Working with Older People and their Families: Key Issues in Policy and Practice

Edited by Mike Nolan, Sue Davies and Gordon Grant.

Open University Press

£55 (hardback)

£17.99 (paperback)

ISBN 0335 2056 1 5 (hardback)

ISBN 0 335 20560 7 (paperback)

This book is written by nursing academics and has much of value.
It is the product of a study “aimed at identifying an epistemology
of practice for those involved in the care of older people…which
will offer a mechanism via which to achieve…the goal of
person-centred care.”

It reviews a wide range of literature and concludes with a
useful framework, based on work done by M R Nolan (1997).

In the context of caring relationships, for older people, for
staff, and for family carers, there are six “senses” needed: a
sense of security, a sense of continuity, a sense of belonging, a
sense of purpose, a sense of achievement, and a sense of
significance.

However, most readers of Community Care will know that
person-centred care is fundamental to every social worker. It has
been instilled in us since it was defined in 1957 by Felix Biestek
in The Casework Relationship. I could find no
acknowledgement anywhere in the book that a profession close to
nurses might have something to offer.

I found myself trying to work out why social work was so
glaringly missing. The contributors’ backgrounds suggest they are
not entirely unfamiliar with social workers.

Key chapters consider the literature on the needs of older
people and their carers in the six areas of acute and
rehabilitative care; community care, continuing care, palliative
care, mental health in older age, and learning difficulty in older
age – all areas where social workers aren’t exactly invisible.

The reason must be due to the dominance of the medical model
with its scientific approach, and consequently, the emphasis on
developing evidence-based theories. The book does acknowledge that
“interpersonal competence” is important.

The chapter “Redefining lay and professional relationships”
explores nursing literature extensively in this area. Why not
social work literature? I am sure that a search of social work,
counselling, psychotherapeutic and other non-scientific literature
would provide very valuable insights in the aim of developing a
coherent approach to explaining and understanding the requirements
of person-centred care.

Perhaps a quicker route to assisting nurses to develop
person-centred care might be to set up some joint training with
social workers. This is already beginning to happen pragmatically
where better joint working is being developed.

However, it is also essential for the academics in both
professions to consider how to build bridges and to learn from each
other.

Mary Anne Hooper is project manager (website
development), adult care services, Hertfordshire
Council.