The ethical landscape of home care practice, management, and funding
An ageing population and improvements in health outcomes is leading to the reconfiguration of long-term care services in the UK. This includes care provided to older adults, those with chronic health conditions, and other people with life-long impairments, such as individuals with physical or intellectual disabilities. In health and social care policy, a person’s own home, situated within the community in which they live alongside family and friends, is interpreted as the optimal location for care delivery. Shifting from residential to home care is viewed as offering the most personalised approach to care delivery, aligned with individuals’ preferences and improvements in patient-reported outcome measures.
Health services research has begun to shed light on the efficacy of new models of care practice in the domestic home setting. However, in contrast to other community care environments, there has been very little attention paid to the ethical issues that arise in planning, funding, managing, and delivering home care services. This project will shed light on these issues, and offers different avenues to explore, depending on the candidate’s experience and interests. Specific research foci within the general theme of home care ethics that could be explored include ethical challenges concerning:
- Home care in later life for older, frail adults where family relations and the home environment are modified to meet new caregiving needs
- Home care in the face of chronic illness or lifelong impairment as families and the individual adapt to supporting well-being when health interventions are incorporated into a domestic setting
- Home palliative care as a person’s own home transitions into a place where the dying process is planned and realised
The management, funding and allocation of professional home care services at a time of policy change and funding cuts.
RESEARCH EXPERIENCE, RESEARCH METHODS AND TRAINING
The project will involve both ethical and qualitative social scientific methodologies, combined such that the project can contribute to the emerging field of empirical bioethics. Specific methods training will be provided by the supervisors, and through exposure to appropriate courses offered in the department and wider university.
field work, secondments, industry placements and training
Field work (interviews/focus groups/observations) will most likely be within Oxfordshire, and will involve data collection within domestic home settings and through domiciliary care agencies.
A social scientist or bioethicist with training or experience in using qualitative research methods, and evidence of experience of, or an interest in, ethical questions in health and care delivery. Experience with, and knowledge of, social care settings will be advantageous.