Overview

Dunhill Medical Trust PhD Studentship: Medicines in Ageing Societies

Title: Developing a human rights approach to medication management in residential care for older people

Supervisors: Dr Lorna Montgomery (School of Social Sciences, Education and Social Work) and Dr Heather Barry (School of Medicine, Dentistry and Biomedical Science).

Context: This project is part of a doctoral training programme (MED-AGE) which will fund four studentships supported by the Dunhill Medical Trust. The interdisciplinary research conducted under this programme will further understanding of the importance of medicines in the lives of older people. The successful candidate will be a member of the cohort of Dunhill students funded under this programme and will be exposed to outstanding training and development opportunities.

Promoting a human rights approach to residential living encourages older people to be involved in when and how medication and treatment are provided and in identifying and preventing abuse associated with medication misuse. Abuse in this context includes medication errors or over sedation.

There is an increasing awareness that abuse in institutional settings for older people is high and underreported (Yon et al., 2019). The extent of the problem is such that in 2002, the World Health Organization identified the mistreatment of older people living in institutional settings in almost every country which adopted the practice of institutional care (Krug et al., 2002). Abuse in residential settings includes medication misuse. A consistent message coming from the investigation into these situations is that statutory recommendations for reform, often shaped by advocates within families and professional groups, have not been effective. Similar scenarios of abuse have been repeated across multiple settings and different times.

This PhD, along with a second study in the MED-AGE programme, will contribute to an important growing body of qualitative research which examines how older adults negotiate their use of prescription drug. This mixed methods exploratory study will use coproduction methods to explore patterns of medication misuse in residential settings and elicit perceptions of older people, care home staff and family members of how medications may be managed in this setting.

Phase 1: An initial desk top review of institutional abuse investigation reports and sample of registration and inspection reports will be undertaken in order to identify levels and patterns of medication abuse in registered residential homes for older people in Northern Ireland. Additionally, a scoping review of the literature will be completed. In promoting co-production, a steering group made up of key stakeholders including older person advocates from the voluntary sector will be established to oversee the project.

Phase 2: These findings will be used to formulate interview schedules to explore the experiences and perceptions of older people, their family members and residential staff through a series of individual and focus group interviews. Where possible participants will be recruited from three residential facilities for older people: a private residential unit: a private nursing unit and a statutory residential unit.

The studentship: The successful student will be based at QUB.

Given the importance of this project, we are seeking an outstanding applicant who can not only demonstrate knowledge and skills but also a strong passion and commitment to work in this area.