Understanding the Needs of People with Dementia and Family Carers

This is the first in a short series that presents case study examples of the positive work achieved by trusts who participated in the Royal College of Nursing's development programme to improve dementia care in acute hospitals. When a person with dementia is in hospital, poor understanding of individual needs and preferences can contribute to a lack of person-centred care. Similarly, the needs of family carers can often be overlooked and staff do not always appreciate these needs at such a stressful time. This article illustrates how three NHS trusts have addressed these issues. To help staff get to know patients with dementia, Salford Royal NHS Foundation Trust has implemented a patient passport. Similarly, The Shrewsbury and Telford Hospital NHS Trust has implemented a carer passport that overcomes the restrictions imposed by hospital visiting hours. Royal Devon and Exeter NHS Foundation Trust also focused on carers, holding a workshop to elicit feedback on what was important to them. This was a useful means of engaging with carers and helped staff to realise that even simple changes can have a significant effect.

Markets, Depots and Sales Tables: The Women's Institute's Rural Retailing

In 1917 the Coventry Evening Telegraph noted that the problems of ‘surplus garden produce’ had arisen and that ‘smallholders were being encouraged to group together in order to bring their supplies in quantity to market. Women’s Institutes have been formed, and these arrange for the opening of a market for a certain number of hours one day a week’. WIs, which had begun being formed under the auspices of the Agricultural Organisation Society from 1915 could be seen to be one of the earliest examples of Farmers Markets. These rural women were to improve the food supply in wartime when there was a food crisis; shortages, queues, price rises and in 1918 the introduction of rationing. The WIs encouraged food saving and preservation their markets enabled small holders, cottage gardeners and allotment holders to find a financial non- exploitive outlet for their produce. Markets and retail outlets developed in a number of towns or even cities in rural areas: Worcester, Leamington Spa and Lichfield and in post-war Britain depot trading centres were set up in some county towns Maidstone in Kent in 1919, Winchester in 1920. Between them they provided rural women with a retail space initially for their garden produce and then in time for the preserves, baking and craftwork. Jam, cakes, toys, knitted toys and garments even a wedding trousseau were ordered or sold through these retail outlets. The Markets were not restricted to WI members and often sold work produced by small­holders, the disabled and ex-servicemen. Membership required buying at least one share; as they were a co-operative venture there was a limit on the number of shares it was possible to purchase. Sales tables at some monthly WI meeting provided yet another retail outlet for rural women. This paper will explore the significance of these retail opportunities to rural women: as a chance to earn much needed cash, in placing a value on domestic labour and as an indication that when looking at rural women’s lives, in first half of the twentieth century, divisions between being consumers and producers of food and domestic products may be more fluid than it is something assumed.

Using Social Worlds Theory to Explore Influences on Community Nurses’ Experiences of Providing Out of Hours Paediatric Palliative Care

Abstract Background: Paediatric oncology palliative care in the community is rare and nationally there is a lack of standardisation of out of hours nursing service provision. Objectives: This paper seeks to explore influences on the experiences of paediatric nurses providing out of hours palliative care within the family home to children with cancer. The study used social worlds theory to aid identification and demonstration of the findings. Methods: Twelve community-based palliative cases were purposively selected from children with cancer treated at one regional centre. Tape-recorded interviews were undertaken with 54 health professionals (general practitioners, community nurses and allied health professionals) involved in providing their palliative care and five facilitated case discussions completed. Data analysis followed a grounded theory approach; chronological comparative data analysis identifying generated themes. Social worlds theory was used as a framework to examine the data. Results: Nurses’ experiences are shaped by their social world and those of the nursing team,child and family and the inter-professional team providing the care. The lack of a formalised service, sub-optimal inter-professional working and impact of social worlds influence the experience of the nurse. Conclusions: Social worlds theory provided a new perspective in understanding these experiences based within a paediatric palliative care setting, knowledge that can be used to inform service provision.