Evolving Approaches to Care
Preparation, Prevention, and Resistance in Extra Care Housing: Residents’ Managing Changing Care Needs at the Boundary between the Third and Fourth Age
Paper Presentation in a Themed Session Eleanor K Johnson
Reporting on a longitudinal study of older people living in four extra care housing (ECH) schemes in the UK, this paper explores how residents negotiated their changing care needs within the context of ECH. Drawing upon theories of the third and fourth age, this paper makes two key arguments. First, that transitions across the boundary between the third and fourth age are not always straightforward or irreversible and, moreover, can sometimes be planned-for, resisted, and managed by older people. Second, institutional practices within ECH schemes can function to facilitate or impede residents’ attempts to manage these transitions. I consider these findings within the context of current debates about what extra care housing is, who it is for, and whether it can be considered a viable "home for life."
The Role of Direct Funding in "Transforming" Home Care Systems in Ontario, Canada: Popular Rhetoric and Policy Directions
Paper Presentation in a Themed Session Mary Jean Hande
Home care systems in Ontario, Canada have undergone major transformation in the last ten years, including a shift towards “patient-centred care,” the standardization of Personal Support Worker training, and recent efforts to move all home care to the public sector. Amid these changes, direct funding (DF), where individuals receive cash transfers to arrange their own services, is under consideration as a policy mechanism that is key to "transforming" the current organization of home care systems and facilitate “aging in place.” DF is championed for improving autonomy, cultural sensitivity, cost-effectiveness, and health outcomes. Yet, it is also an example of neoliberal downshifting and contributes to precarious forms of work. While DF emerged from legacies of disability activism (Kelly 2016), efforts to expand DF programs in the United Kingdom and Australia have fallen short of their promise of equity, autonomy, and choice (Slaberg et al. 2014/15, Ottman et al. 2013). In this paper, we question whether DF can be mainstreamed in Ontario and beyond. We introduce the findings of a textual analysis of forty-nine media and grey literature sources about DF home care in Ontario between 2012 and 2017. We find DF is represented in three main ways, as a solution to a home care crisis, as a form of privatization, and as a mechanism for social transformation. We offer a social justice lens for caring for older people, arguing that the aging “home care crisis” in Ontario requires a complex political and social response
Can the Demands of the Aging Population Be Met in Singapore with the Current Model of Care?
Paper Presentation in a Themed Session Gayathiri Pala
The aging population has been increasing over the years. This research identifies the trends and analyses if Singapore can support and meet the demands in relation to the aging population with the current model of care. Quantitative and qualitative data collection with supporting interviews from stakeholders was undertaken. With the data analysis, it is evident that the demands on the aging population will not be sustainable by the government. With the preference to a changed model of care by working adults, the current model of care for the elderly is to be reviewed. There is an increasing trend with the aging population. The data are able to identify that the number of long-term beds required over the years had increased. The analysis of the data are able to identify the moderate to strong correlations to the identified variables in relation to the long-term beds required. The primary data findings are able to reflect the type of model of care the working adults would prefer in the future. This concept of a new model of care of apartments with medical facilities will be able to address the demands of the aging population as highlighted with the support of the literature review findings.
