Ageing and disability: Transitions into residential care
Ageing and disability: Transitions into residential care

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Ageing and disability: Transitions into residential care

1 Transitions

The term ‘transition’ implies a change, and change has implications for the identity of the person who experiences it. It is likely to require a period of adjustment to assimilate and respond to it. Hopson and Adams (1976) suggest that a major transition, however triggered, can result in a cycle of changes to an individual's self-esteem. For example, moving into residential care is a major transition in anyone's life, yet older people are often assessed for, or seek, residential or nursing care in an atmosphere of crisis with little time to prepare (Youll and McCourt-Perring, 1993). A move may occur when someone is ill and therefore particularly vulnerable. A number of stresses may arise from such a transition, caused by:

  • change of place (loss of home)

  • changing relationships (for instance, death of a partner, gaining and losing friends or local community connections, making new relationships)

  • change of role or status (moving into care is a change in status from householder to resident)

  • deteriorating health

  • loss of independence, possibly increased dependence

  • feelings of loss of dignity, for instance, if support is needed for physical care.

Lee et al. (2002) suggest that the magnitude of the changes associated with this kind of transition accounts for why the perceived likelihood of entering a residential care home is one of the most pervasive sources of fear affecting older people. Therefore, Activity 1 focuses on feelings of loss that service users and their families may experience following a move into residential care and ways that professionals may support them. It also considers some of the tasks that social workers may undertake with service users, their families and other professionals who are involved with the admission of people to residential care.

Figure 1
Harry Venning ©
Harry Venning
Figure 1

Activity 1: Supporting people with transitions

1 hour 0 minutes

In this activity you will consider the impact of moving into residential care on service users and their families. You will also consider how professionals can provide support. Make notes on the following:

  1. The issues to consider when working with people moving into residential care.

  2. The feelings of loss that individuals may experience when they enter residential care.

  3. The feelings a new resident's family may have about the move.

Watch Video 1 below, focusing on the transitions.

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Transcript: Focusing on the transitions

Narrator
Moving from their own home into long-term residential care is a transition that many people find hard to make. The process involves both physical and psychological upheaval.
Maria
When a new resident comes to the home there are a range of different experiences that they go through. It is one of the biggest and most difficult decisions that most people have to make in their life. They’ve gone through their life, most of them never expecting to have to make a decision like that, and it’s really quite frightening.
Narrator
A smooth transition is generally the result of a good match between an individual’s needs and what the home has to offer.
Maria
We would never accept a resident to the home without carrying out an assessment of need.
Although it may be a very long-winded process, the two essential functions are. Does the home suit the needs of the person who is looking for the care? Would they be happy there? Do they think they would settle? Is it close enough for family to visit, etc.?
The other side of the coin is: Can we meet the needs with physical, social, spiritually, you know, that the resident may have in coming in?
Elizabeth
I know that I had visited over a period of years slightly older friends who were in a home, and one thinks, well, I hope I never need to do the same. But I’ve never regretted coming here. And everyone has their own little routine of when they go out and meet other people in the place and when they stay in their room. We all have different interests, because we all have different backgrounds. And we just bring with us as much as we can of the old routine we had at home.
Narrator
Elizabeth and her family had looked at more than a dozen homes before deciding that Drummond Grange best met their needs.
Elizabeth
The staff, I thought, did awfully well.
Narrator
For others the choice was more immediately obvious.
Bill
I have a friend in here whom we came to see and very quickly I decided when we came here. I had known the place was here. I decided that this would be where I would want to come, because it had everything that I was looking for.
Nice wide corridors, self-contained units and it looked very comfortable to me.
Eric
I’d heard about this home, mainly through people that I knew from Liberton Hospital where we used to meet in respite who’d already come here. The rest of the family were going for a summer abroad, so I came in here for twelve days to try it out. And at the time, just about everything that could go wrong, did go wrong. But even so, I decided this was still the place that I wanted to come. And I actually came the next year, the next May in 99. And I didn’t even bother to look at any other homes as such.
Narrator
At Drummond Grange, existing residents play an important role in helping newcomers adapt to their change in situation.
Elizabeth
We try as hard as we can, all of us who are here and settled, when somebody new comes in, to help them over the first 48 hours. And it’s amazing to see people coming in, you know, thinking this is the end of the world, and within perhaps two or three weeks they are living quite a normal life. And working out their own interests and making their own relationships with other people.
Maria
It’s the difference between them being able to settle very quickly and taking a very long time, or thinking that it’s maybe not right for them as well. The more that they can be involved and the more that other residents, without prompting, are involved, the better. And we are very, very lucky here, in that we have a group of residents who are extremely good at it.
Gail
It was great fun, it was fantastic and it was brilliantly organised. The organisation needed to get how many people …?
Elizabeth
A hundred and seventy.
Narrator
The transition also involves big changes for family members and close friends.
Elizabeth
... such a lovely dinner, because it was quite exceptional.
Maria
Often, the support on admission is as much for the relatives as it is for the new resident. Sometimes the new resident is actually more accepting of it and has already worked these issues through in their mind. The family haven’t, or the close friends haven’t. And that can be very, very stressful for them.
Bill
It was a bit bad at times for my wife and for me. Not the least wondering, well, what our friends would say about the fact that I was going into care. But many of them eased the problem for us by wondering … by saying that they were wondering when it was all going to happen anyway. So they had seen from the outside there was some need for some extra help.
When the decision is made to come you accept the decision. You don’t sort of inwardly fight against it by, you know, not in so many words, saying to yourself, ‘I am not going to enjoy this.’
Eric
I don’t really know the names.
Dennis
He usually remembers them.
Bill
You have to kind of open yourself up and make yourself available to what is happening in the home and to try and make a good relationship with the staff. Because they are doing a lot for you. And a lot of intimate services for you.
Elizabeth
We live as a community but I don’t think here that we tend to be institutionalised. I never have that feeling. It’s much more a sort of a rather bigger family than most people have.
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Now listen to the audio below as Maria Hutchinson, the home manager, and Rose Guthrie, the home's counsellor, talk about some of the feelings and anxieties of residents and their families. (We apologise for the background noise on this recording.)

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Transcript: Feelings and anxieties

Rose
I’m Rose Guthrie. I work at Drummond Grange Nursing Home and I work as a charge nurse in the dementia unit but I am also the counsellor for the home.
The counselling role involves working with clients or residents who have come into the home, perhaps young, disabled people who are just admitted to the home and it’s about working with also relatives and maybe staff as well.
People coming into the home, that’s a big change in lifestyle, it’s a lot of change in life so I’d be working with the resident or the client, the adaption to change, it’s adapting to losing independence. And especially in the young disabled unit it might be working with sexuality, because that’s a very important part of the person. We are all sexual people so therefore it’s important that they’re able to express what their feelings are. It’s about how they can cope with that, what we can do to make it as much as possible still part of their life. And I’m there to support and help them through that.
Quite often family do not want their relative, their mother or their father to actually be in the care home. It’s because of circumstances that they are unable to cope with in their own home. They feel very guilty about putting their loved one into a home. And it’s working through those kinds of issues. Or you might have a family where the brother is for the nursing home and perhaps the daughter is saying, ‘I would really like to have mum at home’. So there’s lots of issues that come up for families in that way.
Someone who’s been admitted to the home, there would be observation as to how they’re settling in and some people do settle in very well because they’ve had preparation to think, ‘I would like to go into a nursing home’. That is their decision. But there’s other people who come into our home feeling a bit reticent that they’re here, that they haven’t got family to look after them and it’s like working with a person who has just lost a home. It’s loss of many, many angles, their whole lifestyle changes and so it’s helping them look at those issues and being able to voice it to someone who is not emotionally connected, where it’s very difficult with family to explain that.
I do work with other agencies. I work closely with a GP that comes into the home. I would also be working with a psychiatrist, or a couple of them, and I could be working with staff. If there are issues come up perhaps for an adolescent in the family then I would be referring to someone who would be working with adolescents. So I am linking up with other networks there and other agencies to provide support.
Maria
It’s not just like choosing a new house because in that instance you would have all of your own family round about you and they don’t have their own family round about them twenty four hours a day, so the staff play a very, very key role. Sometimes that’s very minor in just making sure that they’re the ones who make all the extra frequent visits, that they get to know all the same faces over and over again, that they’ve maybe met their key worker before they were admitted, out in the community, so they’ve got a face that they already know when they come into the home. Other times it can be more than that. They can need more.
Very often, especially if they still have a spouse, it can be a very emotional issue and it can very often be a situation where they’re not very sure if their marriage is actually going to survive the point that it’s reached, meaning that the level of dependency and strain that’s put on both parties before the person’s admitted to the home, because sometimes within the community they can reach a very high level of dependence and feeling guilty about how they feel about each other etc., before they do come into the home.
Sometimes the spouse feels very guilty, that there’s a sense of relief that, ‘Oh my goodness, you know, this won’t happen again at one o’clock in the morning and I won’t be rushing to the hospital in an ambulance three hours later and I know that they will be looked after and people will be looking out for them twenty four hours a day and I feel like I can finally have a whole night’s sleep’ and then, ‘Oh, I shouldn’t be thinking like that’. But it is very human nature. So often the support on admission is as much for the relatives as it is for the new resident. Sometimes the new resident is actually more accepting of it and has already worked these issues through in their mind and the family or the close friends haven’t and that can be very, very stressful for them.
One of the ways in which some of the stress can be taken out of being a new admission is trying to maintain some of the links and the interests that the person had before they were admitted. Now sometimes they can’t do that to full capacity. Perhaps they raced homing pigeons but that doesn’t mean to say that they probably couldn’t go to the local pigeon society and join in with their weekly meetings or their monthly meetings and still be involved in the news and who’s rearing the best birds and things like that. That just because they can’t actually physically do exactly what they were doing before, they can still be very involved in different things.
After admission we try to gauge how successful that’s been. Very initially after the first six weeks of admission we ask the resident or the nearest relative to complete a short questionnaire where they can actually say, did they find that their admission to the home was helpful and what things did they like? Did they feel that they understood what they were coming in to? Did the staff understand their needs? Were the staff polite? Did they have all the information they needed to make the decision, etc?
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Discussion

Feelings of loss are not experienced just by the person entering residential care, but may also be felt by those involved in their care. Carers and relatives can also experience the transition as painful, and are sometimes overwhelmed by feelings of guilt because they cannot support their relative or fulfil their sense of family obligation (Phillips and Waterson, 2002).

Social workers are involved in preparing for and carrying out the assessment of need and supporting transitions into care. The information that the social worker provides about the service user when planning admission can help make the transition into residential care a more positive experience. In assessing and then planning changes with older people, social workers should be aware of how ageism affects them. For example, it is ageist to assume that all older people's needs and expectations are similar: it should be remembered that each person has their own distinctive biography (see Aids to Practice card on ‘Biographical Work’).

Click to view ‘Biographical Work [Tip: hold Ctrl and click a link to open it in a new tab. (Hide tip)] ’.

Listening carefully to what people say about their needs, and involving them and their families in planning their own care, helps to overcome ageist practice. If the social work assessment incorporates some biographical details of a new resident and notes their preferences, staff at the home are able to consider how they can help them maintain links – their social networks – and continue to engage in activities that interest them. This is particularly important for service users from minority ethnic groups, where maintaining cultural links helps to smooth the transition to care. Taking into account service users' backgrounds and preferences also helps to preserve their identities and sense of self-worth.

Hopson and Adams (1976) developed a model to explain personal responses to major transitions. They suggest that individuals may pass through seven identifiable stages in a major transition:

  1. Immobilisation (a sense of being frozen, unable to act or understand).

  2. Minimisation (denial that change is important).

  3. Depression.

  4. Acceptance (realisation that there is no going back).

  5. Testing (trying out new behaviours to cope with the situation).

  6. Seeking meanings (reflecting on change).

  7. Internalisation (the new meanings discovered become part of behaviour and a new identity).

This work has influenced practitioners' understandings of the feelings about loss that arise not only from the death of a close friend or relative (Parkes, 1993), but also in relation to failing health and mobility. Importantly, the identification of these stages may also help practitioners to understand the experiences of people moving into residential care and to recognise the emotions that can be aroused by such transitions. However, the stages outlined may not always be experienced by people in the sequence outlined here, and the model does not provide explanations for variations in people's experiences. There are numerous variables which affect personal responses to transitions. It is important to listen carefully to how each individual experiences the process and expresses their feelings about it.

Korbasa et al. (1981) examined why some people appear to cope more readily with stressful life events than others. Their conclusion was that differences in coping may be due to the presence of certain individual characteristics. They studied two groups of executives: one group had become ill after stressful life events; the other, although subject to similar life events, did not. Their findings led them to develop the concept of ‘hardiness’ to explain why, in similar circumstances, some individuals become ill and some do not. They accounted for differences by the presence of certain personality traits which they claimed make people ‘hardy’ enough to cope. These include:

  • control: feeling that they can influence their lives

  • commitment: valuing strong social bonds with family, friends and people in the community

  • challenge: viewing change as a challenge rather than as a threat.

For social workers who meet adults and children in transitions, hardiness is a useful concept, closely linked to some ideas in the literature on resilience in adversity (Gilligan, 2001). Activity 2 further explores the value of the concept of ‘hardiness’ for gaining an understanding of individual responses to change.

Activity 2: Responses to change

1 hour 0 minutes

If you have just completed Activity 1, you may want to take a break before continuing.

In this activity, you will consider the concept of ‘hardiness’, which Korbasa et al. (1981) suggest enables some individuals to cope with major changes.

Watch the video clips below in which Elizabeth, Bill and Eric talk about the experiences of living in residential care. For each of these residents, and Elizabeth's husband, make notes of their responses under the following headings:

  1. Control – feeling that they can influence their lives.

  2. Commitment – valuing strong bonds with family, friends and people in the community.

  3. Challenge – viewing change as a challenge, not a threat.

You might also note other factors, such as personality, degree of optimism and good general health.

Click to view Video 2: Elizabeth's story (8 min 03 sec)

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Transcript: Elizabeth's story

Elizabeth
I am Elizabeth and for nearly 65 years I was the wife of a solicitor. And we were lucky that we grew old together. But as time went on it became more and more difficult to live in our own house. And it was my husband’s decision. We’ll go into a nursing home
Narration
For family reasons, they decided to move several hundred miles south, to Drummond Grange. But once there, things didn’t go quite to plan.
Elizabeth
From the word go he just didn’t settle. And as the staff here said, he’s not ready for it. So he went back home, with just somebody coming in through the day, and a gardener, handyman, who helped with all sorts of things. And after six months he felt he was ready. And he came and joined me and had a very happy year here before he died in January.
He never really fitted in, but he tried to fit in and he really wasn’t in good health. He stayed a lot in his room and just rested through the day. But as far as I was concerned, from the time I walked in the front door I felt nothing but relief. Away from responsibilities and I knew I’d be looked after.
Narration
Inevitably, she found some aspects of her new situation very different to what she had been used to at home.
Elizabeth
Well, the first thing which is a sort of a shock is the time of the meals. Breakfast is elastic, but lunch is early and your cup of afternoon tea is at half past two. That’s early. And your dinner is at quarter past five. And that was the most difficult one to get used to. Because of course it’s a long time from quarter past five until eight or eight thirty in the morning when you have breakfast.
However, it’s amazing how you can adapt. So I have a veritable grocer’s shop here. And I have a sort of equivalent of a midnight feast at eight o’clock in the evening. And that carries me on to the morning.
Narration
Drummond Grange’s regular routines help give a structure to each day. Newspapers are delivered, and your mail comes around ten o’clock in the morning and it’s just amazing how time goes on. Some people say, how do you put in your time? Well, it’s not a case of putting in the time. Time simply flies by.
Narration
Often she spends part of the day pursuing an interest she’s had since her early fifties.
Elizabeth
When I was disabled with this leg, having taken a dose of osteoporosis, I had to sit around a lot and I had started doing tapestries. And once I started I couldn’t stop! I did some quite intricate cushions especially, sixteen stitches to the inch because I had good eyesight. Well eyesight doesn’t go on for ever so I moved on to a slightly coarser one, ten or twelve to the inch. And then I got to eight to the inch.
Narration
Since she’s moved to Drummond Grange, her eyesight has deteriorated even more.
Elizabeth
And I have gone on to very coarse work. It’s coarse, crossstitch really and it’s a bit more like rug making than tapestry. It’s a huge needle with a huge eye! So that makes it easy. And I’m doing a neighbour a bit just now. And as long as I’m able to do that coarse stuff and any of them want cushions or anything, I’ll carry on doing it!
Narration
It’s a task that demands concentration, so she appreciates the peace and quiet she gets in her own room.
Elizabeth
Your room is your little private place and nobody comes into your room without knocking. Any of the staff, whatever they’re doing, bringing you in a water carafe or coming in to clean, tap on the door and ask if they can come in. Which gives you a lovely feeling that this is your own little place. It may only be a few square yards but it’s yours and you can be private here.
Narration
But she’s not one to sit in her room all day and when the weather permits she likes to spend time in Drummond Grange’s delightful walled garden.
Elizabeth
I came out in the spring. I found it was covered with nettles and groundsell and a horrible sort of vetch that has roots that run under the ground and I asked could I get a trowel and I was given this little set of tools, so I have tremendous pleasure coming out and rather than sitting doing nothing just pottering weeding it. And late in the afternoon in the very hot days this is in shade and its lovely place to come and sit. So I feel it’s worth keeping it tidy since I use it for sitting in.
Narration
Although her bit of garden is looking ever better, the rest of the grounds still need care and attention. Elizabeth suggested they should try to find a gardener who was willing to take on part of the job.
Elizabeth
They eventually got this chap whose father is here and he had been in visiting his father and somehow or other they realised that here was somebody who might help.
Elizabeth
Well hello there.
Alex
Oh hello, how are you doing?
Elizabeth
It’s far too hot a day to be doing that! I’ve done very little but sit at the goldfish pond and look at the goldfish.
Alex
Well your bit looks really good. You can come and give me a hand, you know. You can sit there and be the boss and give me the guidance
Elizabeth
Making sure you don’t put orange and pink together.
Alex
Exactly. You keep me right!
Elizabeth
It’s such a pleasure to see you working.
Alex
Oh well, thank you very much.
Elizabeth
Although I’m awfully sorry you’re getting such hot weather.
Narration
As one of two representatives for her floor on the newly formed residents’ committee, Elizabeth has found a new role that she really enjoys.
Elizabeth
For instance there was a question of a hoist. For some of the heavy chaps a hoist has to be used to get them in and out of bed, in and out of the bath. And they weren’t happy about this, because it was rather older and they felt it was unsafe. So I brought that up, and the following day it was taken out of use and they had it guaranteed and back in use again. And of course the people using it were awfully pleased. Just little things like that. But I must say that it’s proving quite useful. At least we all like to think that we’re useful. That’s maybe the answer …
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Transcript: Bill's story

Bill
My name is Bill Maxwell. I’ve done several jobs in my life, latterly becoming a teacher. Now back in 1960 I contracted a circulatory disease and that, throughout the years, has been really chronic. And now it’s quite disabling in terms of my muscle power. Which means I am now in a wheelchair. And for most of these years my wife has had to look after me. And it became clear to both of us that eventually I would have to come into some kind of care.
Narrator
So, in 1998, Bill moved out of his marital home and into Drummond Grange.
Bill
It was a bit worse for my wife at that time I think. Feeling that she was abandoning me and not doing her duty. But it became clear that that was the best step, both for her and for me. Because I think most disabled people, if they were honest and thinking about their whole situation being disabled means that your partner has to go through the same routine that you are going through, and therefore you’re disabling two people.
She does come down regularly, although I tell her not to come too often. Not because I don’t want to see her, but just to give her the freedom to do her own thing and at the same time to find that she has a life of her own. And here, I have a life of my own.
Care staff member
You know you should have more than that today.
Bill
Well, I’ve been busy.
Care staff Member
Computing?
Bill
Well, what else?
Narrator
With his gregarious nature, Bill rapidly forged new friendships.
Bill
I’ve got several close friends in the home, yes. Eric, who you’ll be seeing as well. And then there are one or two others who I’ve been called upon just to meet at first and then we’ve stayed rather friendly. Bob Brown, who had rather a traumatic time. But you know we now like to discuss sporting issues and the terrible way in which the Scottish team perform! And things like that.
Bob
I’ll look forward to it tomorrow.
Bill
OK, we’ll have it tomorrow, there’ll be plenty to discuss then.
Narrator
Bill’s positive attitude makes him well suited to the task of helping recently arrived residents adapt to their new circumstances.
Bob
Tiger must be favourite.
Bill
What I would do is try and encourage them to take part in various group activities in the home. Every day we have our newspaper group and you can come along and make your voice heard.
And when the issues of the day are being discussed … in that way, you know you become part of the home rather than being something shut away, an individual who’s not involved. And that I find helps them as well as helping others just to enjoy the life here.
Narrator
Bill’s activities are far from constrained by Drummond Grange’s four walls. He regularly takes advantage of the home’s specially adapted minibus to get out and about.
Sometimes the bus will take a group of residents to a nearby town or attraction, but today Bill’s just going for short trip up to the local golf club.
On other days, he might arrange a trip into town to spend time with his wife.
Bill
We’ve always said that, although we had to separate in one way, that we would keep up . And we like to go out, usually with some taxi, or handicab, in which I can go and meet her at the shopping centre or something of that nature. And we spend probably the afternoon together. Have a meal together, do a bit of shopping. And spend all my money! It keeps up the link and makes us feel we’re still an item, if you know what I mean.
Minibus driver
They won the Welsh cup so they get to qualify for Europe.
Narrator
But mostly, family and friends come to visit him, in the room that he has made very much his own.
Bill
Well I’ve been able to personalise it. You see I have a lot of family photographs around. I like to have my own things, like my music centre, a television, a video set and CDs that I like to play. And also to have a very important part of my life, my computer, with me. And that sits proudly on the side there and I like to use that to do various forms of work on as well as enjoyment.
Narrator
Bill puts his computer skills to good use. In spite of the difficulties he has with hand movement, he’s happy to create materials that help staff and other residents.
And he played an important role in the run-up to Drummond Grange’s first ever Oscar Ceremony.
The Oscars was a great event here in which we had a great marquee out in the front there and it was all beautifully set up. And quite a lot of work was done for it, on that computer, making the certificates for those who got the Oscars.
The event was all about recognising people’s contribution to the community that, for some, was their place of work and for others their home.
Bill
When I got my own Oscar I was really quite surprised. Because each Oscar had a certain amount of nominations as these ceremonies do. My name was read out and I really was surprised. And very pleasantly surprised. So I now proudly own my Oscar for this year. I’ll wait to see next year whether I get another one or not. I doubt it.
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Click to view Video 4: Eric's story (5 min 22 sec)

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Transcript: Eric's story

Eric
My name is Eric Millar. I’m a retired veterinary surgeon, aged 65. And the reasons that I came in to the home … there had come a stage where my wife couldn’t care for me as much as she’d like to. It was felt that, for her health, I should come into this home.
When I first arrived here it was like going to boarding school, certainly for the first time. They call it the ‘honeymoon period’, which is true. You’re exploring everything, meeting new people, a new set up. I won’t say it was difficult, though you did miss home. It was never going to be the same. But you just had to get on with it.
Narrator
Unlike boarding school, Eric had the freedom to personalise the room that was, for him, going to be the centrepiece of his new home.
Eric
We were told people could have their own décor, curtains, whatever pictures and stuff they wanted. I like a lived-in room where a lot of things are to hand. As long as I can have my phone, television of course, digibox and DVD.
I felt that I … in a way I was still at home. Because if I went back home now there’s really nothing of me there. It’s all changed.
The main thing is the lack of contact with family. Obviously you can see them from time to time. I think night time is quite, quite a sort of lonely time to start with. Weekends even, can be very long.
Narrator
So, right from the start, he took advantage of the facility to have a dedicated phone line installed in his room.
Eric
It’s an absolute must. And when that breaks down for some reason you really do feel cut off. You get horrendous phone bills, but I think it’s worth it.
Narrator
Another of the home’s facilities is effectively free – its extensive grounds.
The wide pathways make it easy for him to get around and keep up his life-long interest in animal life.
Eric
We’ve got certainly roe deer, maybe muntjac, fox family, weasels, stoats.
Certainly a lot of rabbits round here. And just recently a melanic black form has been seen.
Narrator
Until very recently, he was able to use binoculars to get a closer view of the birds, but now his arms have become too weak to be able to use them. Even so, there’s nearly always something to watch.
Eric
Squirrels, we’ve certainly got grey of course, which can be a bit of a nuisance. They’re very clever and come to raid our bird feeders.
Narrator
As he’s become less mobile, Eric has risen to the challenge and developed a new creative interest. It all started after he had his leg removed.
Eric
I had terrible depression. Really followed … not so much the operation, I’d actually resigned myself to that. And even asked for it. It was the drugs that I’d been on which notoriously caused that, and it’s very hard to lift.
So one of the ideas I had myself was to go back into the past and write some anecdotes. It was just called Eric the Vet. And they went on to foolscap pad.
Narrator
People liked it so much, he decided to try to publish it as a paperback book.
Eric
At the end of the day it was the home that actually bankrolled the publication. And the idea always was that the money, certainly to start with, would go back into activities.
Narrator
The home organised a big event to launch the book and celebrate his achievement.
Eric’s new-found interest in writing also came to the attention of the Dark Horse Venture, a national charity that encourages retired and older people to get involved in new activities and interests.
Eric
I have started another book which, very loosely at the moment, is entitled The Iceman Cometh. And the reason for that is that way back as a student in my first and second years’ long summer vacation, to get some money, I worked for a local ice-cream firm. I don’t know if this’ll come to a book. I’ll show my advisors and see what they think.
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Eric's story
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Discussion

You may have noted the similarity between the concepts of ‘hardiness’ and ‘resilience’ as both ideas identify how some individuals have a capacity to resist or rebound from difficulties. While these concepts include psychological characteristics, social resources also matter. Research studies suggest that resilience in older people is connected to a number of protective factors, including the physical, psychological, social and spiritual domains of their lives (Nakashima and Canda, 2005). In situations where social and economic factors threaten an individual's capacity to cope effectively with a major transition, social workers can explore the service user's strengths and build on them. This may involve helping the person to strengthen their personal support networks.

Pearlin and Schooler's (1978) analysis of individuals' ability to cope with change also acknowledges the importance of personal and social resources (Korbasa et al., 1981). Pearlin and Schooler distinguish between coping responses and coping resources. Coping resources can be seen as what is available to the individual in developing their coping repertoires. Coping resources are sub-divided into psychological and social resources. Psychological resources that the individual possesses can be employed to respond to change, and are analogous to Korbasa et al.'s three Cs. Social resources are the interpersonal networks in which the individual is embedded. Coping responses refers to what a person does in response to change. For example, the ability to mobilise social networks at times of stress is seen as a coping response. Pearlin and Schooler also stress the significance of negative social and economic factors, such as poverty, discrimination, unemployment and social exclusion, on an individual's ability to cope effectively with change. Exploring these three areas with service users is part of the ecological assessment framework.

Sometimes older people enter care as a temporary measure for respite stays and intermediate placements following discharge from hospital. Thinking about coping resources and coping responses is useful when supporting a new resident to ‘settle in’. Reed et al. (1998) suggest that the key to successful adjustment to life in a residential home is social relationships. Residents who have inner personal resources and effective social skills are more likely to have the ability to establish new friendships.

Children and young people and other adults may also move into supported accommodation. It is often temporary and for a short stay, but is sometimes over a longer term, and often people experience several moves. Social workers who support people leaving care and moving on to different living arrangements, perhaps to independent living, find that assisting in developing service users' life skills can be helpful. Whatever kind of changes a person experiences, social workers need to appreciate how each individual interprets and feels about the event. By their insight into what is involved, social workers can help the person manage more successfully. Working with service users to identify what they perceive as making the move more or less difficult provides an opportunity to consider sources of support that may smooth their transition.

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