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Melanie Henwood

Bio: Melanie Henwood is an academic researcher from King's Fund. The author has contributed to research in topics: Health care & Agency (sociology). The author has an hindex of 6, co-authored 11 publications receiving 288 citations.

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01 Nov 2017
TL;DR: A recent NIHR-SSCR funded scoping review provides a comprehensive mapping of what is known about carers and caring, and aims to help inform policy, practice and research in relation to carers.
Abstract: This NIHR-SSCR funded scoping review provides a comprehensive mapping of what is known about carers and caring, and aims to help inform policy, practice and research in relation to carers. The review was undertaken by searching 10 electronic bibliographic databases, supplemented by additional web searches to identify academic research, grey literature and wider knowledge. The analysis adopts a selective thematic approach covering: carer variables - the characteristics of different types of carer and different caring situations; types of care - the nature of needs of the cared for person and the features of the care situation; the impact of caring – resilience and coping, employment and health; and carer support and needs assessment. The final section highlights key messages identified from the review. It found that caring involves all sections and age groups of the population, with people are likely to experience one or more periods of caregiving over their lifetime. The uniqueness of each caring relationship is also highlighted. In relation to types of carers, knowledge about ‘hard to reach’ groups, such as BAME and LGBT carers, remains sparse. Older carers are also relatively invisible in policy and research terms. It found that much of the knowledge about carers identified in the review relates to their characteristics, their lived experience and the nature of their caregiving, with relatively less being known about the effectiveness of interventions to support them. The report concludes by offering suggestions for policy and practice. An appendix provides a bibliography of the 3,434 items identified in review, classified into 17 types of reference.

158 citations

Journal ArticleDOI
TL;DR: The authors suggest that developing an integrated paradigm that draws on the strengths and methods of existing paradigms, has considerable potential to generate new knowledge and new evidence and extend understanding of care and caring.
Abstract: The review discussed in this paper provides a unique synthesis of evidence and knowledge about carers. The authors adopted a scoping review methodology drawing on a wide range of material from many different sources published between 2000-16. It offers key insights into what we know and how we know it; reinforces and expands evidence about carers’ profile; shows knowledge is uneven e.g. much is known about working carers, young carers, and carers of people with dementia but far less i about older carers or caring for someone with multiple needs. A striking feature of much research is a focus on caring as a set of tasks, rather than a dimension of an, often dyadic, relationship. Whilst there is substantive evidence about the negative impact of caring, the review suggests that links between caring and carer outcomes are neither linear nor inevitable and vary in depth and nature. A reliance on cross-sectional studies using standardised measures is a major weakness of existing research: this approach fails to capture the multi-dimensionality of the caring role, and the lived experience of the carer. Although research relating to formal support suggests that specific interventions for particular groups of carers may be effective, overall the evidence base is weak. There is a tension between cost effectiveness and what is valued by carers. Developing robust evaluative models that accommodate this tension, and take account of the dyadic context of caring is a critical challenge. A fundamental deficit of carer related research is its location in one of two, largely separate, paradigmatic frameworks: the ‘Gatherers and Evaluators’ and the ‘Conceptualisers and Theorisers’. The authors suggest that developing an integrated paradigm, that draws on the strengths and methods of existing paradigms, has considerable potential to generate new knowledge and new evidence and extend understanding of care and caring.

61 citations

Journal ArticleDOI
TL;DR: This paper examines partnership working between health and social care by exploring the specific issues which this case study of hospital discharge provides and underlines the need for a new relationship between central government and local agencies when old-style models of command and control are no longer fit for purpose.
Abstract: The process of discharging patients from hospital provides a critical indicator of the state of partnership working between health and social care agencies. In many ways, hospital discharge can be seen to epitomise the challenges which beset partnership working. For patients who have care needs which continue following their discharge from hospital, how well health and social care partners are able to coordinate their policies and practice is critical. Where arrangements work well, patients should experience a seamless transition; where things go wrong, patients are all too often caught in the middle of contested debate between health and social care authorities over who is responsible for what. In 2002, growing concerns over the numbers of mainly elderly people who were experiencing delays in being discharged from hospital led to the announcement that a system of 'cross-charging' would be introduced to target delayed discharges which were the responsibility of local authority social services departments. The government's proposals were widely criticised and were the focus of much antagonism. The intervention of the Change Agent Team (an agency with responsibility for providing practical support to tackle delayed discharges) marked a turning point in the presentation of the policy and in supporting local implementation efforts. This paper examines partnership working between health and social care by exploring the specific issues which this case study of hospital discharge provides. The analysis highlights the importance of understanding the dynamics of partnership working on the ground. It also underlines the need for a new relationship between central government and local agencies when old-style models of command and control are no longer fit for purpose. A new approach is required that addresses the complex and multiple relationships which characterise the new partnership agenda.

31 citations

Journal ArticleDOI
Melanie Henwood1
TL;DR: In this article, age discrimination in health care critical public health: Vol 2, No 2, pp 4-14. But no sense of urgency: Age discrimination is not a priority issue.
Abstract: (1991) No sense of urgency: Age discrimination in health care Critical Public Health: Vol 2, No 2, pp 4-14

21 citations


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Journal ArticleDOI
TL;DR: In this paper, the authors examined the extent to which social death may occur before biological death among elderly people with dementia and found evidence of both beliefs and behaviours suggesting that a degree of social death had occurred before the sufferer's biological death.
Abstract: Many cultures have distinguished between biological and social death, the latter usually occurring some time after the former. More recently social death has been noted to occur before biological death in terminally ill comatose patients. This paper presents the results of an exploratory study which examined the extent to which social death may occur before biological death among elderly people with dementia. One hundred semi-structured interviews were conducted with the caregiving relatives of dementia sufferers. Ratings were made of the degree to which carers appeared to believe their dementing dependent was socially (or ‘as good as’) dead, as well as note taken of behaviour suggesting that they had discounted the sufferer in social terms. In over one third of caregiving relatives there was evidence of both beliefs and behaviours suggesting that a degree of social death had occurred before the sufferer's biological death. Almost all those categorised as behaving towards a sufferer as if they were socially dead expressed beliefs indicating that this was how the sufferer was perceived. However, perceiving a sufferer in ways which could be characterised as socially dead was not necessarily combined with behaving as though they were. Examples of degrees of social death are presented and discussed against the background of increasing numbers of dementia sufferers in modern Western societies.

217 citations

Journal ArticleDOI
TL;DR: In this article, the authors analyzed the reasons for higher voting participation among older people in Europe and found that older citizens tend to habituate voting and comply with a growing subjective norm of voting.
Abstract: This article analyses the reasons for higher voting participation among older people in Europe. Over their lifetimes, citizens tend to habituate voting and comply with a growing subjective norm of voting. Furthermore, the average voting participation of older people is influenced by their longer duration of residence, the lack of a mobilising partner, worse physical health and less education, although life experience replaces the function of formal education over a lifetime. Most of these factors are founded on the very nature of human behaviour and the social context of our life course. Thus, they arguably stand outside of the political process and will remain stable into the future. Higher turnout among older age groups, after basic controls for education and gender, has been a consistent finding in many years of research. Older people are more likely to vote—no matter when or where the surveys have been carried out. We are so used to this fact that we forget how unusual the stability of the finding is. Across countries, differences exist in electoral systems, party systems, socioeconomic development and democratic experience. Variations of these country characteristics may have differential impacts on voting participation of various age groups. Over time, there has been a general decline in turnout and a growing disenchantment with electoral politics. In addition to this long-term trend, distinct generations of voters such as the New Deal generation in the USA (Miller and Shanks 1996) or ‘Thatcher’s Children’ in Britain (Russell et al. 1992) have experienced electoral politics in different ways, compared to earlier and later cohorts. Why is it that older people consistently show a higher propensity to vote despite all these generational changes? This article suggests that older people, compared to younger fellow citizens, have habituated voting over their lifetime and feel a stronger subjective norm to vote. Habituating patterns of social behaviour and complying with social norms are universal human propensities that exist everywhere. There are some further important differences between older and younger voters. Older citizens are on average more likely to vote because they have been living in an area for longer. They are less likely to vote because: (a) they tend to lack a mobilising partner; (b) suffer from worse health; and (c) are less educated as a member of an older cohort, although life experience replaces the function of formal education over a lifetime. This article analyses international cross-sectional data (the European Social Survey from 2002/3). Countries in the survey vary so much in their political history that older people have experienced a multitude of idiosyncratic national histories. This research design allows the study of common factors such as habituation that accompany the ageing process and are the same in all countries. After a literature doi: 10.1111/j.1467-856x.2006.00243.x BJPIR: 2007 VOL 9, 90‐121

188 citations

Journal ArticleDOI
TL;DR: Modulation of nutritional characteristics can significantly alleviate the metabolic profile of diabetes and researchers need to promote international scientific studies in this direction.
Abstract: ommendation for diabetic individuals in regard to fiber (coarse cereals) and cholesterol (low animal-product usage). NIDDM patients comprise a heterogenous group, but study of the natural history of diabetes in different continents due to variations in dietary practice can be informative to rationalize dietary recommendations scientifically for this type of diabetes. Modulation of nutritional characteristics can significantly alleviate the metabolic profile of diabetes. Researchers need to promote international scientific studies in this direction.

165 citations

Journal ArticleDOI
01 Nov 1987-Nature
TL;DR: Ramakrishna and Woodwell as mentioned in this paper presented the World Forests for the Future (WFEFT) project, which aims to protect the future of the world's forests.
Abstract: World Forests for the Future. Edited by Kiliparti Ramakrishna and George M. Woodwell. Yale University Press: 1993. Pp. 156. £14.95, $20.

146 citations