Exploring and Improving Access to Direct Payments by People with Dementia Living in Rural Communities

Direct payments are cash payments made to individuals eligible for social care services which allow them to manage and pay for their own social care rather than receiving it directly from their Local Authority. Research suggests that direct payments can enable people with dementia to stay in their own home for longer, and experience greater choice, flexibility and an improved social life. However, uptake of direct payments is currently low. People living in rural communities may particularly benefit from the additional flexibility offered by direct payments; however they may face difficulties accessing appropriate services. The aim of Phase 1 of the research is to explore the reasons why people with dementia who live in rural communities do or do not gain access to direct payments. This will be achieved through analysis of direct payment uptake data, focus groups with social workers, examination of online discussions about direct payments, and interviews with people with dementia, carers and social workers. Findings will inform Phase 2 of the research: the building and pilot testing of an intervention which can be utilised in rural communities to maximise access to direct payments by people with dementia.

Exploring and Improving Access to Direct Payments by People with Dementia Living in Rural Communities

Direct payments are cash payments made to individuals eligible for social care services which allow them to manage their own social care. Research suggests that direct payments can enable people with dementia to stay in their own home for longer and experience greater choice, flexibility and an improved social life. However uptake of direct payments is currently low. The first objective of this research was to explore the experiences of people with dementia living in rural communities, in relation to their access to direct payments. 26 semi-structured interviews were conducted with people with dementia in receipt of social care services in the community, and their carers and social workers. Focus groups were carried out with two community social work teams. Direct payments appeared to afford particular benefits to people with dementia and to those living in rural communities in terms of flexibility, continuity of care and access to local facilities. However it was found that many service users were daunted by the thought of managing their own social care budget. The second objective of the research was to design and pilot test an intervention aimed at increasing uptake of direct payments by people with dementia. This comprised a session delivered to a team of social workers, aimed at encouraging them to offer combined direct payments to service users as a potentially less daunting alternative to full direct payments. Combined direct payments enable service users to receive part of their social care budget as a direct payment while the remainder is retained and managed by the Local Authority. In order to evaluate the intervention direct payment uptake will be examined for the six-month period before and after the intervention session, and social workers in the intervention team will be interviewed about their experiences of offering combined direct payments to service users.

Exploring Access to Direct Payments by People with Dementia Living in Rural Communities

Direct payments are cash payments made to individuals eligible for social care services which allow them to manage their own social care. Research suggests that direct payments can enable people with dementia to stay in their own home for longer and experience greater choice, flexibility and an improved social life. However uptake of direct payments is currently low. There is a lack of research to date in this area which addresses the factors of dementia, ageing and rurality in unison. Therefore the objective of this research was to explore the experiences of people with dementia living in rural communities, in relation to their access to direct payments. 26 semi-structured interviews were conducted with people with dementia in receipt of social care services in the community, and their carers and social workers. Focus groups were carried out with two community social work teams, and existing online discussions regarding direct payments were examined. It was found that direct payments tended to be seen as a fall back option, for example as the only alternative to residential care, or as a potential solution to problems experienced by existing social care service users. Direct payments appeared to afford particular benefits to people with dementia and to those living in rural communities in terms of flexibility, continuity of care and access to local facilities. It is therefore important that this group are enabled to access direct payments; ensuring direct payments are viewed as a positive option by all stakeholders is key to this.

Exploring Access to Direct Payments by People with Dementia Living in Rural Communities

Direct payments are cash payments made to individuals eligible for social care services which allow them to manage their own social care. Research suggests that direct payments can enable people with dementia to stay in their own home for longer and experience greater choice, flexibility and an improved social life. However uptake of direct payments is currently low. There is a lack of research to date in this area which addresses the factors of dementia, ageing and rurality in unison. Therefore the objective of this research was to explore the experiences of people with dementia living in rural communities, in relation to their access to direct payments. 26 semi-structured interviews were conducted with people with dementia in receipt of social care services in the community, and their carers and social workers. Focus groups were carried out with two community social work teams, and existing online discussions regarding direct payments were examined. It was found that direct payments tended to be seen as a fall back option, for example as the only alternative to residential care, or as a potential solution to problems experienced by existing social care service users. Direct payments appeared to afford particular benefits to people with dementia and to those living in rural communities in terms of flexibility, continuity of care and access to local facilities. It is therefore important that this group are enabled to access direct payments; ensuring direct payments are viewed as a positive option by all stakeholders is key to this.

Exploring Access to Direct Payments by People with Dementia Living in Rural Communities

Direct payments are cash payments made to individuals eligible for social care services which allow them to manage and pay for their own social care rather than receiving it directly from their Local Authority. Research suggests that direct payments can enable people with dementia to stay in their own home for longer and experience greater choice, flexibility and an improved social life. However uptake of direct payments is currently low, particularly amongst people with dementia. Those living in rural communities may experience additional barriers to direct payments, such as transport issues and difficulty recruiting carers. There is a lack of research to date in this area which addresses the factors of dementia, ageing and rurality in unison. Therefore the objective of this research was to explore the experiences of people with dementia living in rural communities, in relation to their access to and use of direct payments. 26 semi-structured interviews were conducted with people with dementia in receipt of social care services in the community, and their carers and social workers. Focus groups were carried out with two community social work teams, and existing online discussions about direct payments contributed to by social care staff, people with dementia and their carers were examined. It was found that direct payments tended to be seen as a fall back option, for example as the only alternative to residential care, or as a potential solution to problems experienced by existing social care service users. Direct payments appeared to afford particular benefits to people with dementia and to those living in rural communities in terms of flexibility, continuity of care and access to local facilities. It is therefore important that this group are enabled to access direct payments; ensuring direct payments are viewed as a positive option by all stakeholders is key to this.

Creating Local Institutional Arrangements for Sustainable Wetland Socio-ecological Systems: Lessons from the ‘Striking a Balance’ Project in Malawi

Wetland socio-ecological systems provide livelihood benefits for many poor people throughout the developing world, yet their sustainable development requires local utilisation strategies that balance both environmental and development outcomes. Community-based local institutional arrangements that mediate peoples’ relationships with their environment and facilitate adaptive co-management offer one means of achieving this, and increasingly many NGOs and development practitioners have sought to integrate local institutional capacity-building into development projects. In the context of wider academic debates surrounding the long-term sustainability of externally-facilitated local institutions, this paper draws on the experiences of the three-year Striking a Balance (SAB) project in Malawi which sought to embed sustainable wetland management practices within community-based local institutional arrangements. Drawing on field data collected through participatory methods at three project sites some five years after the cessation of project activities, we examine the extent to which SAB’s local institutional capacity-building has been successful, and from this draw some lessons for externally-driven project interventions which seek win-win outcomes for people and the environment. With reference to Elinor Ostrom’s design principles for long-enduring common property resource institutions, we suggest that the observed declining effectiveness of SAB’s local institutions can be attributed to issues of stakeholder inclusiveness and representations; their sustainability was arguably compromised from their inception on account of them being nested within pre-existing, externally-driven village ‘clubs’ whose membership and decision-making was not congruent with all the wetland stakeholders within the community.

Risk of Exposure to Airborne Ambrosia Pollen from Local and Distant Sources in Europe – an Example from Denmark

Background. Ambrosia artemisiifolia L. is a noxious invasive alien species in Europe. It is an important aeroallergen and millions of people are exposed to its pollen. Objective. The main aim of this study is to show that atmospheric concentrations of Ambrosia pollen recorded in Denmark can be derived from local or more distant sources. Methods. This was achieved by using a combination of pollen measurements, air mass trajectory calculations using the HYPLIT model and mapping all known Ambrosia locations in Denmark and relating them to land cover types. Results. The annual pollen index recorded in Copenhagen during a 15-year period varied from a few pollen grains to more than 100. Since 2005, small quantities of Ambrosia pollen has been observed in the air every year. We have demonstrated, through a combination of Lagrangian back-trajectory calculations and atmospheric pollen measurements, that pollen arrived in Denmark via long-distance transport from centres of Ambrosia infection, such as the Pannonian Plain and Ukraine. Combining observations with results from a local scale dispersion model show that it is possible that Ambrosia pollen could be derived from local sources identified within Denmark. Conclusions. The high allergenic capacity of Ambrosia pollen means that only small amounts of pollen are relevant for allergy sufferers, and just a few plants will be sufficient to produce enough pollen to affect pollen allergy sufferers within a short distance from the source. It is necessary to adopt control measures to restrict Ambrosia numbers. Recommendations for the removal of all Ambrosia plants can effectively reduce the amount of local pollen, as long as the population of Ambrosia plants is small.