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  1. 1. Values in work with older people - research in two care homes Moira Dunworth PEPE Conference : 24 Jan 2008
  2. 2. Workshop Aims <ul><li>Process of the study and the implications for working with a range staff in a multi-disciplinary setting </li></ul><ul><li>Research findings </li></ul><ul><li>Training needs </li></ul><ul><li>The implications for the service user - discussion </li></ul>
  3. 3. Process of the study <ul><li>Idea first! Are SW values so different? </li></ul><ul><li>Reading </li></ul><ul><li>Funding – SWET </li></ul><ul><li>Permission – local authority </li></ul><ul><li>Questionnaire </li></ul><ul><li>Managers – co-operation and planning </li></ul><ul><li>Pilot and revise questionnaire </li></ul><ul><li>Administer and collect questionnaires </li></ul>
  4. 4. Analysis <ul><li>Got help with the stats </li></ul><ul><li>Coded the comments </li></ul><ul><ul><li>Deontological or </li></ul></ul><ul><ul><li>Utilitarian or </li></ul></ul><ul><ul><li>Avoids the dilemma </li></ul></ul><ul><li>Played with the results </li></ul><ul><li>Now trying it out on you! </li></ul>
  5. 5. A diverse staff group <ul><li>I was out of my comfort zone! </li></ul><ul><li>Language and literacy issues </li></ul><ul><li>How much truth to tell? </li></ul><ul><li>Why should they help me? </li></ul><ul><li>How to be neutral </li></ul><ul><li>Issue of ‘right answer’ </li></ul>
  6. 6. Findings - challenges <ul><li>Not possible to see ‘health’ and ‘social care’ </li></ul><ul><li>How much was any difference down to management style rather than profession? </li></ul><ul><li>Numbers quite small but the same as Osmo and Landau (2006) </li></ul>
  7. 7. Findings 1 65 33 32 Total 12 7 5 No box ticked 2 1 1 She should be given a single room 28 13 15 She should be required for health reasons 3 1 2 She should be required – so as to fit in 20 11 9 She should not be pressurised (autonomy) Total Home N Home SW Q6 Bath Issue 65 33 32 Total 12 7 5 No box ticked 11 9 2 She should be given a tranquilizer 2 1 1 They should be cut when she is asleep 40 16 24 She should not be pressurised (autonomy) Total Home N Home SW Q7 Fingernails
  8. 8. Findings 2
  9. 9. Findings 3
  10. 10. Findings 4
  11. 11. Findings 5
  12. 12. Main Conclusions <ul><li>Both homes worked on a social model of disability/age </li></ul><ul><li>Home SW made more comments and gave more complex responses when faced with a list of options. </li></ul><ul><li>Home SW were more likely to write in resident’s notes </li></ul><ul><li>Home N more often referred to a manager only </li></ul><ul><li>Care-qualified staff in both homes were more likely to make comments and to select more options from a list. </li></ul><ul><li>Very few staff made their reasoning explicit </li></ul><ul><li>Overall respondents selected options and made comments which implied a utilitarian reasoning </li></ul><ul><li>Deontological options are more popular the further the problem is removed from the necessity of action </li></ul><ul><li>All staff display some ageist assumptions, esp decision-making - non care-qualified staff more ageist </li></ul>
  13. 13. Training needs <ul><li>Articulation of ethical principles </li></ul><ul><li>Ageist assumptions </li></ul><ul><li>Definition of ‘duty of care’ – for most, but not all, of the respondents this did not include the duty to respect autonomy when there was any safety risk. </li></ul><ul><li>Conflation of responsibility of role and moral responsibility. </li></ul><ul><li>Development of autonomous moral decision-making </li></ul><ul><li>Record-keeping – very few respondents would record information about the situations presented </li></ul>
  14. 14. Implication for service users? <ul><li>????? </li></ul><ul><li>Discuss </li></ul>