鉴于社会隔离被认为是老年的严重风险，可能需要强调群体环境中团聚的价值。个性化政策的实施不一定会导致个体化；日间护理中心对一些人来说可能是基于社区的资产。可能会鼓励那些塑造护理市场的人认识到更广泛的成果，一线社会工作者可能会从听取积极经验中受益，这些经验可能有助于为希望受益于日间护理中心参与的老年人制定有效的护理计划。
