Bakgrund: Inom den kommunala äldreomsorgen har sjuksköterskan ett omvårdnadsansvar i vilket det ingår att se till att äldre som bor på särskilda boenden eller har någon form av hemsjukvårdsinsatser erhåller en säker vård. Omvårdnadspersonalen har närmst kontakt med de äldre inom den kommunala omsorgen. För att verksamheten ska fungera delegerar sjuksköterskor medicinska arbetsuppgifter till omvårdnadspersonalen. Dock får delegering endast ske då det är förenligt med en god och säker vård, något som enligt forskning visat sig vara en utmaning för sjuksköterskorna. Syfte: Syftet var att undersöka sjuksköterskors erfarenheter av delegering av medicinska arbetsuppgifter inom kommunal äldreomsorg. Metod: Studien utfördes som en kvalitativ intervjustudie med semistruktuerade intervjufrågor där sju sjuksköterskor som arbetade inom kommunal äldreomsorg medverkade (varav en var sjuksköterska och sex var distriktssköterskor). Det material som framkom genom intervjuerna analyserades genom kvalitativ innehållsanalys med utgångspunkt i Graneheim och Lundmans metodbeskrivning. Resultat: Analysen resulterade i fyra kategorier: Villkor från verksamheten för delegering, teamets betydelse för delegering som gemensam uppgift, stå som ansvarig för delegering samt förbättringsförslag utifrån erfarenheter i samband med delegering. Kategorin Villkor från verksamheten för delegering handlar om arbetsmiljö, rutiner och utbildning i samband med delegering. Kategorin Teamets betydelse för delegering som gemensam uppgift handlar om kompetensen och kommunikationen i teamet. Kategorin Stå som ansvarig för delegering handlar om att ansvara för att skapa en säker delegeringsprocess och kategorin Förbättringsförslag utifrån erfarenheter i samband med delegering handlar om förslag på förbättringsarbete. Slutsats: Resultatet visade att sjuksköterskorna kunde känna press från organisationen och på grund av tidspress samt att de kände en kluvenhet mellan att hitta den bästa lösningen för patienten men samtidigt skapa en säker vård i samband med delegering. Resultatet har lett till ökad förståelse och ökade kunskaper kring delegeringsförfarandet. / Background: In municipal elderly care, the nurse has a nursing responsibility which includes ensuring that the elderly who live in special housing or have some form of home care interventions receive safe care. The nursing staff has the closest contact with the elderly in municipal care. In order for the operation to work, nurses delegate medical tasks to the nursing staff, however, delegation may only take place when it is compatible with good and safe care, something which according to research has proven to be a challenge for the nurses. Aim: The aim was to investigate nurses' experiences of delegating medical tasks within municipal elderly care. Method: The study was conducted as a qualitative interview study with semi-structured interview questions in which seven nurses working in municipal elderly care participated (of which one was a nurse and six were district nurses). The material that emerged from the interviews was analyzed through qualitative content analysis based on Graneheim and Lundman's method description. Result: The analysis resulted in four categories: Conditions from the activities for delegation, the team's importance for delegation as a joint task, being responsible for delegation and improvement proposals based on experience in connection with delegation. The category Terms from the activities for delegation deals with the work environment, routines and training in connection with delegation. The category The team's importance for delegation as a common task is about the competence and communication in the team. The category Stand as responsible for delegation is about being responsible for creating a secure delegation process and category Improvement proposals based on experience in connection with delegation is about proposals for improvement work. Conclusion: The results showed that the nurses could feel pressure from the organization and due to time pressure and that they felt a gap between finding the best solution for the patient but at the same time creating a safe care in connection with delegation. The result has led to increased understanding and increased knowledge of the delegation procedure.

Det är naturligt att det uppstår konflikter bland människor som arbetar tillsammans, speciellt när de arbetar under stress och stora påfrestningar så som det ser ut i stora delar av dagens vård- och omsorgsorganisationer. Forskning visar att chefer använder 20–25 % av sin tid till att hantera konflikter. Vidare pekar forskning på vikten av att chefer har kompetens i konflikthantering och att chefer har svårt att använda sig av stödresurser på grund av uppdragets utformning men att det sociala stödet är avgörande för både chefens hälsa och ett gott ledarskap. Syftet med den här undersökningen är att bidra med kunskap kring vilka förutsättningar första linjens chefer har för att hantera konflikter i det dagliga vård-och omsorgsarbetet samt vilka strategier de använder. Vi har intervjuat sex inom äldrevården. Data analyserades med kvalitativ innehållsanalys. Analysen resulterade i följande kategorier: (1) Strategier, (2) utmaningar och (3) kompetensutveckling. Resultatet visar att de intervjuade cheferna upplevde sig ensamma i sina yrkesroller, att tidsbristen är påtaglig både för konflikthanteringen och för att arbeta förebyggande, samt att de saknar kunskap kring konflikthantering i skilda kulturer. Cheferna betonade vikten av att förhålla sig neutral, att agera skyndsamt och att inta en stödjande roll som särskilt viktiga förhållningssätt i konflikthantering. I resultatdiskussionen diskuteras problemet med att första linjens chefer har extremt höga krav på sig där de förväntas att vara stödjande och hantera skilda arbetsuppgifter trots bristande förutsättningar. Utifrån resultatet föreslår vi att arbetsgivaren inför mentorskap som ger chefen tillgång till ett bollplank för råd och yrkesrelaterade diskussioner. Vidare tror vi att reflektionsgrupper med reflektionsledare bör erbjudas minst en gång i månaden, där cheferna reflekterar över hur de bäst kan hantera sina utmaningar, men också kan utveckla sitt ledarskap och sin självkännedom. / It is no surprise that conflicts arise among people who work together, especially when they work under stress and great liability as it appears in large parts of today’s healthcare and care organizations. Research shows that managers spends 20-25% of their time managing conflicts. Although research emphasizes that social support is crucial for manager’s health and leaders abilities and they need competence in conflict management, managers have difficult using support resources due to the design of their assignment, The purpose of this study is to contribute with knowledge about the conditions experienced by managers in dealing with conflicts and what strategies they use. We interviewed six managers employed in the elderly care. Data was analyzed using qualitative content analysis. The analysis resulted in the following three categories: (1) Strategies, (2) challenges and (3) skills development. The results show that managers felt alone in their professional roles, that the lack of time was evident both for conflict management and for preventive work and that they lack knowledge about conflict management in different cultures. Managers emphasized the importance of neutral, to act quickly and to take a supportive role as being particularly important in conflict management. In the results discussion, the problem of extremely high demands in terms of expectations for managing a wide variety of work tasks while being supportive, despite the lack of acceptable prerequisites. Based on the results, we suggest that employers introduce a mentorship to give managers easy access to own sounding board for advice and professional discussions with. Furthermore, we believe that reflection groups with reflection leaders should be offered at least once a month where managers may how they can deal with their challenges in the best possible way, but also develop their leadership and self-awareness.

The aim of this study was to highlight and analyze how the understanding of elder abuse is phrased, enunciated and socially constructed by unit managers and care personnel in elderly care. Despite being globally recognized as a social problem, elder abuse is an under-researched field. The data collection consists of eight qualitative and semistructured interviews with unit manager and care personnel in swedish elderly care. The study has been analyzed by applying a theoretical framework consisting of social constructivism, ageism and role concepts. The results of the study shows that unit manager and care personnel has the tools and ambition to notice and perceive elder abuse. The results also shows that the lack of an coherent definition of elder abuse has an influence in how the phenomenon is constructed by care personnel.

This paper aims to investigate how needs assessors in the municipality experience their work with elderly people who experience loneliness, and what different types of support measures they can offer. In addition the paper looks into the discretion which the needs assessors use to provide the elderly people with care that is adapted to individual needs. This qualitative study has been carried out conducting semi-structured interviews with seven needs assessors from five different municipalities. The findings indicate that the work with elderly people experiencing loneliness is very much a question of interpretation. Loneliness can manifest itself in different ways and is not always easy to talk about, nor to interpret. The study also shows that individual assessments can be difficult to implement due to strict guidelines and a tight budget. However, the work towards helping-and supporting elder people and acknowledging the issue of loneliness in later life is an important matter for both older people and needs assessors.

With the Covid-19 pandemic, many of the already identified shortcomings in our welfare society came to be challenged and care for the eldery was particularly affected. Eldery care had to endure harsh criticism and managers in eldery care were questioned. Based on this, the purpose of this study is to gain an in-depth understanding of the eldery care first-line leaders experiences of leading during the Covid-19 pandemic an how they are emotionelly effected and challenged during this period. The study is based on a qualitative method whit semi-stuctured interviews as a data collection method. Eight first-line leaders in eldery care have been interviewed and based on their stories, their experiences of leading during the covid-19 pandemic have been analyzed from Erving Goffman's dramaturgical perspective and Arlie Russel Hoschschild's theory of emotional work. The study shows the importance of a transparent and present leadership and that the unit leaders have experienced loneliness and inadequacy in their role as leaders, wherw the collegial support has proven to be central to being able to stand firmly as a leader during the pandemic.

Att arbeta som första linjens chef innebär ett komplext uppdrag där arbetsuppgifterna består av ansvar för personal, budget och arbetsmiljö. I arbetet befinner sig första linjens chefer i en mellanposition där de behöver ta hänsyn till att politiska riktlinjer följs och finnas tillgängliga för medarbetare och kunder. Syftet med studien är att undersöka första linjens chefers psykosociala arbetsmiljö i äldreomsorgen. Studien bygger på kvalitativ metod. Metoden som vi använde oss av var nio semistrukturerade intervjuer. Studiens teoretiska utgångspunkter är Rubenowitz modell av psykosocial arbetsmiljö och Karasek och Theorell modell om krav, kontroll och stöd. Resultatets teman är första linjens chef, psykosocial arbetsmiljö, handlingsutrymme samt socialt stöd och meningsfullhet. Temat psykosocial arbetsmiljö har en underrubrik som heter covid-19. Vi har kommit fram till att studiens resultat visar på att respondenterna delar samma uppfattning om att det är viktigt med en god psykosocial arbetsmiljö. / Working as a first-line manager implicates a complex mission where the tasks consist of responsibility for staff, budget and working environment. In their work, first-line managers are in an intermediate position where they need to consider that political guidelines are followed and are available to employees and customers. The purpose of the study is to investigate the psychosocial work environment of first-line managers in elderly care. The study is based on a qualitative method. The method we used was nine semi-structured interviews. The study's theoretical starting points are Rubenowitz's model of psychosocial work environment and Karasek and Theorell's model of requirements, control and support. The themes of the result are first-line manager, psychosocial work environment, margin of action and social support and meaningfulness. The theme psyhosocial work enviroment has a subheading named covid-19. We have concluded the results of the study show that the respondents share the same view; that it is important to have a good psychosocial work environment.

Globalization has facilitated international communication and economic activities that motivate more international migration. Different cultures and values from the West and the East are interwoven in the same social context. Meanwhile, aging has become a notable phenomenon in most developed countries due to declining fertility and increased life expectancy. A digital transformation of society is taking place alongside the aging and international migration that will start to question the image of older adults and the patterns of providing elderly care. Chinese elderly care is characterized by familism providing family-based informal care to an older family member. Despite the influence of migration and modern lifestyles, filial piety is expected to continue to guide the care responsibilities and care providing among Chinese families.  This thesis aims to understand the cultural provision of support and care for Chinese older adults living in Sweden and under the influence of the digital transformation of society. It starts by exploring the disparities, barriers, and facilitators for older immigrants in need of home care to utilize digital technology. After constructing knowledge about the influences of the foreign environment and continuous digitalization in home care, the thesis seeks to understand how filial piety continues to be enacted; what part of the tradition is preserved, and what is changed; how the internal and external factors influence the decision of elderly care; and the role of digitalization in this process. The thesis utilizes qualitative in-depth interviews to continue investigations among eight midlife and older Chinese immigrants living in Sweden. Thematic analysis was employed for data analysis. Berry’s acculturation framework and Yeh’s Dual Filial Piety Model provide the theoretical ground for the research.  The results indicated that filial piety is in transition in terms of filial responsibilities, filial behaviors, and intergenerational relationships. Despite the differences in the acculturation level, the authoritarian element of filial piety lacked ground in the Swedish social context. Respondents showed their willingness to strengthen the reciprocity with their adult children by providing additional support, valuing affections rather than hands-on care, respecting adult children’s decisions. The uptake of digital technologies has enabled midlife and older Chinese immigrants to maintain more frequent contact with family members and friends in other countries. It also improves the autonomy and capabilities for respondents to plan more independent later lives. The conclusion is that traditional values such as filial piety was not as prominent in Sweden as they are in China. / Globaliseringen har möjliggjort gränsöverskridande kommunikation och export samt import av varor och tjänster. Även människor rör sig över olika delar i världen och emigrerar till främmande länder. Detta i sin tur innebär att olika kulturer och värderingar från väst och öst behöver vävas samman och samsas i samma sociala kontext. Förutom globaliseringen så har åldrandet; på grund av sjunkande fertilitet och ökad livslängd, blivit en betydande företeelse i de flesta utvecklingsländer. En digital omvandling av samhället pågår parallellt med åldrandet och den internationella migrationen. I det avseendet blir äldre immigranter, deras teknikanvändning och syn på äldreomsorg allt viktigare.  Kinesisk äldreomsorg kännetecknas av familjebaserad informell vård till av äldre familjemedlemmar. Trots samhällets förändring och digitalisering, förväntas barnen ha huvudansvaret för vård och omsorg av sina äldre familjemedlemmar. Fenomenet kallas ”filial piety” och beskriver barnens skyldigheter att sörja för sina föräldrar på ett respektfullt sätt.  Denna licentiatexamen syftar till att öka kunskapen om äldre kinesiska immigranter som bor i Sverige och deras förväntningar på omhändertagandet och äldrelivet i Sverige relaterat till digitaliseringen.  Licentiatexamen börjar med att utforska skillnaderna, hindren och möjligheter i att använda digital teknik bland äldre invandrare i behov av hemtjänst. Licentiatexamen använder kvalitativa djupintervjuer för att undersöka hur åtta medelålders och äldre kinesiska invandrare, bosatta i Sverige. Intervjuerna har analyserat med hjälp av tematisk analys. Berrys ramverk för ackulturation och Yehs ”Dual Filial Piety Model” utgör den teoretiska grunden för forskningen. Resultaten indikerade på att synen på ”filial piety” är i förändring när det gäller vårdnadsansvar, beteenden och relationer mellan generationerna. Trots skillnaderna i nivån av ackulturation saknades det auktoritära inslaget av ”filial piety” i den svenska kontexten. Intervjupersonerna betonade sin vilja att stärka samspelet med sina vuxna barn genom att ge stöd och affektion snarare än att de förväntade att barnen skulle ge praktisk vård och omsorg. De intervjuade visade stor respekt för sina vuxna barns beslut och självständighet. Användningen av digital teknik möjliggjorde att de intervjuade kunde hålla tät kontakt med familjemedlemmar och vänner i andra länder. Den digitala kontakten med familjemedlemmar och vänner i sin tur, ansågs stödja deras autonomi och förmåga att planera sina framtida liv och äldreomsorg. Slutsatsen är att traditionella värderingar så som ”filial piety” påverkades av den svenska kontexten och förväntningarna på de vuxna barnen var inte lika höga och framträdande som de traditionellt sett varit i Kina. / <p>QC 2021-11-02</p>

The aging population is growing and as more elderly need nursing the demand on elderly care is increasing. There is a risk of not having enough staff in an industry that already lacks educated staff. Many of the employees also complain that they are stressed out. This has led to an increasing number of gadgets and tools used within elderly care but not without problems. The technologies have been criticized for being designed to fit the need of the people in control rather than the elderly and the caregivers. This thesis has mapped the situation within todays elderly care and provided a solution to those needs and problems found. The focus has been to make a design that is fit for the elderly and the caregivers. The project has been made with a human centered design approach by letting elderly and caregivers participate in the process. A keystone has been to make the solution emit a sense of coherence for the elderly. The result is a radar unit which scans for blood pressure, respiration, pulse, and falls. The radar can be complimented with a camera to provide even more security. The achieved result can bring a sense of coherence for the elderly but needs to be further tested in order to prove it. This work can be used for future studies.

Previous studies show that elderly people with mental illness tend not to have their needs met due to lack of interaction between authorities (Grundberg, Hansson, Religa &amp; Hillerås 2016). The purpose of this study is therefore to investigate what care managers in social psychiatry and elderly care experience affect their work and collaboration between them. In this way, we want to create a deeper understanding of how work and collaboration affect the care of older people with mental illness. This qualitative study is based on semi-structured interviews with six care managers. We have used a thematic analysis to analyze our empirical material. Through transcription and reading of the empirical material, we have highlighted quotations that have identified repetitions, similarities and differences that have since shaped themes. Furthermore, the material was analyzed based on theories of collaboration (Danermark &amp; Kullberg 1999; Grape 2015) and Lipsky's street level bureaucracy. Our study shows that care managers feel that collaboration is a prerequisite for being able to meet the needs of elderly people with mental illness, but opinions differ on whether the support needs of the target group are actually met. Collaboration between social psychiatry and elderly care is generally perceived to work well, even though our results show some contradictions to this claim. Finally, the study shows that collaboration and social work is influenced by various factors such as proximity and distance, as well as laws and guidelines and knowledge about these. These factors affect the care manager's room for manoeuvre and professional identity, which is also perceived to affect the possibilities for collaboration. Collaboration, room for manoeuvre and professional identity seem to be related and through interaction all parts form a whole.

Swedish elderly care stands before vast employee related challenges in a future with an aging population that will require welfare. By studying what makes working in elder care attractive and what can be done to strengthen its’ attractiveness, tools can be made to attract employees to the occupation and thereby secure the future needs. This qualitative study has investigated employees' experiences of attractive work in a municipal home care service. Through two focus groups based on a model for attractive work, six employees' experiences of what makes their work attractive in a municipal home care organization have been identified. The results show these are social contact and relationships with colleagues, helping others, having varied tasks and care recipients, present and understanding leadership, and problem-solving in work. Improvement points such as increased salaries, more flexible schedules, raising the status of the home care profession, improving employees' ability to show appreciation for each other, and expanding employees' autonomy in their work have also been identified as ways to enhance the attractiveness of the work according to respondents. The study was inspired by hermeneutic-oriented empirical phenomenology, where respondents' experiences of the phenomenon of attractive work are central, but pre-understanding is used to gain a deeper understanding of these experiences and put them in a broader context. Using the model for attractive work, respondents' experiences have been compared to the model and previous research in the field, where similarities and differences have been identified and discussed. / Svensk äldreomsorg står inför stora personalrelaterade utmaningar i en framtid med en åldrande befolkning som kommer behöva välfärd. Genom att undersöka vad som gör hemtjänstarbetet attraktivt och vad som kan göra arbetet attraktivare kan verktyg skapas för att locka fler medarbetare till hemtjänsten och därigenom säkra framtidens behov. Denna kvalitativa studie har undersökt medarbetares upplevelser av attraktivt arbete i en kommunal hemtjänstverksamhet. Genom två fokusgrupper som kommer ifrån en modell för attraktivt arbete har vad sex medarbetarna upplever som attraktivt med sitt arbete hos en kommunal hemtjänstorganisation identifierats. Resultatet visar att dessa är den sociala kontakten och relationen till kollegorna, att hjälpa andra, ha varierande arbetsuppgifter och brukare, veta vad som ska göras, ett närvarande och förstående ledarskap samt att få lösa problem i arbetet. Förbättringsområden som höjda löner, luftigare scheman, att höja hemtjänstyrkets status, att medarbetarna blir bättre på att visa varandra uppskattning samt en utökad handlingsfrihet i arbetet för medarbetarna har också identifierats som respondenterna menade kan stärka arbetets attraktivitet. Studien har inspirerats av en hermeneutisk orienterad empirisk fenomenologi där respondenternas upplevelser av fenomenet attraktivt arbete står i centrum men förförståelse används för att få en djupare förståelse för dessa upplevelser och sätta dem i en större kontext. Med hjälp av modellen för attraktivt arbete har respondenternas upplevelser jämförts med nämnda modell samt tidigare forskning inom fältet för att identifiera och diskutera likheter och skillnader.