two - Setting the scene
Published online by Cambridge University Press: 01 September 2022
Summary
People who need services are often the experts in their own care, and the system for the future must respect this. People with care and support needs should be treated as citizens with rights, rather than having to fight to get services. Everyone who receives care and support must be treated with dignity and kindness, and their human rights must be respected. (DH, 2009, p 9)
The first part of this chapter outlines the social policy and practice context in which the construction of older people's needs and decisions about whether and how these should be met takes place. It provides the context for discussion in subsequent chapters of how the strategies used by older people to manage difficulties are supported or undermined by policy and provision within the statutory and independent care sectors and by wider political, social and cultural discourses. The discussion focuses on social care policy. The second part of the chapter discusses the research processes and methods used to elicit the needs and perspectives of the older people, introduced in Chapter One, whose views and experiences form the central thread of discussion in subsequent chapters.
Policy and practice context
This section begins with a brief review of the 1990 community care reforms and their impact on social work and social care services for older people. More recent policy developments and initiatives (primarily in England) are then outlined. Moving on from this general context, the chapter reviews policy and practice developments that are significant for older people's management of ageing. The analysis is structured according to three key themes: needs-led assessment and person-centred care; prevention and the promotion of well-being; and care, independence and interdependence.
Community care reforms and the introduction of care management
Economic pressures from the mid-1970s, coupled with an increased demand for care services by older people in particular, led to increasing resource constraints (Walker, 1993). Arguably, it was primarily these economic concerns that gave impetus to the care in the community rhetoric and drove forward the reforms (Lewis and Glennerster, 1996). In 1986 an Audit Commission report, Making a reality of community care, identified the increased spending on institutional care for adults as a particular concern.
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- Information
- Managing the Ageing ExperienceLearning from Older People, pp. 27 - 54Publisher: Bristol University PressPrint publication year: 2010