Developing a Relational Model of Care for Older People by James Woodward and Jenny Kartupelis is an inspiring guide proposing a ground-breaking model of care for older people based on relationships. Overall, the book challenges common misconceptions about older people and presents an overview of the various factors that should be considered if looking to develop or research new models and structures of care that offer good quality connections and relationships. The book has evolved from the fruitful collaboration of Woodward and Kartupelis, both of whom have long-standing interest and experience in the care of older people in the United Kingdom. Woodward is principal of Sarum College in Salisbury and visiting Professor in Theology at the University of Winchester. His work encompasses areas of health and healing, old age, the practice of theological reflection and end-of-life care. Kartupelis is a writer, researcher and Director of Faith in Society Ltd. The book draws on a qualitative research commissioned to Kartupelis by Abbeyfield Society about spiritual needs and care in their homes.
The book is divided into eight chapters, each of them addressing important questions around care for older people through the lens of a relationship-centred model. Chapter 1 (‘Old Age Today? Setting the Scene’) sets the scene by presenting an overview of the major issues that characterise the debate about age and ageing in modern Western society. The chapter starts by examining the significance of demographic statistics to show how our society is facing up to a huge challenge, with the number of over-65s set to double by 2050 and that of over-85s growing even faster. The authors then analyse the consequences of this demographic change on many aspects of public policy, including health and social care, pension provision, housing and employment practices, and argue that one of the biggest challenges faced by our society are the negative stereotypes of ageing. The authors point out that ‘a fundamental change in how we as a society think and feel about old age’ is needed and make this argument the guiding principle of the whole book. The following chapters present a thorough analysis of the research findings and summarise a wide range of views and experiences through the words of older people receiving care. Chapter 2 (‘The Spiritual Life of Older People’) analyses the importance of acknowledging and meeting the spiritual needs of older people, while Chapter 3 (‘Listening to the Voices of Older People’) examines ways of purposefully listening to the voices of older people. In Chapters 4 (‘What Makes a Home? Relationships of Spiritual Care’), 5 (‘Creating the Home from Home’) and 7 (‘The Relational Model of Care’), the authors argue the need for a paradigm shift in common care-giving policies and practices. In such a transformative approach, the concept of family is central and care home or sheltered housing are seen as ‘relational’ homes where meaningful relationships should be nurtured, and feelings of dignity, security and mutual recognition fostered. Other interesting chapters are included, such as those that examine the implications of using the relational model of care with people with dementia (Chapter 6, ‘Dementia Homes’) and the choices people have around retirement and living together in older age (Chapter 8, ‘Retirement Choices’).
Developing a Relational Model of Care for Older People makes a strong argument for developing new models of care where meaningful relationships play a central role and analyses the key components that enable such models to find expression, which include, among others, an integrated model of care, the empowerment of older people, the provision of good staff support and a physical environment that fosters community. A profound analysis of each of these components, with proposed evidence-based guidelines on how to transfer such notions into practice including, for example, management, staffing, use of indoor and outdoor spaces, meals, is one of the greatest strengths of this book. Another strength of the book is the use of older people's narratives that allow the reader to connect with the intellectual and emotional world of older people and appreciate the importance of listening to those narratives.
This book is recommended for all those who want to improve the quality of life of older people, including professionals, researchers, students and carers. It can be used by managers and staff in care homes as a guide on how to nurture meaningful and reciprocal relationships, and create a family environment in their services. The book provides useful guidance to family members and carers too, as it identifies the key elements to look for when assessing the accommodation and services to suit their loved one. In a world where social isolation, ageism and discrimination are commonplace, this insightful and accessible book is timely as it challenges some assumptions on which current policy is based and encourages self-reflection.