Patient and carer participation in old age psychiatry in England. Part I: a systemic perspective of the historical and policy context

Abstract

Old age psychiatry patients and carers struggle to be heard but have much to offer to services in partnership with healthcare professionals as partners and allies in service development.

Working alliances not loggerheads: understanding and addressing dissonance between families and treating teams in older people’s mental health

“…The complex biopsychosocial needs of older people mean that they are often embedded within a web of health and social networks, of which the family is an important part. Benbow 4 outlined the benefits of family carer involvement in old age psychiatry, ranging from patient/carer issues to the professional and organizational culture.…”

“…Sometimes resistance can be within the treatment team, who may perceive patient care using a linear, non-systemic paradigm that excludes the family, or perceive family involvement as disempowering, or threatening to professional autonomy and decision-making. 4 The most common form of dissonance between families and treating teams, or the most vexing for health care professionals, is disagreement over treatment decisions, sometimes about diagnosis; but usually about too much, not enough, or the wrong treatment. 1…”

A qualitative exploration of family carer’s understandings of people with dementia’s expectations for the future

“…Staff communication with family as the person transitions into long-term care becomes critical, as families have the information regarding the person’s future expectations and are able to advocate for what they need. Family carers and the wider family network are the experts in knowing the person and health professionals need to rely on this partnership so they can effectively meet the person with dementia’s needs (Benbow, 2012).…”

Review of family therapy and dementia: twenty-five years on

“…The future research would benefit from clarity regarding the therapeutic model employed and its application in practice; evaluation of both family and patient outcomes; and evaluation of broader change within the system. Endeavoring to investigate systemic outcomes will necessitate a way of evaluating collaboration, the mutual exchange of ideas/views between family members and health and social care staff members, and the mutual construction of outcomes, which may be different from the ones originally anticipated (Benbow, 2012). In this way a systemic perspective on the problem determining and dissolving system (Anderson and Goolishian, 1996) would open up multiple perspectives, truths, and realities in how we understand “dementia,” and its “management.”…”