Background: The care for the older adults is facing major challenges with the growing proportion of older people. This entails a need to find new ways to cope with the tasks of elderly care, and digitalization is seen as part of the solution. In order to succeed with digitalizing, the first-line managers in elderly care needs knowledge of change management and digitalization. That knowledge needs to be obtained via educational efforts. Aim: The aim of the study was to examine the experiences of first-line managers within elderly care after they recieved training in change management and digitalization. The aim was further to examine their perspectives on the influencing factors when it comes to leading change management in digitalization. Method: The method was a qualitative interview study with an inductive research approach and the sample consisted of first-line managers within elderly care in a medium-sized Swedish municipality. Semi-structured interviews were conducted which were analyzed by qualitative inductive content analysis.  Results: Four main categories emerged; perspectives on implemented educational efforts; identified potential, barriers and needs in change management and digitalization; responsibilities and roles in change management and digitalization; and perspectives on care users when using health and welfare technology. Potential and barriers included assent from management, cooperation between colleagues, influence of the first-line managers' level of interest, resources, goals and strategies. It also included prioritization of daily operations, employee needs, resistance and information about purpose, implementation process and technology. In order for the first-line managers in elderly care to achieve the expected benefit with training on change management and digitalization, the expectations needs to be well defined. Conclusion: Educational efforts in change management and digitalization alone are not enough to achieve a successful implementation of health and welfare technology in municipal care for the elderly. Digitalization is an ongoing process of changes and the first-line managers can-not do it by themselves. The preferred practice is to be able to create the conditions for interested employees to drive the work of digitalization within their respective operation.

Samhället använder media alltmer idag jämfört med förr och nyhetspubliken matas dagligen av information från olika tidningsartiklar. Äldreomsorg är ett aktuellt ämne i svenska tidningar, både sett till finansiering, personalfrågor och åldrande befolkning med ökade behov av vård och omsorg. Syftet med studien är att undersöka hur media framställer två utvalda problemområden, personalbrist och bristande språkkunskaper, inom äldreomsorgen och hur denna framställan kan påverka samhällets inställning till äldreomsorg. Med en kvalitativ innehållsanalys har totalt 19 tidningsartiklar från Aftonbladet och Expressen analyserats för att besvara studiens syfte och forskningsfrågor. Av analysen framkommer det att media har en negativ framställan om äldreomsorg och det har gått att urskilja fyra olika framställningar om varje problemområde från tidningarna. Analysen visar även att den negativa bevakningen av äldreomsorg kan påverka nyhetspublikens åsikter och inställning till äldreomsorg. Personalens dåliga arbetsvillkor på arbetsplatsen har varit dominerande genom tidningsartiklarna, kopplat till dåliga löner och låg status. Studien redogör även för betydelsen av hur media väljer att framställa olika ämnen, genom lockande rubriker och att endast vissa aspekter av ett ämne lyfts fram. Åldrande befolkning har visat sig vara en befintlig och kommande utmaning inom äldreomsorgen och medias framställan om äldreomsorg kan påverka undersköterskor och socionomers yrkesval. Därmed kan medias negativa framställan om äldreomsorg bidra till ökad personalbrist, vilket blir problematiskt när landet står inför en åldrande befolkning och behovet av undersköterskor och socionomer förväntas öka. / The society use media more and more today compared to the past and the news audience is daily fed by information from different newspapers. Elderly care is a current topic in Swedish newspapers, both in terms of financing, staff issues and an aging society with increased need for care and nursing. The purpose of the study is to examine how media present two selected problem areas, staff shortages and lack of linguistics, in elderly care and how this presentation can influence the news audience’s attitude to elderly care. With a qualitative content analysis, a total of 19 newspaper articles from Aftonbladet and Expressen have been analysed to answer the study’s purpose. The analysis shows that media has a negative presentation about elderly care, and it has been possible to distinguish four different presentations about each problem area from the newspapers. The analysis also shows that the negative coverage of elderly care affects the news audience’s opinions and attitude towards elderly care. The poor working conditions of the staff at their workplace has been dominant through the newspaper articles, connected to low wages and low status. The study also explains the importance of how media chooses to present different topics, through appealing headlines and only certain aspects of a topic is highlighted. The aging population is an existing and a future challenge in elderly care and media’s presentation about elderly care can affect assistant nurses and social worker’s choice of career. For that reason, can medias negative presentations about elderly care contribute to an increased staff shortage, which will be problematic when the country is facing an aging society and the need of assistant nurses and social workers are expected to increase.

I Sverige pågår en förändring av pensionssystemet där pensionsåldern fortsatt förväntas att höjas. Samtidigt har demografiska förändringar med en åldrande befolkning medfört en ökad arbetsbelastning på vård och omsorgssektorn, inte minst äldrevården. Detta har skapat ett växande behov av att bibehålla äldre arbetskraft och värna om kompetensförsörjningen inom yrket. För att möta denna omställning behöver personalchefer inom vård och omsorgssektorn använda HRM- praxis som ett led i att arbeta hållbart och nå ett förlängt arbetsliv, för äldre arbetskraft. Studien har haft för avsikt att undersöka vård och äldreomsorgens personalfunktion och linjechefers (personalchefers) perspektiv på hållbart arbete, genom att söka svar på forskningsfrågorna: 1.) Vilka perspektiv har personalchefer på möjligheter och utmaningar gällande demografiska förändringar i åldrandet, samt på ett förlängt arbetsliv? 2.) Vilka perspektiv har personalchefer angående arbetet med policy och HRM-praxis, för att hantera bristen på mänskliga resurser, samt för att bevara betydelsefull kompetens och äldre arbetskraft inom vård och omsorgssektorn? Data från nio respondenter med personalansvar utgjorda av semistrukturerade intervjuer, analyserades genom tematisk analys. Resultatet visade i korthet att personalchefer beskrev utmaningar med en växande äldre befolkningsandel och med förhöjd pensionsålder. Samtidigt framhölls möjligheten att nyttja äldre arbetskraft längre i yrkeslivet. Vidare beskrevs brister i användandet av HRM-praxis, där individ/ålderspecifika HRM-praxis uttrycktes vara extra utmanande. Dock påtalades att vissa delar av HRM-praxis hade nyttjats, så som att tillmötesgå äldre medarbetare med fysiska hjälpmedel, samt viss kompetensutveckling och möjlighet att reducera tjänstegrad. Samtidigt framkom utmaningar med kompetensförsörjning, psykosociala hjälpmedel och möjligheter till bilateralt nyttjande att arbetskraft. Även om dessa fynd inte går att generalisera kan resultatet innebära viktiga insikter för såväl användandet av HRM-praxis inom vård och äldre omsorgen samt vidare forskning. / In Sweden, a change is taking place in the pension system where the retirement age is still expected raise. At the same time, demographic changes with an aging population have led to an increased workload in the health- and welfare sector, especially within elderly care. This has created a growing need to retain older workers and safeguard the supply of skills in the profession. To meet this change, HR managers in the health care sector need to use HRM practice, as part of working sustainably and achieving an extended working life for older workers. This study aimed to examine the line managers (HR managers) perspectives on sustainable work within the elderly care sector, by seeking answers to research questions: 1.) What perspectives do HR managers have on opportunities and challenges regarding demographic changes in aging, and on extended working life? 2.) What are the perspectives of HR managers regarding the work with policy and HRM practice, to deal with the lack of human resources, and to preserve significant skills and older workforce in the health care sector? Data from nine respondents with personnel responsibilities, consisting of semi-structured interviews were analyzed through thematic analysis. The results showed in short that HR managers described challenges with a growing older population and with an increased retirement age. Nevertheless, the possibility of using older labor longer in working life was emphasized. Furthermore, shortcomings in the use of HRM practices were described, where individual / age-specific HRM practices were expressed to be extra challenging. However, it was pointed out that certain parts of HRM practice had been used, such as accommodating older employees with physical aids, as well as some competence development, and the opportunity to reduce the degree of working hours. At the same time, challenges arose with the supply of skills, psychosocial aids and opportunities for bilateral use of labor. Although these findings cannot be generalized, the results may provide important insights for both the use of HRM practice in care and elderly care as well as further research.

The purpose of this study is to examine the experiences and perspectives of need assessors working with mental illness in older adults. This will be studied to gain a deeper understanding of their work with mental illness in older adults and how they work to promote mental health amongst older adults. A qualitative interview study with six needs assessors was completed to fulfill the purpose of the study, and were later analyzed using thematic analysis. The study’s collected data were furthermore analyzed using two theoretical tools:human service organizations as well as ageism. The results of this study conclude that needs assessors experience their work with mental illness in older adults as indirect due to a lack of elaborate working methods to meet the needs of older adults with mental illness. The study’s results also show that needs assessors perceive mental illness in older adults as a sensitive topic to work with. Additionally, this study highlights that needs assessors feel restricted in their work to promote mental health in older adults as a result of organizational prerequisites in elderly care.

The aim of this study was to examine the level of crisis readiness within the eldercare sector. Because of the worsened security landscape in the world, crisis readiness has become a focal point on the political agenda. The crisis we explore are the types of crisis that could follow a war or the grayzone between war and peace which in Swedish is called “skymningsläge”. The crisis we focus on in the study are power failure, crisis regarding water supply, food and medicin distribution and cyber-attacks. Our survey aimed to explore the new institutional theory to gain insights into the dynamics of social work within the context of crisis management,focusing on organizations' adaptability to new security challenges. By examining the responses of frontline managers, we sought to understand the impact the organizations have on the elder care facilities. Our findings showed discrepancies between municipal and private sectors with front line managers within the private sector demonstrating a culture of greater openness to make changes for improved crisis readiness. However, in terms of crisis readiness, no significant advantage was found for private facilities. By exploring the perspectives of the first line managers we could also understand what impact the organizations have on the managers situation. Our study also showed a correlation between training in crisis management and confidence in leading during crises. The survey also showed that the organizations has taken measures to develop crisis readiness after the pandemic to be more resilient.

Research shows an increase in alcohol consumption among older generations, leading to a rise in alcohol-related issues within this age group. In spite of this, there is a lack of knowledge and national guidelines regarding alcohol abuse among the elderly, resulting in complex work for social welfare officers and home care personnel who must balance the statutory self-determination rights of care recipients with a reasonable standard of living. Through 10 conducted interviews, this study aims to find out how social welfare officers and home care personnel work with alcohol abuse among elderly individuals. The data collected has been analyzed through thematic analysis, aiming to find answers on how professionals describe the work with alcohol abuse among the elderly, as well as how they balance self-determination with a reasonable standard of living. The study's result shows the complexity of working with alcohol abuse among the elderly, the lack of guidelines and policies, as well as the challenges it poses for professionals in their daily work.

I denna vetenskapliga essä undersöker jag begreppet helhetssyn som ord, dess historiska utveckling inom hälso- och sjukvård, hur det uppfattas inom aktuell forskning samt ur ett filosofiskt perspektiv. Fenomenologi, hermeneutik och existentialism utgör det filosofiska ramverket och jag låter dessa teorier gå i dialog med gestaltade berättelser från mitt yrkesutövande som fysioterapeut men också med mina reflektioner och tidigare erfarenheter. Hälsa är ett annat begrepp som undersöks eftersom det är nära besläktat med helhet och också något som människan strävar mot genom hela livet. Eftersom mitt arbete huvudsakligen utförs i möte med åldrade patienter ger jag extra mycket utrymme åt just åldrandet och kroniska sjukdom som fenomen. Den praktiska klokheten, kunskapsformen fronesis, växer fram som en grundläggande förutsättning för att kunna sträva mot helhetssyn med en etiskt grundad kvalitet. Även om jag kommer fram till att helhetssyn förmodligen är en utopi så är det fortfarande ytterst viktigt att sträva mot den. Den essentiella delaspekt av helhetssyn som vuxit fram vid sidan av fronesis väljer jag att benämna situasyn. Utmaningen kallas NPM. / In this scientific essay, I examine the concept of the holistic view — as a notion, its historical development in health and medical care, how it is perceived within current research, and from a philosophical perspective. Phenomenology, hermeneutics and existentialism constitute the philosophical framework and I let these theories go into dialogue with depicted stories from my professional practice as a physiotherapist, and also with my own reflections and past experiences. Health is another concept that I investigate because of its close relationship with wholeness, and also because it is something that man strives towards throughout his life. Since my work is mainly done in meetings with elderly patients, I give extra space to aging and chronic illness as phenomena. The practical wisdom, phronesis, as a form of knowledge, emerges as a basic prerequisite for being able to strive towards a holistic view of an ethically founded quality. Although I will argue that a holistic view is a utopic vision, I conclude that it is still important to strive towards it. The essential part of the holistic approach that emerged, alongside phronesis, I've chosen to call situasyn. The challenge is called NPM.

The study concerns the needs assessment processes that older persons undergo to gain access to home care. The participation of older persons, their relatives and municipal care managers was studied from a communicative perspective. The assessment meetings functions as formal problem-solving events. The older persons´ accounts are negotiated discursively in interaction. Various storylines are used by the older persons and their relatives whether they view home care as an intrusion, as a complement or as a right. In case of divergent opinions the older person has the final say as prescribed by the Swedish social service act. One conclusion is that the role of relatives is not defined and a family perspective is not present. In the study the institutional structure of the assessment process was also analyzed. Older persons are processed into clients; their needs are fitted within the framework of documentation and institutional categories. In the transfer of talk to text all the particulars are not reflected and two types of documentation was identified; a fact-oriented objective language or an event-oriented personal language. Care management models and a managerialist thinking has influenced the assessment process by bureaucratisation of older people trough people processing, which is in contradiction to the individual-centric perspective prescribed by the law. The introduction of care management models in gerontological social work has lead to an embedded contradiction and constitutes a welfare political dilemma. Improved communicative methods are needed in order to achieve a holistic assessment situation. / Studien tar sin utgångspunkt i de bedömningsprocesser äldre personer genomgår för att få tillgång till hjälp i hemmet. Bedömningsprocessen där äldre, deras anhö-riga och kommunala behovsbedömare deltog studerades ur ett kommunikativt perspektiv. Interaktionen vid behovsbedömningssamtalet fungerar som en pro-blemlösningsprocess. Den äldre personens redogörelse för behov förhandlas diskursivt i interaktionen och tre olika berättelselinjer identifierades, baserade på om de sökande betraktar hemtjänsten som ett intrång, som ett komplement och stöd eller som en rättighet. När olika åsikter uttrycks har de äldre sista ordet i enlighet med Socialtjänstlagens föreskrifter. En slutsats är att de anhörigas roll i behovsbedömningsprocessen inte är definierad och att ett familjeperspektiv sak-nas. I studien analyserades också bedömningsprocessens institutionella struktur. De äldre behovssökande processas till att bli klienter, deras behov anpassas till dokumentationens ramverk och kategoriseras i enlighet med institutionella kate-gorier. I transfereringen av tal till text redovisas inte samtliga element i samtalet. Två typer av utredningstext identifierades, den faktaorienterade och den händelse-orienterade. I studien diskuteras det marknadsekonomiska tänkande som kommit att påverka bedömningsprocessen genom byråkratisering vilket står i motsatsställ-ning till det individcentrerade perspektiv som lagen förespråkar. Introduktionen av marknadsmodeller i det gerontologiska sociala arbetet har medfört en inbyggd motsättning och utgör ett välfärdspolitiskt dilemma. Förbättrade kommunikativa metoder behövs för att uppnå en holistisk bedömningsprocess.

Background The Swedish population is ageing quickly and the system for elderly home care is under increasing pressure. Staff turnover is high, nursing assistants are reporting stress, and employers have to recruit staff lacking sufficient experience. These factors are barriers to empathic care, considered essential to patient health outcomes. Elderly care should rely on cognitive empathy, be other-oriented and improve the client’s situation based on contextual understanding. There is a need for education and support for nursing assistants, so that they can provide empathic care. Purpose The thesis explores empathy as a skill in elderly home care to identify opportunities of promoting empathy in the client-nursing assistant interaction, by means of behaviour change interventions delivered through an mHealth application that nursing assistants already use at work. Method A group interview was conducted with six nursing assistants from four elderly home care organisations in a Swedish municipality, to learn about their experience of empathy at work, and factors affecting their ability to give empathic care. The respondents were using the same mHealth application to get and provide information about client visits. The Behaviour Change Wheel framework was used to analyze behavioural drivers of empathic care in elderly home care. Results Influences on empathic behaviour was identified in all 14 domains in the Theoretical Domains Framework. 13 target behaviours, 7 Intervention Functions and 45 Behaviour Change Techniques were suggested as suitable candidates to investigate for intervention development. Conclusion Empathy seems possible to promote through resource-efficient digital behaviour change interventions. Future studies may use this work as a starting point for development of interventions to promote empathic behaviour in elderly care.

I dagens samhälle lider många äldre av ofrivillig ensamhet. Effekterna av den ofrivilliga ensamheten leder till sämre välmående och utveckling av sjukdomar, både psykiskt och fysiskt. Livslängden på människan ökar tillsammans med belastningen på samhället och vården. Trots detta minskas omkostnaderna på äldrevården.  Det ökade geografiska avståndet mellan familjemedlemmarna har gjort att barnens mor- och farföräldrar utesluts mycket mer från barnens liv än för 100 år sedan. Ändå finns det studier på att barn som har den äldre generationen i sin samvaro utvecklar färre sociala problem. Gävle kommun har ett pågående projekt där de ska kombinera skolverksamhet med äldrevård i samma byggnad. I inspiration från detta har examensarbetet utforskat hur en produkt kan öka och förenkla interaktionen mellan förskolebarn och boende på vård- och omsorgsboende. Den utforskande delen med intervjuer har ökat förståelsen för användarna och deras behov. Konceptet är byggt på att skapa ett naturligt möte hos äldre på vård och omsorgsboende och förskolebarn som har olika förutsättningar. Resultatet av arbetet blev Sällskapsspelet Kiderly som är anpassat efter målgruppernas olika behov och förutsättningar. Spelets fokus ligger på att hjälpa förskolebarn och boenden på vård och omsorgsboende till ett naturligt möte som uppmuntrar till konversation. / In today's society, many older people suffer from involuntary loneliness. The effects of involuntary loneliness lead to poorer well-being and the development of diseases, both mental and physical. The lifespan of people increases together with the burden on society and healthcare. Despite this, the costs of care for the elderly are reduced. The increased geographical distance between the family members has meant that the children's grandparents are much more excluded from the children's lives than 100 years ago. Nevertheless, there are studies that children who have the older generation in their company develop fewer social problems. Gävle Kommun has an ongoing project where they will combine school activities with elderly care in the same building. Inspired by this, the degree project has explored how a product can increase and simplify the interaction between preschool children and residents in care and nursing homes. The exploratory part with interviews has increased the understanding of the users and their needs. The concept is based on creating a natural meeting of elderly people in care and nursing homes and preschool children who have different conditions. The result of the work was the board game Kiderly, which is adapted to the target groups' different needs and conditions. The game's focus is on helping preschoolers and residents in care and nursing homes to a natural meeting that encourages conversation.