The document summarizes research conducted in two care homes that examined the values of different staff members in their work with older people. A questionnaire was administered to staff from various disciplines to analyze their responses to ethical dilemmas. The findings showed some differences between health and social care staff in their answers, though numbers were small. Overall, respondents displayed some ageist assumptions and a utilitarian approach to decision making. Training needs identified included articulating ethical principles, addressing ageist attitudes, defining duty of care, and developing autonomous moral decision making. The implications for service users were left for discussion.

1. Values in work with older people - research in two care homes Moira Dunworth PEPE Conference : 24 Jan 2008

2. Workshop Aims Process of the study and the implications for working with a range staff in a multi-disciplinary setting Research findings Training needs The implications for the service user - discussion

3. Process of the study Idea first! Are SW values so different? Reading Funding – SWET Permission – local authority Questionnaire Managers – co-operation and planning Pilot and revise questionnaire Administer and collect questionnaires

4. Analysis Got help with the stats Coded the comments Deontological or Utilitarian or Avoids the dilemma Played with the results Now trying it out on you!

5. A diverse staff group I was out of my comfort zone! Language and literacy issues How much truth to tell? Why should they help me? How to be neutral Issue of ‘right answer’

6. Findings - challenges Not possible to see ‘health’ and ‘social care’ How much was any difference down to management style rather than profession? Numbers quite small but the same as Osmo and Landau (2006)

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. Findings 2

9. Findings 3

10. Findings 4

11. Findings 5

12. Main Conclusions Both homes worked on a social model of disability/age Home SW made more comments and gave more complex responses when faced with a list of options. Home SW were more likely to write in resident’s notes Home N more often referred to a manager only Care-qualified staff in both homes were more likely to make comments and to select more options from a list. Very few staff made their reasoning explicit Overall respondents selected options and made comments which implied a utilitarian reasoning Deontological options are more popular the further the problem is removed from the necessity of action All staff display some ageist assumptions, esp decision-making - non care-qualified staff more ageist

13. Training needs Articulation of ethical principles Ageist assumptions 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. Conflation of responsibility of role and moral responsibility. Development of autonomous moral decision-making Record-keeping – very few respondents would record information about the situations presented

14. Implication for service users? ????? Discuss