Yes / Many intervention studies lack an investigation and description of the factors that are relevant to its success or failure, despite its relevance to inform future interventions. This study aimed to explore the facilitators and barriers to the implementation of a psycho‐educational intervention for care assistants caring for people with dementia in aged‐care facilities. A process evaluation was carried out alongside a pretest/post‐test controlled study conducted in aged‐care facilities. Seven focus‐group interviews involving 21 care assistants (female; mean age 43.37 ± 10.0) and individual semi‐structured interviews with two managers (female; mean age 45.5 ± 10.26) were conducted 2 weeks and 6 months after the intervention, in two aged‐care facilities. Interviews were recorded, transcribed and submitted to content analysis by two independent researchers. Results were organised into implementer, participant and organisation level hindered and facilitator factors. Findings enable the interpretation of the experimental results and underscore the importance of collecting the perception of different grades of staff to obtain information relevant to plan effective interventions. / Foundation for Science and Technology (FCT). Grant Number: SFRH/BD/72460/2010 and RIPD/CIF/109464/2009

Bakgrund: De äldre i Sverige blir allt fler och allt äldre. Många får leva ett friskt och aktivt liv som äldre och andra drabbas av sjukdom och ohälsa redan i ett tidigt stadie av ålderdomen. Sjuksköterskan inom kommunal hemsjukvård ansvarar idag för ett stort antal patienter och har inte möjlighet att gå ut och träffa alla sina patienter dagligen. Det krävs därför att många av de hälso- och sjukvårdsuppgifter som förekommer ute i patienternas hem utförs av delegerad hemtjänstpersonal. Deras ansvar har ökat och de står ofta ensam ute i hemmen med beslut om när patientens hälsotillstånd kräver kontakt med sjuksköterskan. Syfte: Syftet med studien var att beskriva hemtjänstpersonalens upplevelser av att arbeta med delegerade hälso- och sjukvårdsuppgifter. Metod: Åtta Narrativa intervjuer genomfördes vilka analyserades med kvalitativ innehållsanalys Resultat: resultatet visar hemtjänstpersonalens upplevelser av att arbeta med delegerade hälso- och sjukvårdsuppgifter. Analysen av resultatet utmynnade i sex kategorier: tillfredsställelse, ansvar och gemenskap som beskrev bra upplevelser och tre kategorier: tidsbrist, otillräcklighet och krav som beskrev dåliga upplevelser. Då samtliga respondenter återgav både bra och dåliga upplevelser i arbetssituationen skapades temat: Att arbeta med motsägelsefulla känslor. Slutsats: Genom att ta del av hemtjänstpersonalens upplevelser kan sjuksköterskan utveckla delegeringsförfarande. Ge stöd till personalen och skapa tillfällen för att undervisa och handleda, vilket leder till trygghet och ökad patientsäkerhet i vård och omsorg av den äldre / Background: The elderly population in Sweden is increasing and people tend to live longer. Some people live a healthy and active lifestyle until they reach an old age. Others are affected by an illness or disease in the early stages of old age. The nurse in the Swedish municipal home care is responsible for a large number of patients and has therefore gotten less close to his or her patients. The nurse is not able to see his or her patients every day and therefore many health care tasks in patients' homes are conducted by delegated home care assistants. The responsibilities of the assistants have increased and they are often alone in the home with the decision of when the nurse must be contacted due to the patient's health status. Aim: The aim of the study was to describe the health care assistant's experiences of working with delegated health care tasks. Method: Data was collected through eight conducted narrative interviews. The data was analyzed using qualitative content analysis. Results: The analysis of the results led to six categories. Three categories, satisfaction, responsibility, and fellowship, described the good experiences. Three categories, lack of time, the feeling of being inadequate, and feeling of being forced, described bad experiences. The respondents described both good and bad experiences in the work situation. From the categories, the theme of working with conflicting emotions was created. Conclusion: By taking part of the assisted living staff experiences the nurse could develop the delegation routine, support, educate, and supervise the staff, which leads to security and increased patient safety in health and social care of the elderly.

Background: Worldwide one in twelve people are living with diabetes and one in two people do not know they have diabetes. Currently large numbers of the older people live in residential care homes in the UK, and up to one in four older people living in residential care homes present with diabetes. Low vision is one of the complications associated with diabetes in older people. In those aged 75 and over, one in five, and in those aged over 90, one in two people are affected by low vision and they are at an increased risk of developing other eye diseases. Within 20 years of diagnosis nearly all people with Type 1 and almost two thirds of people with Type 2 diabetes (60%) have some degree of diabetic retinopathy. Aims and Objectives: This study aimed to investigate the issues and problems faced by older people living in residential care homes with low vision and diabetes; to evaluate health professionals’ knowledge and understanding of the impact of low vision associated with diabetes in older people living in residential care homes; and to develop an educational toolkit which aimed to educate health care assistants about low vision and diabetes. Methods: This study is an exploratory investigation of older people living in residential care homes with low vision and diabetes. Adopting an open-ended qualitative approach using focus groups, interviews and a health professional’s survey, 116 participants were involved. These included GPs, ophthalmologists, nurses, optometrists, health care assistants and older people with low vision and diabetes. The data was analysed thematically. The educational toolkit was developed in the second part of this study, and 20 healthcare assistants were trained using this toolkit. Their knowledge was tested before the training, immediately after the training and one month after the initial training. Following Kirkpatrick’s model, the skills and practical use of the educational toolkit was assessed using an open-ended qualitative approach. Results: The results found that many older people and the health care assistants had the perception that low vision was a normal ageing process and could not be rectified. The study found that there was evidence to suggest that eye health was not considered to be a priority; instead, it was considered to be a natural part of the ageing process. The results found that 82% of the HCAs had not had any training in the area, and more than half of the nurses and GPs did not have sufficient knowledge of low vision and diabetes. After training, however, their knowledge was increased. This suggested that low vision and diabetes toolkit training could be used to educate healthcare assistants on a regular basis. The study also found that knowledge does decline over time, and therefore regular training for HCAs is required in order to maintain eye health and diabetes in older people, as well as improving their quality of life. Conclusion: In the research findings it was found that 50% to 70% of low vision was preventable or treatable if detected in its early stages and could be avoided by simply wearing appropriate spectacles, or possible surgery. However, in order to identify these 50% to 70% with low vision, everyone concerned should be able to recognise the signs and symptoms of preventable low vision, particularly health care assistants, as according to this study, health care assistants spent large amount of time in the residential care homes compared to the other health professionals.

Background: People living with advanced dementia in nursing homes often spend the majority of time alone, with little contact with anyone. The need to connect with others is a central part of a philosophy known as Person Centred Dementia Care. A significant body of literature demonstrates the effectiveness of a range of approaches that facilitate connections, yet, we know little about staff perspectives on what facilitates them to connect on a daily basis. Aim: To develop a Grounded Theory to explain what facilitates nursing home staff to connect with residents living with advanced dementia. Methods: Semi structured interviews were conducted with nursing home staff (n=21) and relatives (n=5) from seven nursing homes. Following Strauss and Corbin’s (1990, 1998) Interpretivist Grounded Theory methodology, data collection and analysis proceeded iteratively, and theoretical sampling was used to develop the emergent theory. Results: The Grounded Theory ‘making the most of time’ explains that most connections occurred during personal care. Interdependent contextual and individual factors facilitated staff to make the most of time. Effective leaders were described to create a caring culture in which informal leaders (experienced staff) acted as role models. Staff were then more likely to understand, accept and tolerate dementia, know connections were part of their role, get to know residents and express caring values. In the right physical environment, this then facilitated staff to make the most of time during personal care. Increased training and education from specialised dementia units and experiential knowledge from family engagement then supplement such contexts. Implications: Future research could empirically test the theory ‘making the most of time’

There is a worldwide shortage of direct care workers who help older adults in their own homes. The purpose of this multiple case study was to explore strategies that owners of home health care businesses can use to retain adequate direct care workers for their businesses. Five home care agency owners from Wake County, North Carolina, participated. Each owner had successfully implemented strategies to ensure adequate caregivers to sustain the business. Human relations theory was used to address the business problem. Data collection involved interviewing the 5 owners of home care agency businesses in their offices. Through a process of methodological triangulation, observations and documentary evidence supplemented data collected through semistructured interviews. Deductive and inductive coding were used to arrange and identify 3 emergent themes: company reputation, training and career development, and the role of government. The results of this study may contribute to social change because home care agency owners and other business owners can use the findings to improve on their treatment of low income workers which may help eradicate discrimination to ethnic minorities.

In Sweden the need to recruit care assistants is increasing because of a growing older population together with their demands to stay in their own homes as long as possible. Swedish municipalities are responsible for organizing the social care and services for elderly with a coordination of some private provider companies. Moreover, to improve the care work a range of information and communication technologies (ICTs) e.g. safety alarm and electronic health record system are used to support care assistants’ daily activities and communication with elderly. Thus qualitative research aims to explore the care assistants’ use and experiences of existing ICTs. Furthermore, it examines the impact of the ICTs on their daily activities. The thesis pay attention also to care assistants demands, ideas and visions about future ICTs. The research found that care assistants were satisfied with the ICTs, they use today. However, the research also identified some problems related to ICT, which the care assistants are confronted with during their everyday work e.g. alarm buttons loosen and falsely triggered sensors. Care assistants expressed their ideas and visions about the ICT’s degree of involvement in their care activities and elderly’s lives. They had contradictions in their point of views related to the use of monitoring technologies for elder’s care. They also had negative feelings about these technologies. In short, the thesis explored two things; firstly, it reflected ICTs and care assistants’ demands and ideas related to the ICTs. Secondly, the daily activities of care assistants were examined. Therefore this research brings forward care assistants’ activities and makes their work more noticeable in order to be used in the development of new IT systems in the social care work.

By 2020, the coronavirus has spread worldwide and is classified as a pandemic. The purpose of thisstudy has been to, through the perspective of home care assistants, examine the significance of thesocial isolation that the Covid-19 pandemic has meant for older people regarding their mental health.It has thus been about the home care assistants' experiences of the elderly's strategies for dealing withthe recommended social isolation. The study was conducted by using a qualitative research methodthrough semi-structured interviews with home care assistants, who work with elderly people living intheir home. A thematic analysis of the collected material was made and four themes emerged from thecoding. The results showed that the home care assistants experienced a deteriorating mental healthduring the Covid-19 pandemic of the elderly people. This was shown, for example, in the form ofincreased anxiety and sleeping disorders. Furthermore the results showed how the elderly people usedtheir resilience to handle how the virus was affecting their every-day life. Also the result showed theimportance of social stimulation and activity among the elderly and that home care assistants have animportant role for some eldelry who have a limited social life.

No description available.

Contexte : La majorité des résidents en centres d’hébergement et de soins de longue durée (CHSLD) souffrent de troubles neurocognitifs majeurs (TNCM) et un bon nombre d'entre eux ne peuvent verbaliser leurs souffrances. Les préposés aux bénéficiaires (PAB) constituent le groupe de soignants qui, de loin, passe le plus de temps au chevet des résidents. Or, nous connaissons peu la perception qu’ils ont de la souffrance. Objectifs : Cette étude exploratoire vise à comprendre comment les PAB conceptualisent la notion de souffrance et à décrire comment ils l’évaluent chez les personnes atteintes de TNCM sévère. Méthodes : Des entretiens semi-dirigés ont été menés auprès de 6 PAB travaillant de jour, de soir ou de nuit. Les verbatims ont ensuite été analysés selon une approche qualitative inspirée de la théorisation ancrée. Analyse et résultats : Les PAB conceptualisent que la souffrance s’exprime par un changement. Celui-ci peut être par rapport à un état initial de calme (par opposition à une agitation), à un état antérieur cognitivement intact (par opposition aux TNCM), à un état de bien-être (par opposition à l’expression d’une émotion négative par les résidents) et à un état de satisfaction (par opposition aux besoins des résidents qui sont non comblés). La perception de la souffrance vise donc à identifier ces changements. Ainsi, le rôle des PAB s’appuie sur le fait de connaître son résident. Leur compétence est relative à leur expérience. La violence est présente dans les CHSLD. Elle représente un obstacle dans la perception de la souffrance puisqu’elle agit en dévalorisant le rôle des PAB. Elle magnifie également la perte de sens que les PAB éprouvent face à la souffrance, ce qui érode leur idéal de soignants. Cette érosion contribue à ce qu’ils développent des mécanismes de défense qui les éloignent des résidents. Conclusion : La souffrance s’exprimant par un changement, sa reconnaissance passe par l’établissement d’une relation longitudinale avec les résidents. Ceci démontre l’importance d’une stabilité des équipes et souligne que l’évaluation de la souffrance est un processus continu et non uniquement ponctuel. / Background: Most residents in long-term care facilities suffer from major neurocognitive disorders, and many are unable to verbalize their suffering. Health care assistants (HCA) are by far the group of caregivers who spend the most time at residents’ bedsides. Yet we know little about their perception of suffering. Objectives: The aim of this exploratory study was to understand how HCA conceptualize the notion of suffering, and to describe how they assess it in people with major neurocognitive disorders. Methods: Semi-structured interviews were conducted with 6 HCA working day, evening, or night shifts. The verbatims were then analyzed using a qualitative approach inspired by grounded theory. Analysis and results: HCA conceptualize suffering as a change. This may be in relation to an initial state of calm (as opposed to agitation), to a previous cognitively intact state (as opposed to major neurocognitive disorders), to a state of well-being (as opposed to residents' expression of negative emotion) and to a state of satisfaction (as opposed to residents' unmet needs). The perception of suffering therefore aims to identify these changes. Thus, the role of the HCA is based on knowing the resident. Their competence is relative to their experience. Violence is present in long-term care facilities. It represents an obstacle in the perception of suffering since it acts to depreciate the role of HCA. It also magnifies the loss of meaning that HCA experience in the face of suffering, eroding their ideal as caregivers. This erosion contributes to their developing defense mechanisms that distance them from residents. Conclusion: Since suffering expresses itself through change, its recognition requires the establishment of a longitudinal relationship with residents. This demonstrates the importance of team stability and underlines the fact that assessing suffering is an ongoing process, not just a one-off event.

Master's thesis called Spiritual needs in people with cerebral palsy and their saturation in social care focuses on expressing spirituality in people with cerebral palsy (CP) and studies what the spiritual needs may be and if personal care assistants (PCAs) can help to fulfil clients' spiritual needs. The theoretical part shows the issues of CP and the view to people with this disability, with the emphasis to the options of their participation for life in society. It deals with the topic of spirituality and spiritual dimension as one of many dimensions of human personality. After presenting several important theories of needs it continuous with the role of PCAs and their role in fulfilling the clients' spiritual needs. The practical part proceeds from the combination of quantitative and qualitative research; from a questionnaire inquiring the expressiveness of the spirituality and its sharing with PCAs, and interviews seven people with CP inquiring their spiritual needs and possibilities of their fulfilling by PCAs. The results show concrete and stronger spirituality expressing in people with CP than in major population and that the spiritual needs come out from their live situation. Besides spiritual needs and forces that allow them to fulfil their needs on their own. The PCAs are also a rich...