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The promise of assistive technology in institutionalized old age care: economic efficiency, improved working conditions, and better quality of care?
- Authors:
- SIREN Anu, et al
- Journal article citation:
- Disability and Rehabilitation: Assistive Technology, 16(5), 2021, pp.483-489.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
Purpose: Assistive technologies in care work are expected to alleviate the challenges related to population aging, namely the pressure on public budgets and a shortage of care professionals. This study examines how various stakeholders view the potentials of assistive technology in an institutionalized care setting in Denmark. Method: Using ethnographic field observations, interviews, and document analysis, we explore the residents’, the staff’s, and the municipality’s perspectives on the technologies and analyze whether they live up to the stated expectations. Results: We identify three parallel narratives representing each of the stakeholder’s perspectives. The municipality’s triple-win narrative emphasizes expected gains in terms of efficiency, improved working conditions, and better quality of care. The staff’s ambiguity narrative contains both negative views regarding the motive for using technologies to save resources and positive accounts of how technologies have reduced work-related pain. The residents’ limited agency narrative reflects an internalization of the staff’s perspectives. Conclusions: We conclude that, despite both the staff and the municipality highlighting the residents’ well-being and comfort as important outcomes of assistive technologies, the residents’ wishes have limited influence on whether and, if so, how assistive technologies are used. (Edited publisher abstract)
Formal and informal care: trajectories of home care use among Danish older adults
- Authors:
- KJAER Agnete Aslaug, SIREN Anu
- Journal article citation:
- Ageing and Society, 40(11), 2020, pp.2495-2518.
- Publisher:
- Cambridge University Press
To adjust future care policies for an ageing population, policy makers need to understand when and why older adults rely on different sources of care (e.g. informal support versus formal services). However, previous scholars have proposed competing conceptualisations of the link between formal and informal care, and empirical examinations have often lacked a dynamic approach. This study applied an analytical method (sequence analysis), allowing for an exploratory and dynamic description of care utilisation. Based on 15 years of data from 473 community-dwelling older individuals in Denmark, this study identified four distinct clusters of care trajectories. The probability of belonging to each cluster varied with predisposing factors (such as age and gender), needs factors (such as dependence in activities of daily living and medical conditions) and enabling factors (such as co-habitation and contact with adult children). A key finding was that trajectories characterised by sporadic use of informal care were associated with low needs and strong social relations, whereas trajectories characterised by reliance on formal care were associated with high needs and limited contact with children. Taken together, the findings provide new evidence on the associations between care use and multiple determining factors. The dynamic approach to studying care use reveals that sources of individual care utilisation change over time as the individual and societal determinants change. (Edited publisher abstract)
International policy perspectives on independence in old age
- Author:
- PLATH Debbie
- Journal article citation:
- Journal of Aging and Social Policy, 21(2), April 2009, pp.209-223.
- Publisher:
- Routledge
- Place of publication:
- Philadelphia, USA
Although the promotion of independence is a common feature of policies on older people across the world, independence has a variety of meanings that are shaped by different social, political and economic contexts and by different values and attitudes towards older people. This study compares policies in Australia, Denmark, India and the UK. In Australia and the UK, liberal democratic values translate into support for individual independence in old age. In Denmark, a strong emphasis on social responsibility and the right to public services means that choice, rather than independence, for older people is the prime focus. In India, independence is of less significance in the context of economic constraints and strong social values supporting family responsibility for the care of older people. This analysis raises important questions about the promotion of independence as a goal in the aging policies of international bodies such as the UN and WHO.
The influence of social relations on mortality in later life: a study on elderly Danish twins
- Authors:
- RASULO Domenica, CHRISTENSEN Kaare, TOMASSINI Cecilia
- Journal article citation:
- Gerontologist, 45(5), October 2005, pp.601-608.
- Publisher:
- Oxford University Press
The authors examined whether the presence of a spouse and the frequency of interaction with children, relatives, and friends significantly influence the risk of dying in late life. They assessed these effects separately by gender, controlling for self-reported health. In addition, whether interaction with the co-twin has a different impact on mortality for identical and fraternal twins was examined. The data set consists of 2,147 Danish twins aged 75 years and older, who were followed prospectively from 1995 to 2001. The results found that survival is extended by having a spouse and close ties with friends and the co-twin. However, contact frequency with friends and the co-twin is significant, respectively, only for women and identical twins. The results stress the importance of social relations beyond the presence of the spouse for survival even at very old ages.
Over- and under-diagnosis of dementia in ethnic minorities: a nationwide register-based study
- Authors:
- NIELSEN T. R., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 26(11), November 2011, pp.1128-1135.
- Publisher:
- Wiley
Professionals in several European countries have suggested that dementia is under-diagnosed and under-treated to a greater extent among ethnic minorities than the native population. This study compared the prevalence of register-based dementia diagnoses in the largest ethnic minority groups in Denmark with the prevalence of register-based dementia diagnoses in the general Danish population. Linking the Danish hospital registers with the Danish Civil Registration System, made it possible to identify dementia cases for three main ethnic minorities (ex-Yugoslavia, Turkey and Pakistan). Age- and gender-specific prevalence rates were calculated. The study population consisted of 68219 persons aged 20 and older. A total of 174 dementia cases were identified, with a mean age at diagnosis of 57.7 years. Compared to the general population, there was a higher prevalence of dementia among those below 60 years, and a markedly lower prevalence among those 60 years and older. The authors conclude that dementia is, as hypothesised, under-diagnosed to a greater extent among ethnic minorities in the age group 60 years and older but note that it is over-diagnosed in younger age group. They suggest factors that may contribute to this pattern, including cultural differences in help-seeking behaviour, and problems in navigating the health-care system. It is also noted that cross-cultural assessment of dementia can be difficult because of language barriers and cultural differences.
The vulnerable elderly's need for recognizing relationships – a challenge to Danish home-based care
- Author:
- LIVENG Anne
- Journal article citation:
- Journal of Social Work Practice, 25(3), September 2011, pp.271-283.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This article explores the most vulnerable elderly with complex problems receiving home-based care. Their perspective is examined from several qualitative interviews and observations. The interviews suggested that they often live on the edge of accepted standards for living, but want to live as they always have – to be respected as competent human beings and be identified through the life they have lived. To establish a relationship in which an elderly person can be recognised in an existential sense could indeed be the key to establishing contact. The author suggests that in order to develop this approach, staff have to possess certain competencies, and there needs to be some organisational backup for developing this type of relationship. Home-based care in Denmark is founded on new public management (NPM) theory, although rules and regulations implied in NPM do not always provide home helpers with the time, support, autonomy or flexibility necessary for them to establish a recognising type of relationship. The author questions whether the application of NPM in the welfare state increases exclusion for those who are most dependent on public support.
PTSD in older bereaved people
- Author:
- O'CONNOR Maja
- Journal article citation:
- Aging and Mental Health, 14(6), August 2010, pp.670-678.
- Publisher:
- Taylor and Francis
The prevalence of post traumatic stress disorder (PTSD) and depression in recently bereaved older people and whether the loss of a spouse in old age can lead to PTSD was investigated. 276 bereaved older people (mean age 73 years) from the county of Aarhus in Denmark, contacted two months after bereavement, agreed to participate. The results from this group were compared with a control group of 276 married older people. Prevalence of PTSD and depression was measured through a self-report questionnaire. The results indicated that older bereaved people in the sample were four times more likely to have PTSD than those who were still married. The author concludes that this demonstrates that late life bereavement is a traumatic experience for some, and discusses the results and their implications.
Delusional disorder in old age and the risk of developing dementia - a nationwide register-based study
- Author:
- KRONER Alex
- Journal article citation:
- Aging and Mental Health, 12(5), September 2008, pp.625-629.
- Publisher:
- Taylor and Francis
This study examines whether very late first-contact delusional disorder carries a risk for later development of dementia. By linkage of the psychiatric and the somatic nationwide registers of all out- and in-patients with hospital contact in Denmark, the study included all 60+ patients with first ever from 1 January 1994 to 31 December 2001 with the index main diagnosis: delusional disorder. First contact osteoarthritis patients as well as the general population were used as controls. A total of 1,437 patients with persistent delusional disorder and 7,302 patients with osteoarthritis were included. Median follow-up time until first diagnosis of dementia at discharge was 1.87 and 4.40 years, respectively. The probability of getting a dementia diagnosis was estimated using Poisson regression models with dementia as the outcome of interest. Patients with very late first-contact delusional disorder had an 8.14 (95% CI, 6.51; 10.19) times increased rate of subsequently developing dementia compared with very late first contact osteoarthritis patients. Compared with the general population the rate ratio was 5.49 (95% CI, 4.81; 6.26). Very late first-contact delusional disorder increases the risk of subsequently getting a diagnosis of dementia 5-8 times compared with osteoarthritis patients and the general population.
The most important activity and the reasons for that experience reported by a Danish population at age 75 years
- Authors:
- LEGARTH Karen Hedvig, RYAN Susan, AVLUND Kirsten
- Journal article citation:
- British Journal of Occupational Therapy, 68(11), November 2005, pp.501-508.
- Publisher:
- Sage
The data in this study were derived from a cross-sectional study of 748 Danish 75-year-old men and women, born in 1914. The people were interviewed at home by means of a questionnaire. The most important activity was revealed by an open-ended question: what is your most important activity? The answers were classified into three qualities: type, site and social relations. The participants were asked if the activity was important because it gave enjoyment, self-confidence, challenges, company, cooperation, usefulness, new skills and/or new experiences. The majority of the participants reported physical and individual activities as the most important and the reasons given by most participants for stating their activity as most important were work enjoyment and usefulness. It was concluded that attention should be paid to older people's possibilities for having important activities.
Growing older in the community: European projects in housing and planning
- Authors:
- BRECH Joachim, POTTER Philip
- Publisher:
- Anchor Housing Trust/Wohnbund
- Publication year:
- 1994
- Pagination:
- 197p.,tables,illus.,bibliogs.
- Place of publication:
- Oxford
Research report looking at how meeting the care and housing needs of older people, to enable them to live in the community for as long as possible, is being tackled by European countries.