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Journal article

Time for caring? Elderly care employees' occupational activities in the cross draft between their work priorities, 'must-do's' and meaningfulness

Authors:
NILSSON Emma, NILSSON Kerstin
Journal article citation:
International Journal of Care Coordination, 20(1-2), 2017, pp.8-16.
Publisher:
Sage

An increasing number of older people in the population will bring new challenges for the society and care coordination. One of the most important questions in care coordination is the employees’ work performance. The overall aim of this study was to examine care employees’ experience of factors that rule how they allocate their time and tasks in the care work. The study was qualitative and consists of focus group interviews with 36 employees in elderly care in five Swedish municipalities. Much of the work that care employees perform is controlled by others in the municipality organised health care. The employees had a limited possibility to decide what should be given priority in their work. However, the employees who participated in the focus group interviews did not want to prioritise tasks and duties they felt were faulty or in direct conflict with their own convictions. When employees experienced that the assistance assessments were correct and helpful to the individual elderly patient this contributed to the employees’ priority and performance of the task. The formal and informal control systems caused the employees’ priority to be mainly quantitative and visible work tasks, rather than more qualitative tasks and care giving to the elderly. In the intention to organise good care coordination that fit each elderly patients’ need it is important that those who work closest to the patient to a greater extent are given the opportunity to make their voice heard in decisions of care planning and assistance assessments. (Publisher abstract)

Journal article

Income mobility among the elderly in Sweden during the 1990s

Authors:
ZAIDI Asghar, GUSTAFSSON Björn
Journal article citation:
International Journal of Social Welfare, 16(2), January 2007, pp.84-93.
Publisher:
Wiley-Blackwell

Using a large panel dataset, this article investigates the degree of, and explanatory factors for, income mobility amongst the elderly in Sweden during the 1990s. It contributes to literature on welfare indicators for the older population as it supplements the welfare picture of the income adequacy with insights into income certainty during old age. The study uses the administrative register data for Sweden, which provides a reliable record of incomes for a large sample of the elderly. Results for Sweden-born and foreign-born elderly persons are analysed separately and compared with corresponding groups of people of working age. The majority of the results indicate that the income of the older population is more stable than that of the working age population, and upward income mobility is not as usual among the elderly as among other groups. The multivariate regression analyses identify several explanatory factors affecting those elderly who experienced income mobility. Most importantly, the death of a spouse increases the probability of downward income mobility, particularly amongst women. These and other findings of this research point to triggers of income poverty in old age that should be taken into account in policies concerned with the level and indexation of retirement income of future pensioners.

Journal article

Consuming care and social services: comparisons between Swedish-born older people and older people born outside Sweden

Authors:
ALBERTSSON Marie, et al
Journal article citation:
Practice: Social Work in Action, 16(2), June 2004, pp.99-110.
Publisher:
Taylor and Francis

Compared consumption of public care and social service in Vaxjo municipality among people aged 55 and over born outside Sweden and a corresponding group of Swedish-born older people. Results showed significant differences: less use of mobility allowances, meals-on-wheels and safety alarms among people born outside Sweden, and a higher number of sole relatives as caregivers. Those born outside Sweden who did receive domestic assistance and personal care services also received more extensive help (more that 14 hours a week). The majority (57.6%) were aged 65-79; only 32.3% were 80 plus. Further study is needed to find explanations for these differences at the level of structure, organisation and actors.

Journal article

Formal support, mental disorders and personal characteristics: a 25-year follow-up study of a total cohort of older people

Authors:
SAMUELSSON G., et al
Journal article citation:
Health and Social Care in the Community, 11(2), March 2003, pp.95-102.
Publisher:
Wiley-Blackwell

This study was designed to describe the pattern of long-term formal support received by people with mental disorders and to investigate the relationship between the medical, psychological and social characteristics of the participants and types of formal support, based on a cohort of 192 people born in 1902 and 1903 in a community in Southern Sweden. They were assessed using interviews, psychological tests and medical examinations. Information was collected about the use of primary healthcare and social services. The first assessment took place when the cohort was aged 67 and on 8 further occasions until they were 92. Participation ranged from 72% to 100%. During the observation period of 25 years, 53% of people with dementia eventually received both home help and institutional care compared to 34% with other psychiatric diagnoses and 12% with good mental health. The last group all had physical health problems and/or problems with activities of daily living. However, 35% of the dementia group, 46% with other psychiatric diagnoses and 52% with good mental health received no formal support. Males and self-employed people were significantly less likely to use formal support. The institutionalised group reported loneliness significantly more often than the other 2. In a logistic regression analysis, loneliness, low social class, high blood pressure and low problem-solving ability were predictors of formal support use. People with mental disorder, including dementia, were significantly more likely to use formal support compared with people with good mental health. Social factors were the main factors predicting formal support.

Journal article

Is the association between social capital and health robust across Nordic regions? Evidence from a cross-sectional study of older adults

Authors:
NYQVIST Fredrica, NYGARD Mikael
Journal article citation:
International Journal of Social Welfare, 22(2), 2013, pp.119-129.
Publisher:
Wiley-Blackwell

The study examined the association between structural and cognitive social capital and self-rated health among 65- and 75-year-olds in Vsterbotten in Sweden and Österbotten and Pohjanmaa in Finland. Data were retrieved from a cross-sectional postal questionnaire survey conducted in 2005 and was answered by 3,370 persons, yielding a total response rate of 69 per cent. The association between self-rated health and interpersonal trust and membership in organisations was tested by logistic regression analysis. The results showed that older adults in Vsterbotten in Sweden experienced better self-rated health than in Finland. Furthermore, interpersonal trust and active membership in organisations were associated with self-rated health among 65- and 75-year olds even after having controlled for the influence of region. We therefore conclude that the association between social capital and self-rated health tends to be robust across contextually similar regions, but that further analyses are warranted in order to clarify the nature of this relationship. (Publisher abstract)

Journal article

The marketisation of care: rationales and consequences in Nordic and liberal care regimes

Authors:
BRENNAN Deborah, et al
Journal article citation:
Journal of European Social Policy, 22(4), 2012, pp.377-391.
Publisher:
Sage

The use of markets and market mechanisms to deliver care is one of the most significant and contentious ways in which welfare states have been transformed. This article examines debates and policies concerning the marketisation of eldercare and childcare in Sweden, England and Australia. It shows how market discourses and practices intersect with, reinforce or challenge traditions and existing policies and examines whether care markets deliver user empowerment and greater efficiency. Markets for eldercare and childcare have developed in uneven and context specific ways with varying consequences. Both politics and policy history help to shape market outcomes.

Journal article

Helpful citizens and caring families: patterns of informal help and caregiving in Sweden in a 17-year perspective

Authors:
JEGERMALM Magnus, GRASSMAN Eva Jeppsson
Journal article citation:
International Journal of Social Welfare, 21(4), October 2012, pp.422-432.
Publisher:
Wiley-Blackwell

This article reports on an analysis of informal help and caregiving in Sweden with a focus on patterns of change over 17 years. In particular, it examines whether there has been a change in the extent of caregiving, the type of caregivers, and the relationship between the caregivers and the recipients of help. The discussion is based on results from a national survey repeated 4 times between 1992 and 2009. The survey asked whether the respondent regularly helped someone with whom they did not live (relatives, neighbours, co-workers or friends) with activities such as housework, transport, or gardening. In order to discuss how the trends can be understood in the Swedish context, the findings are analysed using 2 interpretative perspectives: the welfare state and impact of recent changes; and civil society and its possible and changing role. The findings indicate that in the 1990s the figures were stable, but from the late 1990s to 2009, there was a dramatic increase in the extent of informal help giving. Concerning types of helpers, the patterns implied involvement not only from family members, but also from other types of helpers.

Journal article

To feel safe in everyday life at home: a study of older adults after home modifications

Authors:
PETERSSON Ingela, LILJA Margareta, BORELL Lena
Journal article citation:
Ageing and Society, 32(5), July 2012, pp.791-811.
Publisher:
Cambridge University Press

This qualitative study investigated contributory factors of safety in everyday life for eight older adults who received modification services. Three main categories emerged from interviews: prerequisites that enable a feeling of safety; strategies that enable safety in everyday life; and use of and reliance on technology impacts on safety. The results suggested that to feel safe in everyday life was based on three prerequisites: feeling healthy; having someone to rely on; and feeling at home. These prerequisites further impacted on the participants' strategies for handling problems in everyday life but also on the ability to use and benefit from technology such as home modifications. Interventions increase safety for older adults should primarily be focused on the presence and fulfilment of prerequisites and later on other interventions such as technology. Technology such as home modifications and assistive devices was not found in this study to facilitate the feeling of safety unless supported by the fulfilled prerequisites.

Journal article

Factors related to frequent usage of the primary healthcare services in old age: findings from The Swedish National Study on Aging and Care

Authors:
RENNEMARK Mikael, et al
Journal article citation:
Health and Social Care in the Community, 17(3), May 2009, pp.304-311.
Publisher:
Wiley-Blackwell

People aged 60 or more are the most frequent users of healthcare services. In this age range, however, both frequent and infrequent users can be found. Frequent users have high rates of illnesses. Previous research has found that the frequency may be influenced also by psychological and social factors. The aim of this study was to investigate to what degree such factors add to the explanation of differences in number of visits to a physician. A cross-sectional study was conducted with a random sample consisting of 1017 individuals, aged 60 to 78 years, from the Blekinge part of the Swedish National Study on Aging and Care database. The data were collected during 2001 to 2003. Hierarchical logistic regression analyses were used with frequent (three visits or more during a year) and infrequent use as a dichotomous dependent variable. The final statistical analyses included 643 individuals (63% of the sample). Independent variables were sense of coherence (SOC), internal locus of control, education level and social anchorage. Control variables were age, gender, functional ability and comorbidity. The results showed that comorbidity was most strongly related to frequent use. In addition, SOC and internal locus of control had small, but significant effects on the odds of being a frequent user. The lower the SOC and the internal locus of control were, the higher were the odds of frequent use. Education level and social anchorage were unrelated to frequency of use. The results indicate that frequent healthcare services users are more ill than infrequent users. Psychological factors influence the use only marginally, and social factors as well as age and gender are not by themselves reason for frequent healthcare services use.

Journal article

Relationships between physical activity and perceived qualities of life in old age. Results of the SNAC study

Authors:
RENNEMARK Mikael, et al
Journal article citation:
Aging and Mental Health, 13(1), January 2009, pp.1-8.
Publisher:
Taylor and Francis

The Swedish SNAC-Blekinge baseline database, consisting of data on 585 men and 817 women 60-96 years of age, was utilized. The independent variables were light and strenuous physical activity. Four dependent variables concerned with various quality of life components were employed (well-being, engagement, emotional support and social anchorage). Age, gender, functional ability and co-morbidity were included as possible confounders. Non-parametric bivariate and multivariate statistical tests were performed.  Correlations suggested there to generally be a positive relationship between physical activity and quality of life. Multivariate logistic regression analyses controlling for possible confounders showed light physical activity to increase the odds of experiencing well-being, engagement and social anchorage, whereas strenuous physical activity increased the odds of experiencing engagement and emotional support. Thus, light physical activity and strenuous physical activity differed in their relation to quality of life generally. The results indicate that physical activity has a salutogenic effect by enhancing the quality of life, and it can be assumed to be connected to quality of life by generating pleasure and relaxation.

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