Hong Kong cannot single out herself from the global problem of increasing elderly population. The increase of elderly population like in other countries is the by-product of dwindling of birth rate and the longevity of life caused by the advanced medical care, enhancement of nutrition and low mortality rate which prolong people's life expectancy. Provision of housing as the integral part of care to the elders at their retirement age becomes a hot topic of the government to deal with. Comprehensive housing services help to develop the concept of ageing in place, care in the community and continuum services for achievement of the healthy ageing and successful ageing of the elders Moreover, government cannot cater for the needs of all elders who require residential care services when all elders becoming old and frail. Private residential care home services fills in the gap to provide such services in the elderly market. This research studies the causes of the requirement of the private residential care homes which under-went the change of family structure, change of status of elders in the traditional families due to low fertility rate, change of economic and social aspects due to urbanization and industrialization. Development of private elderly housing services provided by government and private sector from past to present and future are overviewed. Statistics on provision of private elderly care homes places in the current market are mentioned. The studies focus on the quality of services provided by the private residential care homes for the elderly. Methodology for the research is based on a mix of qualitative and quantitative method. Measurements on the level of satisfaction of the elderly respondents are identified and itemized basing on their required physical daily personal services. Face-to-face personal contact and ' in-person' dialogues with the elderly respondents and the frontline workers and operators were conducted for questionnaires and interview results. The elderly respondents were categorized into 3 ranges, namely, the young-old, old-old and the oldest-old for analysis of their level of satisfaction of services. Different age range respondents expressed different level of satisfaction with same items of services due to different requirements at various age strata. Comparisons on the services provided by sole privately operated residential care homes, NGO and Government Purchasing Scheme are examined. Results of the research are analyzed and finalized for conclusions and recommendations. The elders' willingness of ageing in place is definite yet with expectations of improvement for upgrading life quality. / published_or_final_version / Housing Management / Master / Master of Housing Management

Set within the context that the world’s population is ageing at an unprecedented rate, it is argued that care of the elderly, and their everyday lived experiences are poised to become prominent concerns. In the shadow of this, the ageing population poses a myriad of challenges not only for the elderly but also for policy makers who put in place systems for the provision of services within residential care homes. By virtue, given that communities of elderly consumers voices are often muted within many academic analyses of social policy and service provision this study illuminates and distils communities of elderly consumers understandings of residential care homes. Given the absence of suitable literature within the fields of marketing and interpretive consumer research, this study turns to the sociological and anthropological literature of Hall and Jefferson (1976) and Levi-Strauss (1966). In doing so, communities of elderly consumers within residential care homes can be theorised as a cultural community of ‘bricoleurs’ within a ‘cultural map of meaning’. Furthermore, viewed through this lens, such bricoleurs can be seen to understand their meaningful everyday lived experiences within, and through, the use of ‘bricolage’. Emanating from eight existential-phenomenological interviews, a rich picture emerges wherein bricoleurs understandings of residential care homes can be seen to be embedded not only within, but also through, such things as the body, leisure trips, noise disturbances, death, large items of furniture, small hand-sized objects, mobility aids, quality of care and social interaction. Moreover, in the light of the resultant interpretations common themes can be seen to emerge within communities of bricoleurs social and material understandings of residential care homes, namely the notion of cultures of dependency, trauma and comfort. This research contributes to marketing knowledge in that it argues that communities of ‘elderly bricoleurs’ within residential care homes can be seen to be held together by unique understandings of cultures of dependency, trauma and comfort. Furthermore, it is also argued that elderly bricoleurs address themselves to a relatively limited amount of bricolage that enables them to keep alive actual, desired, imagined and fictional community ties. Furthermore, the reality and efficacy of cultural communities of elderly bricoleurs seems to depend on their ability to address ‘whatever is to hand’ (Levi-Strauss, 1966) in order to construct and understand their cultural maps of meaning within residential care homes.

Dementia is a degenerative disease which appears to take away personhood and identity and calls into question how we understand what it means to be a person. My argument is that how people with dementia are seen and imagined is key both to the understanding of their value and the care that is offered. The aim of this study is to determine how the Christian ethos of Methodist Homes (MHA) influences the care of people with dementia in order to develop a general theology of care from within practical theology. The thesis explores the ways in which the Methodist emphases of social justice and prevenient grace offer a basis for dementia care, and how MHA has drawn on its origins within the Methodist Church to develop an ethos of care that places respect for the person with dementia at the centre. This concern for those with dementia is then surveyed and the themes of respect and relationality emerge offering the potential for human becoming. Within MHA the care offered is based on a person-centred model. In order to discover how the Christian ethos of the organisation influences care this thesis explores patterns of delivering care in three homes of each of three types; well-established, recently-acquired and new-build. In each home the views of the staff were surveyed. Three in-depth interviews were conducted when questions were asked in order to understand their perception of the person with dementia. The interviews uncovered what carers regarded as good care and when care did not meet the needs, and why they believed that happened. Browning’s ‘strategic practical theology’ was used to evaluate these findings from within a Christian context to examine the influence of MHA’s ethos on the care offered. The core value chosen as the most important for care was ‘respect’; and while the care offered across all types was ‘person-centred’ the way it was delivered varied. The culture of MHA that gave rise to the values is investigated, along with the challenge of retaining ‘mutuality’ as an ideal as the needs of older people changed. The themes that emerged were those around quality of life and the things that enable the change in thinking from basic ‘caring’ to ‘caring for the person’ as the person is seen in a different way. Dementia is sometimes called the ‘theological disease’, and this understanding of dementia and the person is explored to discern what can be offered from theology to the best ideals of care in order to provide true person-centred care that is respectful of the person. I argue from within practical theology that a new way of seeing the person with dementia is needed in order to anticipate the possibility for human flourishing that is possible in a person, even in dementia. And that, offered with respect, good person-centred dementia-care can be a sign of the Kingdom. Part 1 of the D.Prof. comprises four sections in which I explore dementia from within practical theology; how it impacts on personhood, how I, as a practitioner within Methodist Homes (MHA), could enable others to offer care of the whole person; and how the carers’ understanding of the person makes a difference. In the first section, the literature was surveyed in order to discover the historical development of the term dementia. Until the middle of the twentieth century, there was little care as the condition was not named. But then drugs were discovered that could control unsocial behaviour, and the medical model of care developed. However, a new culture of care developed (person-centred care), because of the better understanding of the social nature of the disease. From within the context of theology, I explored how personhood can be understood within dementia and how, even in dementia, it might be possible to grow into the fullness of Christ as spirituality is enhanced. The second section was in the form of a publishable article which explored how it might be possible to evaluate spiritual care within a dementia-care setting. This took the form of a case study in which I worked with staff in a home that had difficulty evidencing spiritual care. It raised issues about the nature of care and assessment of spiritual care, as well as the rationale behind, and the delivery of, that care. What developed used the biblical concept of ‘fruits of the spirit’ as a way of recognising spiritual dis-ease as it is these qualities which enable inspiration, reverence, awe, meaning and purpose even in those who have no religious beliefs. The model used to offer this care was through the 3 R’s of reflection, relationship and restoration. Section three, reflective-practice section, emerged out of my practice as a chaplaincy adviser for MHA, in which I reflected critically on the contexts and understanding of the manager and chaplain, and how a chaplaincy manual was developed. The ability of the chaplain to work effectively and enable good spiritual care in the home, depended on the relationship between the manager and chaplain. By exploring the culture of both manager and chaplain, a way to enable good communication was discovered. The role of pastoral care and how it is seen within an organisation, that must have a professional management, was investigated and ways suggested for mutual understanding using the chaplaincy manual. The last section examined whether the Christian ethos of MHA encouraged a model of person-centred care. I suggested that a way of making sense of the data is by using types to describe personhood and how that can be made visible by their care. Considering the way that therapeutic interventions (reminiscence therapy, reality orientation, validation therapy, drug therapy) were used offered a way to enable the ethos of the home to be seen more clearly. Central to theological anthropology is the concept of the person which includes an ethical dimension. MHA has the strap line, ‘care informed by Christian concern’, so the study investigated whether this Christian ethos is lived out in the care offered. These aspects of study have led me to begin this thesis to research how care is delivered and what carers understand to be appropriate care. An appreciation of the context in which this care takes place also highlighted a need to conduct a theological exploration of the nature of the person with dementia.

Bakgrund: I en befolkning där medelåldern ökar finns risk för ett ökat antal äldre med demenssjukdom. Demens är ett samlingsnamn för sjukdomar som medför minnessvårigheter och personlighetsförändring, vilket i sin tur kan sänka livskvaliteten. Syfte: var att beskriva aspekter av vad livskvalitet kan vara för personer med demens på särskilt boende. Metod: Detta är en litteraturstudie med deskriptiv design. Nio artiklar som besvarade studiens syfte valdes från databaserna Cinahl och Medline. Resultat: Flera studier rapporterar om vad livskvalitet är enligt demenssjuka som bor i särskilt boende. Livskvalitet är relaterad till bl.a. social samvaro, aktivitet, kost samt fysisk och psykisk känsla av hälsa. Slutsats: Sjuksköterskans omvårdnadsåtgärder kan påverka upplevelsen av livskvalitet för den demenssjuke. Meningsfulla aktiviteter som utförs tillsammans med vårdpersonalen och anhöriga är exempelvis betydelsefulla. Sjuksköterskan bör visa respekt för personens integritet, värdighet, autonomi och delaktighet.

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An idea often held in the mainstream society in the United States is a phenomenon of common occurrence between tornadoes and mobile home residences. While such perceptions could be learned from media presentations of tornadic events, a spatial investigation into such events in the Southeastern United States presents other possibilities. A statistical analysis of correlation is used to investigate the nature of relationship of coincidence between the two variables. Counties with relatively high densities of each variable are used for a case study of common geofactors at the micro scale. Results of this research suggest that a regional correlation between the two variables is non-existent. Results of the case study suggest that, while some similarities in geofactors existent between counties with high densities of each variable, no definitive conclusion can be reached with the data used in this study. / Department of Geography

In the United States, Habitat for Humanity is at the forefront of the providing affordable housing to low income homeowners. Because of this work, Habit for Humanity is one of the leading homebuilders in the United States. A recent development in the assessment of home building is an increased emphasis on the use of technology and methods that reduce the impact of housing construction and occupation on the world’s environment. Numerous methods exist to assess this impact, a major one in the United States is the LEED system developed by the US Green Building Council. Two problems exist with the LEED system, one being cost and the time of preparation of the necessary paperwork. Other research work exists on these implementation problems for the broader community, but this study looks at the specific impact and impediments to obtaining LEED certification for Habit for Humanity housing, specifically in Texas. This study assesses Habit for Humanity affiliate’s involvement with LEED and sustainable building. This is accomplished in two parts, a survey and an analysis of LEED scorecards. To gauge the current state of sustainable building in Habitat for Humanity affiliates of Texas a survey was conducted. There were 15 participants out of 84 affiliates. The survey looked in to the current sustainable practices and barriers for the affiliates to participate in the LEED program. Then LEED score cards were obtained and analyzed, eleven scorecards total were obtained. Six scorecards were from homes built by Habitat for Humanity affiliates across the United States, and the other five scorecards came from a production home builder in Texas. The scorecards were then compared by determining the mean of points for each question. From this case study, the survey shows cost and knowledge to be the largest barriers to LEED certification. The data from the LEED scorecards showed Water Efficiency and Indoor Environmental Quality to be the two weakest categories for the HFH affiliates compared to the production homes. These barriers can potentially be overcome by the availability of grants for sustainable building and by educating the affiliates on LEED and sustainable building. The fact that HFH is a leader in affordable housing means if HFH affiliates can build to LEED standard so can other affordable builders.

Research Doctorate - Doctor of Philosophy (PhD) / There is little evidence to show the critical factors that impact on managing aggression in people with dementia and what model of care ensures integrity for both the resident and the personnel responsible for their care. Aggression in this study is defined as an overt act, involving the delivery of noxious stimuli to (but not necessarily aimed at) another organism, object or self which is clearly not accidental. (Patel and hope 1002. p 212). This study used ethnographic techniques, incorporating the use of critical incidents, to explore and explain the culture and context of care situations where nursing personnel experience aggression and violence when dealing with residents with dementia. A Critical Incident Technique was used to identify behaviours of both staff and residents that contributed to and or reduced the amount of aggression that occurred. In particular, this study explored the nature of aggression and the responses of staff and the tensions that exist in the maintenance of rights of both personnel involved in care and the residents for whom they care. Findings revealed the extent to which responses to violence and aggression are related to staff education and understanding of dementia, as well as the illness the resident is suffering at the time. Staff had employed some creative ways to manage aggression in residents. This idicated that a model of care based on person centred care (Kitwood, 1997) would be appropriate for the management of these residents. A framework for an alternate model for the care of people with dementia who are violent and aggressive based on the person centred care approach is proposed and suggestions made for future research.

Diss. (sammanfattning) Umeå : Umeå universitet, 2008. / Härtill 4 uppsatser.