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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)
The meaning of social participation for daily mobility in later life: an ethnographic case study of a senior project in a Swedish urban neighbourhood
- Author:
- STJERNBORG Vanessa
- Journal article citation:
- Ageing International, 42(3), 2017, pp.374-391.
- Publisher:
- Springer
- Place of publication:
- New York
This paper presents an ethnographic case study that aims to understand the meaning of social participation in a neighbourhood for daily mobility in later life. In the study, the mobility of the participants of a senior-citizen project was monitored over 18 months. The project was founded as a result of a municipal district’s targeting of social sustainability. The results show that social participation had positive effects on the daily mobility of the participants. The implementation of broad-minded thinking from the municipality and the cooperation of various municipal actors were shown to be essential for the positive outcome of this project. (Publisher abstract)
Understanding eldercare users' views on quality of care and strategies for dealing with problems in Swedish home help services
- Authors:
- WESTERBERG Kristina, HJELTE Jan, JOSEFSSON Sara
- Journal article citation:
- Health and Social Care in the Community, 25(2), 2017, pp.621-629.
- Publisher:
- Wiley
The aim of the present study was to gain a deeper understanding of eldercare users' strategies for dealing with problems in the quality of care and care satisfaction in relation to home help services. Based on earlier research and evaluations, it was assumed that users would express satisfaction and gratitude, and also be unwilling to complain. The specific research questions were: (i) What, if any, quality of care problems do the users mention? (ii) How do the users explain the reasons for these problems? and (iii) What strategies do the users employ to deal with these problems? A total of 35 interviews were conducted in November 2013 with 15 men and 20 women (66–92 years). The data were analysed using thematic and qualitative content analysis. The results showed that almost all users expressed overall satisfaction with their care. However, all but one also mentioned problems. The users stated very clearly and explicitly the reasons for these problems, and in most cases, they referred to the work conditions, work organisation and lack of other resources in the eldercare organisation. Two strategies were commonly used to deal with these problems: trivialisation and adaptation. A third strategy was expressed dissatisfaction, where the problem led to actions or plans to take action. One interpretation of the findings is that what is actually measured in official quality assessments and follow-ups may be care users' understanding of the work conditions and work organisation of eldercare. The understanding attitude may prevent care users from complaining because it lowers their expectations. (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)
Adaptation to care dependency in community care
- Authors:
- VINGARE Emme-Li, CARLSSON Oie Umb
- Journal article citation:
- Quality in Ageing and Older Adults, 18(4), 2017, pp.254-264.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to explore the lived experiences of adapting to care dependency among adults receiving health and social care in ordinary housing. Design/methodology/approach: This was done by conducting a phenomenological study by interviewing ten adults, receiving home care services in ordinary housing. Findings: Participants not only adapted by becoming a “good patient” but they had four strategies they used: sociability, distance, competence and compliance, contributing to a sense of dignity and personal safety. Research limitations/implications: Further research is needed regarding how to preserve quality of care with adults with various ways of adapting to care dependency. Practical implications: The relationship between professionals and adults in care dependency is a dynamic process where a need for understanding different modes of adaptation is vital. Good treatment and quality care may be different things to different adults, depending on what aspects of the process of adaptation concern them the most, and depending on their individual adaptation strategy. Originality/value: This paper contributes to the understanding of modes of adaptation to care dependency from the perspective of adults indicating that working person centred may include respecting strategies not traditionally being associated with “the good patient.” (Edited publisher abstract)
Moments of homecoming among people with advanced dementia disease in a residential care facility
- Authors:
- NORBERG Astrid, TERNESTEDT Britt-Marie, LUNDMAN Berit
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 16(5), 2017, pp.629-641.
- Publisher:
- Sage
This study concerns moments of homecoming among people with advanced dementia disease living in a residential care facility. The authors' main finding from participant observations with nine residents was that the residents showed moments of homecoming, i.e. they alternated between verbal and/or nonverbal expressions of feeling at home and of not feeling at home. If care providers understand that they can help people with advanced dementia disease experience moments of homecoming, they can focus on aspects of care that can promote these experiences (Edited 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)
Exploring the role of line managers in implementing evidence-based practice in social services and older people care
- Authors:
- MOSSON Rebecca, et al
- Journal article citation:
- British Journal of Social Work, 47(2), 2017, pp.542-560.
- Publisher:
- Oxford University Press
This qualitative study explored the vital role of line managers, namely the managerial level directly above employees, in effectively implementing evidence-based practice (EBP) from their own perspectives. Interviews were carried out with twenty-eight line managers within social services and older people care in seven Swedish municipalities. Thematic analysis was performed. Findings revealed that managers in social care perceived their role as important in implementing EBP. However, notable differences were observed between the two settings, where social services managers had more knowledge and held more positive attitudes towards working according to EBP, and described a more active role in the implementation process than managers in older people care. Overall, the implementation of EBP was performed ad hoc rather than systematically, and with little consideration to analysis of needs according to the local context and limited focus on follow-up and sustainability. This study highlighted that line managers in social services and older people care have different prerequisites for implementing EBP, and are greatly dependent on organisational strategies and context. Gaining knowledge of line managers’ perceptions is essential for making informed decisions regarding the support required to achieve EBP in social care, and thus for providing the best possible care for clients. (Publisher abstract)
Mental health first aid for the elderly: a pilot study of a training program adapted for helping elderly people
- Authors:
- SVENSSON Bengt, HANSSON Lars
- Journal article citation:
- Aging and Mental Health, 21(6), 2017, pp.595-601.
- Publisher:
- Taylor and Francis
Objectives: Epidemiological studies have shown a high prevalence of mental illness among the elderly. Clinical data however indicate both insufficient detection and treatment of illnesses. Suggested barriers to treatment include conceptions that mental health symptoms belong to normal ageing and lack of competence among staff in elderly care in detecting mental illness. A Mental Health First Aid (MHFA) training programme for the elderly was developed and provided to staff in elderly care. The aim of this study was to investigate changes in knowledge in mental illness, confidence in helping a person, readiness to give help and attitudes towards persons with mental illness. Method: Single group pre-test–post-test design. Results: The study group included staff in elderly care from different places in Sweden (n = 139). Significant improvements in knowledge, confidence in helping an elderly person with mental illness and attitudes towards persons with mental illness are shown. Skills acquired during the course have been practiced during the follow-up. Conclusions: The adaption of MHFA training for staff working in elderly care gives promising results. Improvements in self-reported confidence in giving help, attitudes towards persons with mental illness and actual help given to persons with mental illness are shown. However, the study design allows no firm conclusions and a randomised controlled trail is needed to investigate the effectiveness of the programme. Outcomes should include if the detection and treatment of mental illness among the elderly actually improved. (Edited publisher abstract)
Psychotropic drugs and the risk of fall injuries, hospitalisations and mortality among older adults
- Authors:
- JOHNELL Kristina, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 32(4), 2017, pp.414-420.
- Publisher:
- Wiley
Objective: To investigate whether psychotropics are associated with an increased risk of fall injuries, hospitalizations, and mortality in a large general population of older adults. Methods: The study performed a nationwide matched (age, sex, and case event day) case–control study between 1 January and 31 December 2011 based on several Swedish registers (n = 1,288,875 persons aged ≥65 years). The study used multivariate conditional logistic regression adjusted for education, number of inpatient days, Charlson co-morbidity index, dementia and number of other drugs. Results: Antidepressants were the psychotropic most strongly related to fall injuries and antipsychotics to hospitalizations and death. Number of psychotropics was associated with increased the risk of fall injuries, hospitalization and death in a dose-response manner. Among persons with dementia (n = 58,984), a dose-response relationship was found between number of psychotropics and mortality risk. Conclusions: The findings support a cautious prescribing of multiple psychotropic drugs to older patients. (Edited publisher abstract)