Preventive Role of social care for Older People: triggers, judgement calls and processes (the PROP study)
Our preventive programme looked at the work that at-home and out-of-home community services do to monitor and maintain the physical, cognitive and mental health and wellbeing of older people, particularly those living alone. This study was focused on South London.
The Preventive Role of social care for Older People (PROP)
The PROP study explored the work of homecare agencies, befriending services, lunch clubs for minority groups and men’s sheds that support older people living alone. We spoke to 30 people working or volunteering in 18 services across South London, followed by group discussions with 8 health and social care stakeholders.
We found that people working and volunteering in these services routinely keep an eye on people’s health and wellbeing. They are well-placed to spot small changes and follow up on a wide range of concerns and respond to emergencies.
Regular contact leading to trusting relationships were the foundation of this work. Personal or professional experience, feelings of responsibility, teamwork and internal structures guided staff and volunteers’ follow-up actions which included consulting with the older people themselves, their families, internal and external experts, and signposting and referring onwards. On occasions, support was provided beyond official role boundaries, which could feel burdensome.
Health and social care experts told us that these services filled a gap; they occupied a role that statutory services simply cannot replicate. Ongoing opportunities talk and trusting relationships enabled services staff and volunteers to notice, or be told about, subtle changes, emerging risks and unmet needs earlier than clinical encounters ever could. This type of cross-sector referral work is essential for person-centred care. However, some barriers will need to be addressed for it to be more effective and sustainable.
Our research concluded that the work these services do makes an important contribution to the maintenance of health, independence and quality of life among older people living alone who use these services. With an increase in numbers of people living alone and a renewed policy focus on community-based prevention, there is scope for a systemic shift in the way services such as these are viewed and supported financially within an integrated care model.
- Read our 6-page briefing summarising the findings.
- Read the vignettes showing individual examples of health and wellbeing concerns that services followed up.
- We are currently drafting journal articles covering different perspectives and will update this page as they are published.
Day centres’ preventive work
While developing the Day Centre Resources Hub, we asked older people’s day centre stakeholders and others working in health and social care about their views on day centres’ preventive function. Our findings, published in the International Journal of Qualitative Studies on Health and Wellbeing, highlight how work undertaken in day centres falls under the radar as a systemic contribution to the prevention agenda within health and social care.
Read our blog introducing the findings.
To find out more about this prevention work, contact Katharine.Orellana@kcl.ac.uk.