Dementia and Well-Being: Possibilities and Challenges

Dementia and Well-Being: Possibilities and Challenges

Dementia and Well-Being: Possibilities and Challenges

Dementia and Well-Being: Possibilities and Challenges

Synopsis

In recent years, policy and legislation in both England and Scotland has sought to promote the well-being of users of health and social care services, such as people with dementia. Most recent policy across the UK has identified key objectives, attainment of which is essential to the well-being of service users, as governments have introduced a range of initiatives to ensure that services deliver good outcomes to service users. To date, however, there has been very little consideration of how inclusive this agenda is to people with dementia. Author Ailsa Cook addresses this gap by critically reviewing recent health and social care policies in Scotland and England in light of the growing body of empirical research into the experiences and perspectives of people with dementia. She draws on this evidence to consider the particular challenges associated with delivering four key outcomes to people with dementia, identified by policy makers as fundamental to well-being. These key outcomes are independence, health, choice, and social inclusion. The book examines the potential for current policy proposals to meet the needs of people with diverse experiences of dementia. It considers the particular issues related to including people with dementia as partners in policy and practice - a key principle underpinning all health and social care. In so doing, the book contributes a much needed policy perspective to the field of dementia, as well as providing a fresh lens through which to consider the differences that proposed policies can make to a diverse range of service users. Intended as a text for dementia studies and gerontology students, the specific focus of this book on the inter-relationship of policy and dementia ensures its place as a key reference for policy makers and administrators assessing the impact of policies, both implemented and proposed.

Excerpt

Over the past twenty years significant shifts in health and social care policy across the UK have transformed the lives of many adults with disabilities and physical and mental health problems. The remit for health and social care services has been extended beyond providing just basic treatment and support and their role in supporting the well-being of service users and their carers is now explicitly recognised in policy. Specifically, well-being was headlined in the 2005 English Green Paper on social care Independence, Well-being and Choice (Department of Health, 2005a), and is identified as one of four high-level outcomes in the Scottish National Outcomes Framework for Community Care. All health and social care partnerships in Scotland are now directed to working towards delivering these outcomes for service users and their carers (Joint Future Unit, 2007).

This focus on well-being is reflected in the rafts of policy and legislation following the 1990 National Health Service and Community Care Act that have enabled many individuals, previously condemned to live out their lives in institutions, to move into independent accommodation in the community. Policy has sought to remove the barriers that many people face in accessing mainstream health services and to encourage people to live healthy lives engaged with their local communities (e.g. Adding Life to Years, Scottish Executive, 2002). Most recently, policy makers have demonstrated their commitment to mainstreaming new models of commissioning and providing individualised packages of care that give service users choice and control over the care they receive (e.g. Our Health, Our Care, Our Say, Department of Health, 2006). There is, however, a growing body of evidence that people with dementia are being excluded from many of these initiatives and are not getting the attention from policy makers that the condition deserves. This, it has been argued, has been a key challenge to improving well-being for people with dementia and has led the Alzheimer’s societies in both England and Scotland to call upon their respective governments to make dementia a priority.

It is welcome, therefore, that in 2007 both administrations responded to these calls and announced that they were developing specific programmes of policy for dementia to be launched in 2008. In Scotland, dementia was identified as a national priority from 2008 in Better Health, Better Care (Scottish Government, 2007) and in England the first National Dementia . . .

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