Prevention: developing a framework for conceptualising and evaluating outcomes of preventive services for older people
Focusing on older people, this article seeks a way to locate prevention within a theoretical model of successful ageing. This conceptualises ageing as involving adaptation to the changing balance between gains and losses over the life course. Successful ageing is perceived as the attainment of valued goals, the minimisation of losses and maximisation of gains through the linked processes of selective compensation and optimisation. Preventive services may be conceived as resources to be drawn upon to support compensatory strategies. Outcomes and effectiveness of services may be evaluated in terms of whether they facilitate/ allow older people to achieve valued goals. In developing and evaluating preventive services in social care the question is what contribution do specific services make in optimising gains and compensating for the losses that accompany ageing? This framework is explored in respect of two areas ripe for secondary prevention services and strategies - bereavement and instrumental support in the home.