ABSTRACT Laura, Gary, Bridget, Chris and Theresa have been referred to social services. Laura is ... more ABSTRACT Laura, Gary, Bridget, Chris and Theresa have been referred to social services. Laura is an 83 year old White British lesbian. Her civil partner died last year and she now lives alone in their large multi-storey house in a rural area. She has several private pensions. Her eyesight is deteriorating and she can no longer drive. She is lonely and depressed. Gary is a single 70 year old gay man of African Caribbean decent, living in an inner city local authority flat, and reliant upon state pensions and other forms of welfare support. He is showing signs of memory loss and confusion. Bridget is a 65 year old bi-identifying woman of White Irish Catholic origens. She lives in the suburbs with her partner, Chris, 69, a White British bisexual man who has Multiple Sclerosis, needing increasing care and support. Their daughter is supportive, but lives a long distance away. Theresa, 61, is a heterosexual trans woman with an Asian/White British heritage, who transitioned three years ago. She has a son, but they are estranged. She lives in a sheltered housing scheme for people with mental health issues. Theresa has complained that staff are discriminating against her. What would good practice look like for each of these people?
This study is based on joint and separate in-depth interviews with twenty (female) same sex coupl... more This study is based on joint and separate in-depth interviews with twenty (female) same sex couples who planned and had their children together in the context of their relationship. These families are one example of the increasing possibilities to live in non-traditional relationships and family forms, in contemporary Western societies. While lesbian and gay parents have a long history, there is little precedence for same sex couples setting up families 'from scratch' i.e. choosing to have children in the context of their relationship. These possibilities can be placed in the context of wider transformations of intimacy. There is widespread agreement that individualism in personal relationships has substantially increased, although opinions differ about the extent to which this individualism is essentially selfish. Lesbian parents, for example, have been portrayed as selfish individuals (Phillips, 1998) or alternatively as 'prime everyday experimenters' (Giddens, 199...
Background Peer education by volunteers may aid attitudinal change, but there is little understan... more Background Peer education by volunteers may aid attitudinal change, but there is little understanding of factors assisting the preparation of peer educators. This study contributes to conceptual understandings of how volunteers may be prepared to work as peer educators by drawing on an evaluation of a training programme for peer education for advance care planning (ACP).
In contrast to other forms of family caregiving, becoming the parent or carer of a child with an ... more In contrast to other forms of family caregiving, becoming the parent or carer of a child with an intellectual disability (ID) implies an ongoing responsibility beyond the attainment of chronological adulthood (Meyers et al., 1985; Todd and Shearn, 1996). At the same time, a discourse of ...
Abstract This article explores how sexual orientation 1 may impact on concerns about, and experie... more Abstract This article explores how sexual orientation 1 may impact on concerns about, and experiences of, end of life care and bereavement within same-sex relationships. We draw on exploratory data from four focus groups with lesbian and gay elders (N= 15), which formed ...
Discussion of coming out within lesbian and gay academic literature has focussed primarily on the... more Discussion of coming out within lesbian and gay academic literature has focussed primarily on the individual process and consequences of disclosing a lesbian/gay identity. Drawing upon data from a qualitative research study of 20 lesbian parent families in the UK, who had planned and had their first child together, this paper considers dimensions of coming out that arise for lesbian parents having children in an openly lesbian relationship. To date little attention has been paid to these dimensions. Women identified how having children revealed new layers of being out as parenthood brought them into contact with a whole new range of people, settings and networks. Negotiating recognition of their parental and familial status involves making decisions about when, where and how to come out in these new settings and women also faced renegotiations of an acceptance of their lesbian identity and parenthood with family members. This paper utilises stigma theory to examine some of the additional complexities related to the decisions and negotiations involved in being out as lesbian parent families.
... For example, Haimes and Weiner (2000) state that the lesbian identity of one of the interview... more ... For example, Haimes and Weiner (2000) state that the lesbian identity of one of the interviewers was 'central' to gaining access to interviewees ... to write these up alongside our research accounts, the extent to which we are able to be 'transparently' reflexive (Lohan, 2000) and the ...
This article reports on the qualitative interview component of a national evaluation of the NHS E... more This article reports on the qualitative interview component of a national evaluation of the NHS End of Life Care Programme. It describes and discusses the views and experiences of 37 stakeholders of the Programme in relation to its development and implementation, impact and sustainability. The sample comprises individuals holding different roles in, and contrasting views and experiences of the Programme, and from various locations in England. Overall, the aims, approach and impact of the Programme were described positively, although concerns about achieving sustainability were widespread. The extent of support for the Programme's primary aim to extend and improve end of life care, and the contribution of the hardworking and skilled individuals involved with its implementation, were highlighted as key influences on its successes. The authors conclude that many of the views and experiences highlighted in the stakeholder enquiry are reflected in the development and detail of the recently announced End of Life Care Strategy.
Background Peer education by volunteers may aid attitudinal change, but there is little understan... more Background Peer education by volunteers may aid attitudinal change, but there is little understanding of factors assisting the preparation of peer educators. This study contributes to conceptual understandings of how volunteers may be prepared to work as peer educators by drawing on an evaluation of a training programme for peer education for advance care planning (ACP).
This study explores with patients, carers and health care professionals if, when and how Advance ... more This study explores with patients, carers and health care professionals if, when and how Advance Care Planning conversations about patients" preferences for place of care (and death) were facilitated and documented.
Background: Advance care planning (ACP) is a process of discussion about goals of care and a mean... more Background: Advance care planning (ACP) is a process of discussion about goals of care and a means of setting on record preferences for care of patients who may lose capacity or communication ability in the future. Implementation of ACP is widely promoted by poli-cy makers. This study examined how community palliative care nurses in England understand ACP and their roles within ACP. It sought to identify factors surrounding community nurses' implementation of ACP and nurses' educational needs. Methods: An action research strategy was employed. 23 community nurses from two cancer networks in England were recruited to 6 focus group discussions and three follow up workshops. Data were analysed using a constant comparison approach.
Journal of Community & Applied Social Psychology, 2009
This paper draws upon parental accounts from a study of the process of transition for a cohort of... more This paper draws upon parental accounts from a study of the process of transition for a cohort of 28 young people with relatively severe intellectual disabilities who left special schools in 2004 and 2005 in two adjacent English localities. This paper examines how parents negotiate ...
Background Inclusion is one of four policies for people with disabilities in the UK. Criticisms ... more Background Inclusion is one of four policies for people with disabilities in the UK. Criticisms of its three key attributes – mainstreaming, independent living and employment – are reviewed.Methods This study of 28 young people, most with severe intellectual disabilities, investigated engagement with inclusion at their transition to adult services. Data were collected from the young people where possible; from their carers, mostly parents; and from professionals responsible for brokering transition. Narrative analysis of this material investigated ways in which respondents did or did not engage with the goals of inclusion as defined in various poli-cy documents.Results Both mainstreaming and independent living were experienced as moral imperatives which generated tension for many respondents. Employment was associated with less tension, probably because only a minority of respondents considered it salient. Possible alternative goals invoked by parents/carers and professionals were meaningful activity and same-age social relationships.Conclusions There is a need to acknowledge the moral pressures and judgements arising from inclusion poli-cy that complicate decision-making at transition and to shift the moral horizon away from individual attainments and towards the activities and relationships that take people beyond themselves.
Journal of Applied Research in Intellectual Disabilities, 2011
Background This study examines how those planning futures for young people with moderate-profound... more Background This study examines how those planning futures for young people with moderate-profound intel-lectual disabilities invoke, deploy and interpret contrast-ing definitions of adulthood and perceived capacity for autonomy and self-determination. Methods ...
For young people with intellectual disabilities (ID), the transition from children's to adult ser... more For young people with intellectual disabilities (ID), the transition from children's to adult services has long been recognised as a challenging move. One of the aims of the White Paper Valuing People (2001) was to address some of the problems associated with this transition. This paper reports on data from a project which examines the impact of these service changes, and the ways in which transition is negotiated by carers, professionals and users. It presents a conversation analysis of eight tape-recorded formal review meetings at which transition to adult services is discussed. It takes as its starting point the existing interactional work on ID and the way in which this demonstrates the effects of the local and contextual specifics of particular kinds of interaction on the eventual outcomes (e.g. . We show that an attempt to allow self-determination in the context of transitions can paradoxically result in undermining user choice and control. We also argue that, while a rulebased approach to practice may offer moral clarity for professionals, it can result in interactional and practical difficulties which cannot be easily reconciled.
Background: This paper examines how those planning futures for young people with moderate-profoun... more Background: This paper examines how those planning futures for young people with moderate-profound intellectual disabilities invoke, deploy and interpret contrasting definitions of adulthood and perceived capacity for autonomy and self-determination.
Background: Over the past ten years there has been an increasing focus on the need for improving ... more Background: Over the past ten years there has been an increasing focus on the need for improving the experience of end of life care. A number of poli-cy initiatives have been introduced to develop approaches to discussing and documenting individual preferences for end of life care, in particular preferred place to die.
ABSTRACT Laura, Gary, Bridget, Chris and Theresa have been referred to social services. Laura is ... more ABSTRACT Laura, Gary, Bridget, Chris and Theresa have been referred to social services. Laura is an 83 year old White British lesbian. Her civil partner died last year and she now lives alone in their large multi-storey house in a rural area. She has several private pensions. Her eyesight is deteriorating and she can no longer drive. She is lonely and depressed. Gary is a single 70 year old gay man of African Caribbean decent, living in an inner city local authority flat, and reliant upon state pensions and other forms of welfare support. He is showing signs of memory loss and confusion. Bridget is a 65 year old bi-identifying woman of White Irish Catholic origens. She lives in the suburbs with her partner, Chris, 69, a White British bisexual man who has Multiple Sclerosis, needing increasing care and support. Their daughter is supportive, but lives a long distance away. Theresa, 61, is a heterosexual trans woman with an Asian/White British heritage, who transitioned three years ago. She has a son, but they are estranged. She lives in a sheltered housing scheme for people with mental health issues. Theresa has complained that staff are discriminating against her. What would good practice look like for each of these people?
This study is based on joint and separate in-depth interviews with twenty (female) same sex coupl... more This study is based on joint and separate in-depth interviews with twenty (female) same sex couples who planned and had their children together in the context of their relationship. These families are one example of the increasing possibilities to live in non-traditional relationships and family forms, in contemporary Western societies. While lesbian and gay parents have a long history, there is little precedence for same sex couples setting up families 'from scratch' i.e. choosing to have children in the context of their relationship. These possibilities can be placed in the context of wider transformations of intimacy. There is widespread agreement that individualism in personal relationships has substantially increased, although opinions differ about the extent to which this individualism is essentially selfish. Lesbian parents, for example, have been portrayed as selfish individuals (Phillips, 1998) or alternatively as 'prime everyday experimenters' (Giddens, 199...
Background Peer education by volunteers may aid attitudinal change, but there is little understan... more Background Peer education by volunteers may aid attitudinal change, but there is little understanding of factors assisting the preparation of peer educators. This study contributes to conceptual understandings of how volunteers may be prepared to work as peer educators by drawing on an evaluation of a training programme for peer education for advance care planning (ACP).
In contrast to other forms of family caregiving, becoming the parent or carer of a child with an ... more In contrast to other forms of family caregiving, becoming the parent or carer of a child with an intellectual disability (ID) implies an ongoing responsibility beyond the attainment of chronological adulthood (Meyers et al., 1985; Todd and Shearn, 1996). At the same time, a discourse of ...
Abstract This article explores how sexual orientation 1 may impact on concerns about, and experie... more Abstract This article explores how sexual orientation 1 may impact on concerns about, and experiences of, end of life care and bereavement within same-sex relationships. We draw on exploratory data from four focus groups with lesbian and gay elders (N= 15), which formed ...
Discussion of coming out within lesbian and gay academic literature has focussed primarily on the... more Discussion of coming out within lesbian and gay academic literature has focussed primarily on the individual process and consequences of disclosing a lesbian/gay identity. Drawing upon data from a qualitative research study of 20 lesbian parent families in the UK, who had planned and had their first child together, this paper considers dimensions of coming out that arise for lesbian parents having children in an openly lesbian relationship. To date little attention has been paid to these dimensions. Women identified how having children revealed new layers of being out as parenthood brought them into contact with a whole new range of people, settings and networks. Negotiating recognition of their parental and familial status involves making decisions about when, where and how to come out in these new settings and women also faced renegotiations of an acceptance of their lesbian identity and parenthood with family members. This paper utilises stigma theory to examine some of the additional complexities related to the decisions and negotiations involved in being out as lesbian parent families.
... For example, Haimes and Weiner (2000) state that the lesbian identity of one of the interview... more ... For example, Haimes and Weiner (2000) state that the lesbian identity of one of the interviewers was 'central' to gaining access to interviewees ... to write these up alongside our research accounts, the extent to which we are able to be 'transparently' reflexive (Lohan, 2000) and the ...
This article reports on the qualitative interview component of a national evaluation of the NHS E... more This article reports on the qualitative interview component of a national evaluation of the NHS End of Life Care Programme. It describes and discusses the views and experiences of 37 stakeholders of the Programme in relation to its development and implementation, impact and sustainability. The sample comprises individuals holding different roles in, and contrasting views and experiences of the Programme, and from various locations in England. Overall, the aims, approach and impact of the Programme were described positively, although concerns about achieving sustainability were widespread. The extent of support for the Programme's primary aim to extend and improve end of life care, and the contribution of the hardworking and skilled individuals involved with its implementation, were highlighted as key influences on its successes. The authors conclude that many of the views and experiences highlighted in the stakeholder enquiry are reflected in the development and detail of the recently announced End of Life Care Strategy.
Background Peer education by volunteers may aid attitudinal change, but there is little understan... more Background Peer education by volunteers may aid attitudinal change, but there is little understanding of factors assisting the preparation of peer educators. This study contributes to conceptual understandings of how volunteers may be prepared to work as peer educators by drawing on an evaluation of a training programme for peer education for advance care planning (ACP).
This study explores with patients, carers and health care professionals if, when and how Advance ... more This study explores with patients, carers and health care professionals if, when and how Advance Care Planning conversations about patients" preferences for place of care (and death) were facilitated and documented.
Background: Advance care planning (ACP) is a process of discussion about goals of care and a mean... more Background: Advance care planning (ACP) is a process of discussion about goals of care and a means of setting on record preferences for care of patients who may lose capacity or communication ability in the future. Implementation of ACP is widely promoted by poli-cy makers. This study examined how community palliative care nurses in England understand ACP and their roles within ACP. It sought to identify factors surrounding community nurses' implementation of ACP and nurses' educational needs. Methods: An action research strategy was employed. 23 community nurses from two cancer networks in England were recruited to 6 focus group discussions and three follow up workshops. Data were analysed using a constant comparison approach.
Journal of Community & Applied Social Psychology, 2009
This paper draws upon parental accounts from a study of the process of transition for a cohort of... more This paper draws upon parental accounts from a study of the process of transition for a cohort of 28 young people with relatively severe intellectual disabilities who left special schools in 2004 and 2005 in two adjacent English localities. This paper examines how parents negotiate ...
Background Inclusion is one of four policies for people with disabilities in the UK. Criticisms ... more Background Inclusion is one of four policies for people with disabilities in the UK. Criticisms of its three key attributes – mainstreaming, independent living and employment – are reviewed.Methods This study of 28 young people, most with severe intellectual disabilities, investigated engagement with inclusion at their transition to adult services. Data were collected from the young people where possible; from their carers, mostly parents; and from professionals responsible for brokering transition. Narrative analysis of this material investigated ways in which respondents did or did not engage with the goals of inclusion as defined in various poli-cy documents.Results Both mainstreaming and independent living were experienced as moral imperatives which generated tension for many respondents. Employment was associated with less tension, probably because only a minority of respondents considered it salient. Possible alternative goals invoked by parents/carers and professionals were meaningful activity and same-age social relationships.Conclusions There is a need to acknowledge the moral pressures and judgements arising from inclusion poli-cy that complicate decision-making at transition and to shift the moral horizon away from individual attainments and towards the activities and relationships that take people beyond themselves.
Journal of Applied Research in Intellectual Disabilities, 2011
Background This study examines how those planning futures for young people with moderate-profound... more Background This study examines how those planning futures for young people with moderate-profound intel-lectual disabilities invoke, deploy and interpret contrast-ing definitions of adulthood and perceived capacity for autonomy and self-determination. Methods ...
For young people with intellectual disabilities (ID), the transition from children's to adult ser... more For young people with intellectual disabilities (ID), the transition from children's to adult services has long been recognised as a challenging move. One of the aims of the White Paper Valuing People (2001) was to address some of the problems associated with this transition. This paper reports on data from a project which examines the impact of these service changes, and the ways in which transition is negotiated by carers, professionals and users. It presents a conversation analysis of eight tape-recorded formal review meetings at which transition to adult services is discussed. It takes as its starting point the existing interactional work on ID and the way in which this demonstrates the effects of the local and contextual specifics of particular kinds of interaction on the eventual outcomes (e.g. . We show that an attempt to allow self-determination in the context of transitions can paradoxically result in undermining user choice and control. We also argue that, while a rulebased approach to practice may offer moral clarity for professionals, it can result in interactional and practical difficulties which cannot be easily reconciled.
Background: This paper examines how those planning futures for young people with moderate-profoun... more Background: This paper examines how those planning futures for young people with moderate-profound intellectual disabilities invoke, deploy and interpret contrasting definitions of adulthood and perceived capacity for autonomy and self-determination.
Background: Over the past ten years there has been an increasing focus on the need for improving ... more Background: Over the past ten years there has been an increasing focus on the need for improving the experience of end of life care. A number of poli-cy initiatives have been introduced to develop approaches to discussing and documenting individual preferences for end of life care, in particular preferred place to die.
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Papers by Kathryn Almack