Care and Case Management for Older People in Ireland

This study provides, for the first time, a systematic review of how health and social services are currently being delivered to older people with the purpose of identifying models of best practice within a Care Management framework. The research allows the voices of a wide range of health and social service providers to comment individually about how care is currently delivered in Ireland. In addition, the research provides them with an opportunity to express how they feel about Care and Case Management as a model for the planning, co-ordination and delivery of services and its feasibility in an Irish context Download the Report here

Towards Care Management: Conference Proceedings

Towards Care Management: Conference Proceedings The original brief for this study proposed an investigation into the attitudes and perceptions that health and social service providers have about barriers to and incentives for the effective implementation of Care Management in Ireland. Click here to download PDF 712kb

Hungry for Change: Social Exclusion, Food Poverty and Homelessness in Dublin

This study investigates the impact of poverty and social exclusion on the food, diet and nutrition of people out-of-home in Dublin. The research involved a food frequency survey carried out with 75 people out of home, qualitative interviews with 12 individuals as well as a self-completion questionnaire administered to 18 food service providers in Dublin city. One of the main findings from the study was that the extent and experience of food poverty among homeless people was not only conditioned by income inadequacy and other socio-economic and cultural determinants, but particularly, by access to accommodation, as well as the quality of that accommodation. The report makes a number of practice and policy recommendations to tackle food poverty and homelessness. The qualitative approaches to food poverty employed for use with this sample of people out-of-home aimed to deal in depth with issues around food consumption. Through drawing a sub-sample from those who participated in the survey research (a process of recapture), the authors sought to expand on the survey questionnaire information on food issues. The themes for the Focus Group Discussions (FGDs) emerged from the analysis of the survey questionnaires and 4 key thematic areas were selected. i) Access to cooking, preparation and storage facilities ii) Access, choice and constraints in food purchase and consumption iii) Access to information about healthy diet, food preparation and storage iv) Expectations, cultures, values and choice concerning eating The qualitative aspect of the research enquiry eventually generated one FGD and seven semi-structured interviews representing the views of a total of 12 persons all of whom had completed the initial survey questionnaire.This resource was contributed by The National Documentation Centre on Drug Use.

Putting a health inequalities focus on Northern Ireland cardiovascular service framework - Summary report

The PHA, supported by the Institute of Public Health in Ireland (IPH) and other agencies and individuals, has completed a health impact assessment (HIA) on the Cardiovascular Service Framework (CVSFW) for Northern Ireland.The CVSFW is the first in a series of service frameworks developed in Northern Ireland to guide HSC provision from prevention and health improvement over early intervention in communities and general practice into hospital and other institutional settings towards rehabilitation, palliative care and end of life.The CVSFW is relevant to everyone who has a part in HSC services for health improvement, hypertension, hyperlipidaemia, diabetes, heart disease, cerebrovascular disease (stroke), peripheral vascular disease and renal disease. This includes patients, carers, families, communities, voluntary and statutory service providers, policy makers and researchers.

Putting a health inequalities focus on the Northern Ireland cardiovascular service framework

The PHA, supported by the Institute of Public Health in Ireland (IPH) and other agencies and individuals, has completed a health impact assessment (HIA) on the Cardiovascular Service Framework (CVSFW) for Northern Ireland.The CVSFW is the first in a series of service frameworks developed in Northern Ireland to guide HSC provision from prevention and health improvement over early intervention in communities and general practice into hospital and other institutional settings towards rehabilitation, palliative care and end of life.The CVSFW is relevant to everyone who has a part in HSC services for health improvement, hypertension, hyperlipidaemia, diabetes, heart disease, cerebrovascular disease (stroke), peripheral vascular disease and renal disease. This includes patients, carers, families, communities, voluntary and statutory service providers, policy makers and researchers. There are many determinants which impact on cardiovascular disease. Individual lifestyles are major contributors and smoking remains one of the biggest risk factors for the disease alongside sedentary lifestyles and alcohol consumption. Circumstances experienced during the early years influence health and wellbeing into adulthood. Breastfeeding can help protect against obesity, while physical activity and eating habits developed from a young age often form lifelong patterns of behaviour. Living and working conditions also impact on health. Type of job, level of control and employment conditions are major factors. Educational achievement and income are also powerful influences on health. The environment where we live can provide access to open and green space, which plays an important part in physical activity patterns alongside available transport infrastructure. As well as physical health impacts, all of these factors also influence mental health and emotional wellbeing.

A picture of health: A study of the health status and health promotion needs of homeless people in the west.

Homeless people have been identified as a group that experience inequality in health and a target group in relation to health promotion initiatives. In developing health promotion initiatives it is important to take account of the broader determinants of health and to address the physical, mental and social well-being of homeless people. The study aimed to identify the health status and health promotion needs of homeless people in the Western Health Board region.To gain an understanding of the health problems and health promotion needs of homeless people one to one interviews were carried out with homeless people and focus groups were carried out with service providers. Sixty five interviews were carried out with people currently accessing voluntary services in Galway and Mayo. Three focus groups were carried out with service providers from voluntary and statutory services.This resource was contributed by The National Documentation Centre on Drug Use.

A study of cocaine use in Northern Ireland 2009.

This study explored the patterns of cocaine use and the lifestyles of users in Northern Ireland with the aim of providing the Department of Health, Social Services and Public Safety (DHSSPS) and treatment service providers with a better understanding of cocaine use in Northern Ireland. This primarily qualitative study was conducted in two phases. In Phase I a â?~Community Assessment Processâ?T was conducted to gain an understanding of the experiences of drug treatment professionals to cocaine use in Northern Ireland. In phase II 40 in-depth interviews were conducted with cocaine users. The study identified two types of cocaine user, these are recreational or socially integrated users and those referred for drug treatment who as a group was socially marginalized users. For the purposes of this study these users will be referred to as either recreational or treatment users. The demographic profiles of each type of user differed in a number of important respects. The recreational users were typically young, educated and anchored to a largely conventional lifestyle and whose pattern of non-work activities involved partying and drug use. Treatment users, on the other hand, generally had low level educational qualifications and were typically unemployed and living on state benefits. A number of the treatment users were either living in a hostel at the time of interview or had experienced homelessness at some time in their life. None of the recreational users reported any experience of homelessness. These distinctions, as well as differences between the groups in terms of their drug use patterns, preferences and practices, strongly suggest that in unravelling the nature of cocaine use and cocaine problems there is a need to look beyond the drug itself.This resource was contributed by The National Documentation Centre on Drug Use.

FLYER: Ethics, Consent and Participation in Research With Children and Young People

  Date: Friday, 14 June 2013   Time:10:30 – 13.30 Location: G13, Western Gateway Building, University College Cork The children's Research Network for Ireland and Northern Ireland in conjunction with the Children and Young People Research Cluster at the Institute for Social Sciences in the 21st Century at UCC are holding a workshop on ethics, consent and participation in research with children and young people. The event will explore some of the complex ethical issues involved in conducting research with children and young people, from the perspectives of researchers, children, families and service-providers.  

Public Policy and Ageing in Northern Ireland: Identifying Levers for Change

Public Policy and Ageing in Northern Ireland: Identifying Levers for Change Judith Cross, Policy Officer with the Centre for Ageing Research Development in Ireland (CARDI)��������Introduction Identifying a broad range of key public policy initiatives as they relate to age can facilitate discussion and create new knowledge within and across government to maximise the opportunities afforded by an ageing population. This article looks at how examining the current public policy frameworks in Northern Ireland can present opportunities for those working in this field for the benefit of older people. Good policy formulation needs to be evidence-based, flexible, innovative and look beyond institutional boundaries. Bringing together architects and occupational therapists, for example, has the potential to create better and more effective ways relevant to health, housing, social services and government departments. Traditional assumptions of social policy towards older people have tended to be medically focused with an emphasis on care and dependency. This in turn has consequences for the design and delivery of services for older people. It is important that these assumptions are challenged as changes in thinking and attitudes can lead to a redefinition of ageing, resulting in policies and practices that benefit older people now and in the future. Older people, their voices and experiences, need to be central to these developments. The Centre for Ageing Research and Development in Ireland The Centre for Ageing Research and Development in Ireland (CARDI) (1) is a not for profit organisation developed by leaders from the ageing field across Ireland (North and South) including age sector focused researchers and academics, statutory and voluntary, and is co-chaired by Professor Robert Stout and Professor Davis Coakley. CARDI has been established to provide a mechanism for greater collaboration among age researchers, for wider dissemination of ageing research information and to advance a research agenda relevant to the needs of older people in Ireland, North and South. Operating at a strategic level and in an advisory capacity, CARDI�۪s work focuses on promoting research co-operation across sectors and disciplines and concentrates on influencing the strategic direction of research into older people and ageing in Ireland. It has been strategically positioned around the following four areas: Identifying and establishing ageing research priorities relevant to policy and practice in Ireland, North and South;Promoting greater collaboration and co-operation on ageing research in order to build an ageing research community in Ireland, North and South;Stimulating research in priority areas that can inform policy and practice relating to ageing and older people in Ireland, North and South;Communicating strategic research issues on ageing to raise the profile of ageing research in Ireland, North and South, and its role in informing policy and practice. Context of Ageing in Ireland Ireland �۪s population is ageing. One million people aged 60 and over now live on the island of Ireland. By 2031, it is expected that Northern Ireland�۪s percentage of older people will increase to 28% and the Republic of Ireland�۪s to 23%. The largest increase will be in the older old; the number aged 80+ is expected to triple by the same date. However while life expectancy has increased, it is not clear that life without disability and ill health has increased to the same extent. A growing number of older people may face the combined effects of a decline in physical and mental function, isolation and poverty. Policymakers, service providers and older people alike recognise the need to create a high quality of life for our ageing population. This challenge can be meet by addressing the problems relating to healthy ageing, reducing inequalities in later life and creating services that are shaped by, and appropriate for, older people. Devolution and Structures of Government in Northern Ireland The Agreement (2) reached in the Multi-Party Negotiations in Belfast 1998 established the Northern Ireland Assembly which has full legislative authority for all transferred matters. The majority of social and economic public policy such as; agriculture, arts, education, health, environment and planning is determined by the Northern Ireland Assembly at Stormont. There are 11 Government Departments covering the main areas of responsibility with 108 elected Members of the Legislative Assembly (MLA�۪s). The powers of the Northern Ireland Assembly do not cover ��� reserved�۪ matters or ��� excepted�۪ matters . These are the responsibility of Westminster and include issues such as, tax, social security, policing, justice, defence, immigration and foreign affairs. Northern Ireland has 18 elected Members of Parliament (MP�۪s) to the House of Commons. Public Policy Context in Northern Ireland The economic, social and political consequence of an ageing population is a challenge for policy makers across government. Considering the complex and diverse causal factors that contribute to ageing in Northern Ireland, there are a number of areas of government policy at regional, national and international levels that are likely to impact in this area. International The Madrid International Plan of Action on Ageing (3) and the Research Agenda on Ageing for the 21st Century (4) provide important mechanisms for furthering research into ageing. The United Kingdom has signed up to these. The Madrid International Plan of Action on Ageing commits member states to a systematic review of the Plan of Action through Regional Implementation Strategies. The United Kingdom�۪s Regional Implementation Strategy covers Northern Ireland. National At National level, pension and social security are high on the agenda. The Pensions Act (5) became law in 2007 and links pensions increases with earnings as opposed to prices from 2012. Additional credits for people raising children and caring for older people to boost their pensions were introduced. Some protections are included for those who lost occupational pensions as a result of underfunded schemes being wound up before April 2005. In relation to State Pensions and benefits, this Act will bring changes to state pensions in future. The Act now places the Pension Credit element which is up-rated in line with or above earnings, on a permanent, statutory footing. Regional At regional level there are a number of age related public policy initiatives that have the potential to impact positively on the lives of older people in Northern Ireland. Some are specific to ageing such as the Ageing in an Inclusive Society (6) and others by their nature are cross-cutting such as Lifetime Opportunities: Governments Anti-Poverty Strategy for Northern Ireland (7). The main public policy framework in Northern Ireland is the Programme for Government: Building a Better Future, 2008-2011(PfG) (8) . The PfG, is the overarching high level policy framework for Northern Ireland and provides useful principles for ageing research and public policy in Northern Ireland. The PfG vision is to build a peaceful, fair and prosperous society in Northern Ireland, with respect for the rule of law. A number of Public Service Agreements (PSA) aligned to the PfG confirm key actions that will be taken to support the priorities that the Government aim to achieve over the next three years. For example objective 2 of PSA 7: Making Peoples�۪ Lives Better: Drive a programme across Government to reduce poverty and address inequality and disadvantage, refers to taking forward strategic action to promote social inclusion for older people; and to deliver a strong independent voice for older people. The Office of the First Minister and deputy First Minister (OFMDFM) have recently appointed an Interim Older People�۪s Advocate, Dame Joan Harbison to provide a focus for older peoples issues across Government. Ageing in an Inclusive Society is the cross-departmental strategy for older people in Northern Ireland and was launched in March 2005. It sets out the approach to be taken across Government to promote and support the inclusion of older people. The vision coupled with six strategic objectives form the basis of the action plans accompanying the strategy. The vision is: ���To ensure that age related policies and practices create an enabling environment, which offers everyone the opportunity to make informed choices so that they may pursue healthy, active and positive ageing.�۝ (Ageing in an Inclusive Society, Office of the First Minister and Deputy First Minister, 2005) Action planning and maintaining momentum across government in relation to this strategy has proved to be slower than anticipated. It is proposed to refresh this Strategy in line with Opportunity Age ��� meeting the challenges of ageing in the 21st Century (9). There are a number of policy levers elsewhere which can also be used to promote the positive aspects of an ageing society. The Investing for Health (10) and A Healthier Future:A 20 Year Vision for Health and Well-being in Northern Ireland (11), seek to ensure that the overall vision for health and wellbeing is achievable and provides a useful framework for ageing policy and research in the health area. These health initiatives have the potential to positively impact on the quality of life of older people and provide a useful framework for improving current policy and practice. In addition to public policy initiatives, the anti-discrimination frameworks in terms of employment in Northern Ireland cover age as well as a range of other grounds. Goods facilitates and services are currently excluded from the Employment Equality (age) Regulations (NI) 2006 (12). Supplementing the anti-discrimination measures, Section 75 of the Northern Ireland Act 1998 (13), unique to Northern Ireland, places a statutory obligation on public authorities in fulfilling their functions to promote equality of opportunity across nine grounds, one of which is age(14). This positive duty has the potential to make a real difference to the lives of older people in Northern Ireland. Those affected by policy decisions must be consulted and their interests taken into account. This provides an opportunity for older people and their representatives to participate in public policy-making, right from the start of the process. Policy and Research Interface ���Ageing research is vital as decisions in relation to policy and practice and resource allocation will be made on the best available information�۝. (CARDI�۪s Strategic Plan 2008-2011) As outlined earlier, CARDI has been established to bridge the gap to ensure that research reaches those involved in making policy decisions. CARDI is stimulating the ageing research agenda in Ireland through a specific research fund that has a policy and practice focus. My work is presently focusing on helping to build a greater awareness of the key policy levers and providing opportunities for those within research and policy to develop closer links. The development of this shared understanding by establishing these links between researchers and policy makers is seen as the best predictor for research utilization. It is important to acknowledge and recognise that researchers and policy makers operate in different institutional, political and cultural contexts. Research however needs to ���resonate�۪ with the contextual factors in which policy makers operate. Conclusions Those working within the public policy field recognise all too often that the development of government policies and initiatives in respect of age does not guarantee that they will result in changes in actual provision of services, despite Government recommendations and commitments. The identification of public policy initiatives as they relate to age has the potential to highlight persistent and entrenched difficulties that social policy has previously failed to address. Furthermore, the identification of these difficulties can maximise the opportunities for progressing these across government. A focus on developing effective and meaningful targets to ensure measurable outcomes in public policy for older people can assist in this. Access to sound, credible and up-to-date evidence will be vital in this respect. As well as a commitment to working across departmental boundaries to effect change. Further details: If you would like to discuss this paper or for further information about CARDI please contact: Judith Cross, Policy Officer, Centre for Ageing Research and Development in Ireland CARDI). t: +44 (0) 28 9069 0066; m: +353 (0) 867 904 171; e: judith@cardi.ie ; or visit our website at: www.cardi.ie References 1) Centre for Ageing Research and Development in Ireland (2008) Strategic Plan 2008-2011. Belfast. CARDI 2) The Agreement: Agreement Reached in the Multi-Party Negotiations. Belfast 1998 3) Madrid International Plan of Action on Ageing. http://www.un.org/ageing/ 4) UN Programme on Ageing (2007) Research Agenda on Ageing for the 21st Century: 2007 Update. New York. New York. UN Programme on Ageing and the International Association of Gerontology and Geriatrics. 5) The Pensions Act 2007 Chapter 22 6) Office of the First Minister and deputy First Minister (2005). Ageing in an Inclusive Society. Belfast. OFMDFM Central Anti-Poverty Unit. 7) Office of the First Minister and deputy First Minister (2005). Lifetime Opportunities: Government�۪s Anti-Poverty and Social Inclusion Strategy for Northern Ireland. Belfast. OFMDFM Central Anti-Poverty Unit. 8) Northern Ireland Executive (2008) Building a Better Future: Programme for Government 2008-2011. Belfast. OFMDFM Economic Policy Unit. 9) Department for Work and Pensions, (2005) Opportunity Age: Meeting the Challenges of Ageing in the 21 st Century. London. DWP. 10) Department of Health, Social Services and Public Safety (DHSS&PS) (2002) Investing for Health. Belfast. DHSS&PS. 11) Department of Health, Social Services and Public Safety (DHSS&PS) (2005) A Healthier Future:A 20 Year Vision for Health and Well-being in Northern Ireland Belfast. DHSS&PS. �� 12) The Employment Equality (Age) Regulations (Northern Ireland) 2006 SR2006 No.261 13) The Northern Ireland Act 1998, Part VII, S75 14) The nine grounds covered under S75 of the Northern Ireland Act are: gender, religion, race, sexual orientation, those with dependents, disability, political opinion, marital status and age.

Women speaking across the Border: The impact of the Border and the conflict on women's health and roles

This research was commissioned by Derry Well Woman and carried out on its behalf by the Institute of Public Health in Ireland in association with the Institute for Conflict Research and Rethink.The research had two distinct aims:- to improve understanding of the impact of the border and of the conflict on both sidesof the border on women’s health- to improve understanding of women’s roles, particularly as they impact on mental health, in post conflict society.- The research was conducted with a view to its recommendations being used to inform the work of the Cross Border Women’  Health Network as well as other cross border health forums or organisations responsible for service planning and delivery.- The findings of this research are based on a series of 31 in-depth interviews and one focus group with women both north and south of the border and on one focus group and six interviews with women who were specifically consulted as service providers.

Direct Payments Policy and Practice Review Report (PDF 243 KB)

Direct Payments are cash payments made in lieu of social service provisions, to individuals who have been assessed as needing services. Direct Payments increase choice and promote independence. They provide for a more flexible response than may otherwise be possible for the service user and carer. They allow individuals to decide when and in what form services are provided and who provides them, who comes into their home and who becomes involved in very personal aspects of their lives. Direct Payments put real power into the hands of service users and carers, and allow them to take control over their lives. Access to Direct Payments as a means of delivering social services in Northern Ireland has been available since 1996 under the Personal Social Services (Direct Payments) (Northern Ireland) Order 1996. Since then take up of Direct Payments has been limited in number with the majority being accessed in the physical disability programme. åÊ

Department of Health and Children Business Plan 2003

Department of Health and Children Business Plan 2003 The National Health Strategy â?oQuality and Fairness: A Health System for Youâ?Âù is based on a whole-system approach to health matters. It recognises the role of stakeholders such as the public, community and voluntary bodies, health service providers, statutory and non-statutory bodies, other Government Departments and international bodies in working together to produce a world-class health system and a healthier population. Click here to download PDF 2.5mb

North South Survey of Children's Oral Health 2002

North South Survey of Children’s Oral Health 2002 This report presents the results of the first contemporaneous North South study of the oral health of children and adolescents on the island of Ireland. The last National Survey of Childrenâ?Ts Oral Health in the Republic of Ireland was carried out in 1984. The present study describes the oral health experience of children and adolescents in Ireland today. The results are of interest to the public, to policymakers and to service providers and will be of assistance in the evaluation of current oral health services and the planning of services for the next decade. Click here to download PDF 666kb

National Physical and Sensory Disability Database - information pack

The need for information on the service needs of people with physical and/or sensory disabilities was first highlighted in Shaping a Healthier Future: A strategy for Effective Healthcare in the 1990s.  This strategy document identified the establishment of a national database as the means of gathering such information.  Subsequently, the report of the Review Group on Health and Personal Social Services for People with Physical and Sensory Disabilities, Towards an Independent Future, identified the lack of reliable information on the numbers of people with a physical and/or sensory disability needing a health and personal social service and their precise service needs. Download the Report here