No Wrong Door: The Salvation Army Doorways Case Management Service

The primary aim of the evaluation project was to determine the impact of The Salvation Army Doorways case management model in relation to client satisfaction and meeting client needs. Specifically, the project sought to: • Provide an overview of structural barriers confronting individuals who are entrenched in enduring poverty; • Provide an overview of the specific issues encountered by individuals, including insight into personal challenges, hopes and dreams; • Analyse the effectiveness of Doorways interventions, specifically: o How important is the relationship with staff at the Doorways centre? o What skills and knowledge do staff need? o What Doorways activities are the most successful in breaking the cycle of poverty? o How important are community connections? • Provide information to The Salvation Army on what works well in Doorways and how Doorways might be improved or enhanced.

“We have to work within the system!”: Staff perceptions of organizational barriers to decision making for older adults with dementia in Australian aged care facilities

The current study explored the perceptions of direct care staff working in Australian residential aged care facilities (RACFs) regarding the organizational barriers that they believe prevent them from facilitating decision making for individuals with dementia. Normalization process theory (NPT) was used to interpret the findings to understand these barriers in a broader context. The qualitative study involved semi-structured interviews (N = 41) and focus groups (N = 8) with 80 direct care staff members of all levels working in Australian RACFs. Data collection and analysis were conducted in parallel and followed a systematic, inductive approach in line with grounded theory. The perceptions of participants regarding the organizational barriers to facilitating decision making for individuals with dementia can be described by the core category, Working Within the System, and three sub-themes: (a) finding time, (b) competing rights, and (c)not knowing. Examining the views of direct care staff through the lens of NPT allows possible areas for improvement to be identified at an organizational level and the perceived barriers to be understood in the context of promoting normalization of decision making for individuals with dementia.