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Responses to vulnerability: care ethics and the technologisation of eldercare
- Author:
- HAMALAINEN Antti
- Journal article citation:
- International Journal of Care and Caring, 4(2), 2020, pp.167-182.
- Publisher:
- Policy Press
This article argues for a re-conceptualisation of care relations and uses the re-conceptualisation to scrutinise the way in which technology is adopted in eldercare practices. First, it draws on the definition of care as attentiveness to vulnerability, as used in the tradition of care ethics. Second, it specifies four essential aspects of care relations: relationality, dyadic mutuality, corporeality and devotion. Third, using socio-technical and phenomenological perspectives, care relations are contrasted with the idea of intertwining technological and human actors in care practices. Finally, using two adaptations of telecare as examples, the essential aspects of care relations are shown to be crucial for a thorough socio-technical understanding of eldercare and technology. (Publisher abstract)
Tensions and resilience: the experiences of adult foster-care workers in Finland
- Author:
- LEINONEN Emilia
- Journal article citation:
- International Journal of Care and Caring, 2(2), 2018, pp.181-196.
- Publisher:
- Policy Press
This article examines adult foster care for older people in Finland. This is a semi-formal service in which older people are cared for by foster carers who are remunerated for their work by the local municipality. In the article, the tensions and resources of resilience of foster-care work are analysed. The data consist of 12 thematic interviews with foster carers. The results suggest that foster-care work is emotionally draining and has adverse effects on social relationships. However, foster carers see caring as purposeful, they see themselves as professionals and they have enough social resources. (Edited publisher abstract)
Alcohol consumption in midlife and old age and risk of frailty: alcohol paradox in a 30-year follow-up study
- Authors:
- STRANDBERG Arto Y, et al
- Journal article citation:
- Age and Ageing, 47(2), 2018, pp.248-254.
- Publisher:
- Oxford University Press
Background: alcohol consumption has many harmful health effects, but also benefits of moderate consumption on frailty have been reported. We examined this relationship longitudinally from midlife to old age. Methods: data of reported alcohol consumption in midlife (year 1974) and in old age (years 2000 and 2003) were available of a socioeconomically homogenous sample of 2360 men (born 1919–34, the Helsinki Businessmen Study). Alcohol consumption was divided into zero (N = 131 at baseline), light (1–98 g/week, N = 920), moderate (99–196, N = 593), and high consumption (>196, n = 716). Incidence of phenotypic frailty and prefrailty was assessed in 2000 and 2003. Alcohol consumption (reference 1–98 g/week, adjusted for age, body mass index and smoking) was related to frailty both longitudinally (from 1974 to 2000, and from 2000 to 2003) and cross-sectionally in 2000 and 2003. Results: during a 30-year follow-up, high consumption clearly decreased whereas lighter consumption remained stable. High consumption in midlife predicted both frailty (odds ratio = 1.61, 95% confidence interval = 1.01–2.56) and prefrailty (1.42; 1.06–1.92) in 2000, association with zero and moderate consumption was insignificant. Cross-sectionally in 2000, both zero (2.08; 1.17–3.68) and high consumption (1.83; 1.07–3.13) were associated with frailty, while in 2003 only zero consumption showed this association (2.47; 1.25–4.88). Conclusion: the relationship between alcohol and frailty is a paradox during the life course. High, not zero, consumption in midlife predicts old age frailty, while zero consumption in old age is associated with frailty, probably reflecting reverse causality. (Publisher abstract)
Investigating burden of informal caregivers in England, Finland and Greece: an analysis with the short form of the Burden Scale for Family Caregivers (BSFC-s)
- Authors:
- KONERDING Uwe, et al
- Journal article citation:
- Aging and Mental Health, 22(2), 2018, pp.280-287.
- Publisher:
- Taylor and Francis
Objectives: The burden of informal caregivers might show itself in different ways in different cultures. Understanding these differences is important for developing culture-specific measures aimed at alleviating caregiver burden. Hitherto, no findings regarding such cultural differences between different European countries were available. In this paper, differences between English, Finnish and Greek informal caregivers of people with dementia are investigated. Methods: A secondary analysis was performed with data from 36 English, 42 Finnish and 46 Greek caregivers obtained with the short form of the Burden Scale for Family Caregivers (BSFC-s). The probabilities of endorsing the BSFC-s items were investigated by computing a logit model with items and countries as categorical factors. Statistically significant deviation of data from this model was taken as evidence for country-specific response patterns. Results: The two-factorial logit model explains the responses to the items quite well (McFadden's pseudo-R-square: 0.77). There are, however, also statistically significant deviations (p < 0.05). English caregivers have a stronger tendency to endorse items addressing impairments in individual well-being; Finnish caregivers have a stronger tendency to endorse items addressing the conflict between the demands resulting from care and demands resulting from the remaining social life and Greek caregivers have a stronger tendency to endorse items addressing impairments in physical health. Conclusion: Caregiver burden shows itself differently in English, Finnish and Greek caregivers. Accordingly, measures for alleviating caregiver burden in these three countries should address different aspects of the caregivers’ lives. (Publisher abstract)
Marketisation of Nordic eldercare: is the model still universal?
- Author:
- MOBERG Linda
- Journal article citation:
- Journal of Social Policy, 46(3), 2017, pp.603-621.
- Publisher:
- Cambridge University Press
- Place of publication:
- Cambridge
The objective of this article is to analyse whether the increased reliance on marketisation in the provision of social care challenges the universality of eldercare in Sweden, Denmark, Finland and Norway. The study focuses on national reforms for contracting out and user choice of provider, analysing their consequences for four universalistic dimensions: (i) equal inclusion, (ii) public funding, (iii) public provision and (iv) comprehensive usage. The findings suggest that, although need-based inclusion and public funding remain key principles in all four countries, there is an increased reliance on private provision in Sweden, Denmark and Finland. In addition, the introduction of topping-up services challenges the dimension of comprehensive usage by enabling users with economic resources to turn to the private market to increase the comprehensiveness and quality of their care. (Publisher abstract)
Physical restraints and associations with neuropsychiatric symptoms and personal characteristics in residential care: a cross-sectional study
- Authors:
- KURONEN Marja, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 32(12), 2017, pp.1418-1424.
- Publisher:
- Wiley
Background: Physical restraints are widely used in residential care. The objective was to investigate restraint use and its associations with neuropsychiatric symptoms and personal characteristics in residential care. Methods: Data were collected in the South Savo Hospital District from 66 of 68 public or private institutions providing long-term residential care. Nurses assessed the use of physical restraints and neuropsychiatric symptoms (NPS) included in the symptom list of the Neuropsychiatric Inventory (NPI). Drug use was obtained from medical records, and activities of daily living (ADL) were assessed by the nurses according to the Barthel Index. Results: The total number of persons in residential care was 1386. Any restraint was used for 721 patients (52%) in the preceding 24 h. Bedrails were the most common restraints. In the multivariate analysis, psychotic symptoms (OR 1.94, 95% CI 1.14–3.31) and use of benzodiazepines (OR 1.69, 95% CI 1.18–2.41) were positively associated with restraint use, whereas antipsychotic (OR 0.62, 95% CI 0.44–0.87) and antidepressant drug use (OR 0.64, 95% CI 0.45–0.90) and higher ADL score (OR 0.9, 95% CI 0.92–0.93) were negatively associated. Concomitant use of at least two restraints was associated with high prevalence of hyperactivity NPS symptoms. Conclusions: More than half of the residents were exposed to some physical restraint, most frequently bedrails, within the last 24 h. Psychotic symptoms and benzodiazepine use increased while good ADL and antipsychotic or antidepressant use decreased the risk of restraint use. Bedridden persons were the most frequently restrained which may pose an ethical problem. (Publisher abstract)
Responsibility for child and elderly care: who should cover the costs? A comparison of Baltic and Nordic countries
- Authors:
- GARCIA-FAROLDI Livia, DE MIGUEL-LUKEN Veronica, AYUSO Luis
- Journal article citation:
- Social Policy and Administration, 51(4), 2017, pp.638-658.
- Publisher:
- Wiley
Using data from the International Social Survey Programme (2012), this study compares public attitudes towards who should cover the costs of caring for children and older people in five Nordic countries (Finland, Sweden, Norway, Iceland and Denmark) and two Baltic ones (Latvia and Lithuania). The study found interesting differences between both groups of nations: citizens from Baltic countries consider the role of the family more important than their counterparts in Nordic countries. Results show Latvians holding the most familistic views in terms of covering costs, and Swedish people the least. Individual socio-demographic variables are less important than national contexts in explaining these attitudes. The article finds important variations among the social-democratic countries and, surprisingly, in the case of childcare, Sweden shows higher differences to Denmark than to Latvia and Lithuania. This finding suggests that the social-democratic bloc in this respect is more heterogeneous than what is generally thought. (Edited publisher abstract)
Facing the challenges in the development of long-term care for older people in Europe in the context of an economic crisis
- Authors:
- DEUSDAD Blanca A., PACE Charles, ANTTONEN Anneli
- Journal article citation:
- Journal of Social Service Research, 42(2), 2016, pp.144-150.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This article introduces the content of this special issue, which incorporates eight articles in which authors evaluate recent changes and developments in long term conditions (LTCs) for older people in European countries, most particularly from the perspective of restructuring taking place in the LTC for older people. The economic and state financial crises are the most important drivers behind widespread overall restructuring processes. (Edited publisher abstract)
Social capital and self-rated health among older adults: a comparative analysis of Finland, Poland and Spain
- Authors:
- KOUTSOGEORGOU Eleni, et al
- Journal article citation:
- Ageing and Society, 35(3), 2015, pp.653-667.
- Publisher:
- Cambridge University Press
The aim of this paper is to investigate the association between structural and cognitive aspects of social capital and self-rated health among adults aged 50 or more, living in three countries: Finland, Poland and Spain. The study, which was based on data from the European Social Survey (2008/09), was a part of the EU research project COURAGE in Europe. More specifically the paper assesses the association between social capital indicators - informal social network and general trust - and good self-rated health through single-level and joint effects analyses. The results showed that Finland was a country of high social capital, in terms of both social networks and general trust, while Spain showed low levels of general trust and Poland low levels of informal social networks. As to the association between social capital and self-rated health, high levels of general trust and high networks were found to be associated with good health among all countries' respondents. Older persons living in partnerships, with higher education, higher levels of engagement in informal networks and general trust, were found to be more likely to show good self-rated health. The comparative analyses revealed different associations between social capital and health according to country. (Edited publisher abstract)
The effect of out-of-home activity intervention delivered by volunteers on depressive symptoms among older people with severe mobility limitations: a randomized controlled trial
- Authors:
- RANTAKOKKO Merja, et al
- Journal article citation:
- Aging and Mental Health, 19(3), 2015, pp.231-238.
- Publisher:
- Taylor and Francis
Objectives: To examine the effects of an individualised outdoor activity intervention carried out by volunteers on depressive symptoms among community-living older people with severe mobility limitations who have difficulties accessing the outdoors independently. Methods: Secondary analyses of the 'Volunteering, Access to Outdoor Activities and Wellbeing in Older People' (VOW) data (ISRCTN56847832). VOW was a randomised single blinded two-arm controlled trial conducted in Jyväskylä, Finland, in 2009-2011. At baseline, 121 people aged 67-92 years with severe mobility limitations were interviewed at home and randomized into either an intervention or waiting list control group. Volunteers (n = 47) had retired from regular work and were trained for the study. A volunteer assisted the participant in attending recreational out-of-home activities once a week for three months. Depressive symptoms were assessed using the Center for the Epidemiological Studies Depression Scale (CES-D). Results: In the intervention group the CES-D score did not change during the intervention, while in the control group it increased from 17.0 ± 1.3 to 19.1 ± 1.4 (intervention effect p = .096). Among the subgroups with minor depressive symptoms at baseline, the CES-D score decreased in the intervention group and increased in the control group. Conclusion: A three-month outdoor activity intervention may improve mood among older people with severe mobility limitations. More randomized controlled trials of the topic are needed. (Edited publisher abstract)