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Home care services for older clients with and without cognitive impairment in Sweden
- Authors:
- SANDBERG Linda, et al
- Journal article citation:
- Health and Social Care in the Community, 27(1), 2019, pp.139-150.
- Publisher:
- Wiley
Little is known about the types of home care services granted to older clients in Sweden. The objectives of this study were to: (a) identify and describe the range of granted home care services and service hours; (b) compare services granted for clients with and without documented cognitive impairment; and (c) examine associations between the range of granted home care services and factors related to cognitive impairment and demographical characteristics. The study design was descriptive and cross‐sectional. The data, included records of granted home care services for clients age 65+ with (n = 43) and without (n = 88) cognitive impairment documented by the local municipality assessors, collected from one agency in Sweden during a 2‐month period in 2015. Data analyses resulted in an overview of the range of home care services divided into two categories: personal care and service. In the personal care category, the median was 3 for types of services (range 0–12), and shower (n = 69; 52.7%) was the most common service. In the service category, the median was 5 for types of services (range 0–10), and cleaning the household (n = 103; 78.6%) was the most common service. The median for service hours was 27 hr per month (range 2.5–127.5). Logistic regression models revealed that cognitive impairment was associated with a higher number of services in the personal care category and a higher number of hours per month. Living alone was associated with a higher number of services in the service category. In conclusion, a wide range of home care services were provided for clients who have complex needs in daily life. Home care services were granted to clients with cognitive impairment and to a greater extent with clients who were living alone. (Edited publisher abstract)
Older persons' experience of being assessed for and receiving public home help: do they have any influence over it?
- Authors:
- JANLÖV Ann-Christin, HALLBERG Ingalill Rahm
- Journal article citation:
- Health and Social Care in the Community, 14(1), January 2006, pp.26-36.
- Publisher:
- Wiley
The aim of this qualitative study was to explore older persons' experience of participation in and influence on decisions about public home help/care when undergoing needs assessment and receiving public home help. A purposive sample of 28 home help recipients over the age of 75 were selected. Data were collected by means of in-depth interviews. A content analysis revealed one overarching category: 'Having to be satisfied, adjust, and walk a fine line when balancing between needs and available help'; and three principal categories: Balancing the comfort and guilt – receiving help from the family at the limits of their capacity; 'A necessary evil'– balancing feelings and resources against having no choice but to accept; Incorporating the home help into daily life to gain a sense of continuity. The findings indicate that older persons have difficulties coping and adapting to their new life situation and have no actual influence over the decisions about their home help. The officer told them what was available. This implies a need to pay attention to the frail persons' mental state in the needs assessment and to ensure adequate understanding of information. Further, it suggests that the needs assessment and the home help officer should to a larger extent focus on individual needs as a whole, involve and encourage the older person to strengthen his or her sense of being in control.
Handling the dilemma of self-determination and dementia: study of case managers’ discursive strategies in assessment meetings
- Authors:
- OSTERHOLM Johannes H., LARSSON Annika Taghizadeh, OLAISON Anna
- Journal article citation:
- Journal of Gerontological Social Work, 58(6), 2015, pp.613-636.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
In assessment meetings concerning care services for people with dementia, Swedish case managers face a dilemma. On the one hand, according to the law, the right to self-determination of every adult citizen must be respected, but on the other hand cognitive disabilities make it difficult to fulfil obligations of being a full-fledged citizen. In this article, the authors examine 15 assessment meetings to identify discursive strategies used by case managers to handle this dilemma. The authors also examine how these affect the participation of persons with dementia, and indicate implications of their study for social work practice and research. (Edited publisher abstract)
Care managers' experiences of cross-cultural needs assessment meetings: the case of late-in-life immigrants
- Authors:
- FORSSELL Emilia, TORRES Sandra, OLAISON Anna
- Journal article citation:
- Ageing and Society, 35(3), 2015, pp.576-601.
- Publisher:
- Cambridge University Press
Research on care managers' experiences of the needs assessment process is scarce even though the literature on needs assessment practice is relatively extensive. This study examines the ways in which care managers experience the challenges that are presumably posed by increased ethnic, cultural, linguistic and religious diversity among prospective elder care recipients. It is based on a project that aims to shed light on care managers' experiences of the needs assessment process in general and cross-cultural needs assessment meetings in particular. The data are constituted of focus group interviews with care managers in Sweden (N=60). This article focuses on care managers' experiences of needs assessment with older people who have immigrated late-in-life, who come from cultures considered different from the Swedish one and who have not mastered the Swedish language. This was the group of older people that the care managers mostly thought of when asked to describe their experiences of cross-cultural needs assessment meetings. The interviewed care managers discussed the challenges that these meetings present, which were related to communication due to language barriers, different demands and expectations, insecurity regarding what is customary in such meetings, as well as perceived passivity among late-in-life immigrants. The article discusses the contributions of the findings to research on care management practices in general, as well as to needs assessment practice in particular. (Edited publisher abstract)
Care management in practice: on the use of talk and text in gerontological social work
- Authors:
- CEDERSUND Elisabet, OLAISON Anna
- Journal article citation:
- International Journal of Social Welfare, 19(3), July 2010, pp.339-347.
- Publisher:
- Wiley
This article focuses on the assessment processes older people undergo to gain access to home care, an assessment which often falls within the scope of gerontological social work. The process involves meetings between care managers, acting as social workers, and older people in their homes to reach decisions about their home care. The article describes a study of these meetings between care manager and citizens in one type of welfare organisation – the municipal elder care system in Sweden. The article highlights how older people’s claims are dealt with in the processing of home care applications. Twenty encounters between social workers and older people were studied using discourse analysis. The findings showed that discursive practices are part of the routine when the applications are processed, and that the application handling follows an agenda-bound pattern that is visible in the encounters. The authors suggest that within these standardised procedures, verbal discourse is embedded in routines that also include the use of texts, but, however, within this institutional order there is also an important element of negotiation between the parties. In conclusion, the authors claim that the encounters include a negotiated order that does not exist on its own, but is achieved through the on-going interaction.
The effects of rationing home-help services in Spain and Sweden: a comparative analysis
- Authors:
- SUNDSTRÖM Gerdt, TORTOSA Maria Angeles
- Journal article citation:
- Ageing and Society, 19(3), 1999, pp.343-361.
- Publisher:
- Cambridge University Press
Compares Spain and Sweden, two countries with different experiences of providing home-help services for older people, and to consider how they ration these services when there is a short supply. Spain provides relatively few hours of help with household tasks, primarily to poor old people. Sweden focuses on the oldest and frailest people of all social classes who live alone. Spain uses strict needs assessment and eligibility criteria to target clients and Sweden has sharpened its needs assessment and raised fees to discourage users with lesser needs.