The aim of this study was to get an increased understanding regarding how carers relate to consent while working with people who has dementia. The study asks the following questions: How does the carers understand the concept of consent associated with giving care to people with dementia? What is considered by the carers in connection to consenting to caregiving by people with dementia? And lastly, how does consent mediate between carers and people with dementia? It had a hermeneutic and qualitative scientific approach. The data was collected through three focus groups with carers and then analyzed according to Jens Rennstam and David Wästerfors (2015) method of analysis. The theoretical analysis was performed with three different theoretical aspects called: Scope for action and relationship, Being a client and relational power. The authors of the theoretical aspects were Kerstin Svensson, Eva Johnsson and Leili Laanemets (2014), Roine Johansson (2007), Katarina Jacobsson, Joakim Thelander and David Wästerfors (2010) and also Mats Franzén (2010). The main conclusion of this study was that the carers used body language and had to phrase their questions well towards the people with dementia regarding if they consented to let them help or not. The relationship between carers and the people with dementia was vital - without it consent was very hard to reach.

Syftet med detta arbete var att undersöka om det finns likheter och skillnader mellan barnskötare och förskollärares syn på lekens betydelse för barns utveckling och lärande. Undersökningen skedde genom semistrukturerade intervjuer med förskollärare och barnskötare baserat på deras tankar och åsikter. Fyra förskollärare respektive fyra barnskötare intervjuades på två olika förskolor. I analysen uppkom ett antal teman som också blev underrubriker i resultatet. Dessa var, Leken i relation till lärande och utveckling, Det sociala samspelet, Aktivt deltagande, Lekens betydelse för utveckling av kommunikativa förmågor, En närvarande vuxen för att stötta barnen i olika leksituationer och Personalens förändrade syn på lek i relation till utveckling och lärande. Utifrån resultatet kan vi urskilja att samtliga deltagare anser att leken är en stor del av förskolans verksamhet och ses som något positivt. Dock har vi kunnat synliggöra skillnader i motiveringarna beroende på antal år i yrket och vissa skillnader beroende på yrkesroll. Resultatet visade även på likheter, vilket var att samtliga deltagare ansåg att barnen utvecklar språkliga och kommunikativa förmågor i samband med leken.

This thesis extends prior research on LGBT caregivers and carer-employees by employing a mixed-methods approach to investigate the intersecting factors of identity, employment type, and geographical location on the experiences of Two-Spirit, lesbian, gay, bisexual, transgender, and queer (2SLGBTQ+) caregivers in Canada. These caregivers are broadly absent from both the carer-employee and LGBT caregiving literature, and this dissertation offers an initial attempt to correct this. It begins with a quantitative study involving 2SLGBTQ+ carer-employees, assessing how their identity and experiences of discrimination influence their quality of life, work life, and willingness to seek workplace accommodations for caregiving responsibilities. Subsequently, a qualitative component delves into how employment type shapes these experiences, with a particular focus on how insecure customer service workers and those employed in unionized pink-collar work navigate work-care conflicts. This section also examines the impact of non-traditional caregiving dynamics on the ability of these caregivers to navigate such conflicts. Lastly, it explores how past and current experiences of discrimination, non-conventional relationships, and geographical location affect the capacity of 2SLGBTQ+ carer-employees to interact with healthcare providers and advocate for their care recipients. This research offers a substantial contribution by bringing to the forefront a hitherto unaddressed population. The existing body of literature on carer-employees has overlooked the specific challenges faced by 2SLGBTQ+ carer-employees, and the LGBT caregiving literature has similarly overlooked the role of employment in shaping the experiences of these caregivers. Furthermore, it underscores the significance of geographical location for 2SLGBTQ+ caregivers in rural and remote areas and highlights the experiences of midlife and younger caregivers, particularly those providing care for individuals experiencing severe mental illness. It concludes with discussions of the policy implications of this research. / Dissertation / Doctor of Philosophy (PhD) / This thesis examines and explores the experiences of Two-Spirit, lesbian, gay, bisexual, transgender, and queer (2SLGBTQ+) carer-employees in Canada. These caregivers balance their unpaid care work with their paid employment, and face barriers when navigating care and work that are related to their 2SLGBTQ+ identity. Building on research that has identified that LGBT caregivers have unique needs and characteristics, and on research that highlights that individuals attempting to balance unpaid care work with paid employment face significant challenges when attempting to do so, this research brings these two fields together to examine how 2SLGBTQ+ identity impacts these experiences. In particular, it highlights that these caregivers experience poorer quality of life and worklife, that type of work and non-traditional caregiving dynamics may leave these caregivers more vulnerable to negative consequences associated with work-care conflicts, and that experiences of discrimination and concerns regarding confidentiality and anonymity for rural and northern 2SLGBTQ+ caregivers shape their ability to successfully navigate healthcare systems.

<p><strong>ABSTRACT</strong></p> <p>It is estimated that twenty percent of the Canadian population experiences a serious mental illness at some point in their lifetime. A portion of those that do so will be parents. Research indicates that in some circumstances, when a parent with a serious mental illness needs support that they are not getting from other adults or the formal mental health care system, the caregiving responsibilities can fall to their children. Sometimes called “young carers” in literature developed in the U.K. and elsewhere, there has been little attention in Canada to this population or the implications of the term “young carers”. Through a critical feminist lens, a small qualitative study was undertaken to explore the lived experiences of adults looking back on having been “young carers”, a perspective seldom taken in the literature.</p> <p>The four study participants had all cared for their mothers in households with extended social networks that included fathers and siblings- an interesting counterpoint to the “young carer” literature, which has centered on isolated single parents with children. Participants described how they found themselves in caring roles, what their caring consisted of, and why they continued to care despite other options being available. The study reveals the intricate social pressures that the participants faced, and suggests that becoming a carer may be more complex than past studies have indicated. I examined participants’ stories with an eye to the structural forces that shaped their pathways as carers and their reflections on those pathways. The discussion focuses on what the participants’ experiences can tell us about the contemporary neoliberal political climate: how its emphases on individualism, independence and smaller government, contribute to the depletion of public mental health services and a troubling focus on sustaining “young carers” rather than questioning their positioning.</p> / Master of Social Work (MSW)

Yes / Objectives: The objectives of the study are to investigate how different levels of functional ability relate to quality of life, well‐being, and satisfaction with life, conceptualised as reflecting capability to “live well” in people with dementia. Methods/design: Participants were 1496 people with mild‐to‐moderate dementia and 1188 informants who completed baseline assessments in the Improving the experience of Dementia and Enhancing Active Life (IDEAL) cohort study. Total selfrated and informant‐rated scores on the Functional Activities Questionnaire were split into six ability levels to monitor how poorer functioning impacts the ability to live well. We also investigated the potential influence of sociodemographic and diagnostic variables, depression, cognition, and carer stress. Results: Multivariate multiple regression models found that people with dementia who had the greatest functional impairment according to self‐ratings and informant ratings had poorer living well scores than those with the least functional impairment. Sociodemographic and diagnostic factors and cognition had little impact on effect sizes. For self‐ratings, depression attenuated the relationship between functional ability and living well, whereas carer stress attenuated informant ratings. Conclusions: People with dementia with the least functional impairments had greater capability to live well than those with the most functional impairment. Even subtle perceived difficulties in functional ability had a detrimental effect on the ability of people with dementia to live well. Depression in people with dementia and carer stress in informants influenced these associations, and therefore, these factors should be routinely included in future research studies and clinical assessments.

Yes / Key points: The focus on living well with dementia encourages a more positive and empowering approach. The right support can improve the experience of living with dementia. An holistic approach to assessing the needs of people with dementia and identifying the factors that impact on their well-being is essential. Enabling people to live better requires a broad approach that encompasses both health and social systems and the wider community. / The IDEAL study was funded jointly by the Economic and Social Research Council (ESRC) and the National Institute for Health Research (NIHR) through grant ES/L001853/2. The IDEAL2 study’ is funded by Alzheimer’s Society, grant number 348, AS-PR2-16-001. The support of ESRC, NIHR and Alzheimer’s Society is gratefully acknowledged. LC acknowledges support from the NIHR Applied Research Collaboration South-West Peninsula. / Research Development Fund Publication Prize Award winner, Sep 2021

Yes

ABSTRACT Stroke can result in aphasia which is an acquired language disorder. It affects both the person with aphasia and the relatives. Previous studies have shown that people with aphasia consider themselves to have fewer difficulties with communication in comparison to their relatives’ opinions. The relatives rate the difficulties as less severe in comparison to the speech and language pathologists. The scales Communication Outcome after Stroke (COAST) and Carer Communication Outcome after Stroke (Carer COAST) can be used to investigate the experiences of the people with aphasia and their relatives regarding the language and communication ability of people with aphasia and the quality of life for both groups. By using COAST and Carer COAST this study aimed to investigate the experiences of people with aphasia and their relatives and to compare their experiences to the assessment of language. This study also aimed to start a validation of COAST and Carer COAST on a Swedish population. A qualitative and a quantitative analysis were used. Twenty people with aphasia and nineteen relatives were participating. The ratings between people with aphasia, their relatives and the speech and language pathologist did not differ a lot even though the relatives rated the difficulties as most severe. The quality of life was negatively affected for almost all participants. This study provided deeper insight in the different experiences which can be crucial in the clinical practice. The validation of COAST and Carer COAST can contribute to an extended use of the scales clinically and in research. Keywords: aphasia, stroke, relative, experiences, speech and language pathology, Communication Outcome after Stroke, Carer Communication Outcome after Stroke SAMMANFATTNING Afasi är en förvärvad språkstörning som kan uppkomma efter stroke och påverkar både personen som fått afasi och de närstående. Enligt tidigare studier anser personer med afasi att de har mindre kommunikationssvårigheter än vad de närstående upplever. De närstående upplever i sin tur svårigheterna som mindre än vad logopeder bedömer. Skattningsformulären Communication Outcome after Stroke (COAST) och Carer Communication Outcome after Stroke (Carer COAST) kan användas för att undersöka upplevelserna hos personer med afasi och deras närstående avseende den språkliga och kommunikativa förmågan hos personen med afasi samt livskvaliteten hos båda parter. Studien syftade till att med COAST och Carer COAST studera upplevelserna hos personer med afasi och deras närstående samt hur dessa förhöll sig till en språklig bedömning. Ytterligare ett syfte var att påbörja validering av COAST och Carer COAST på en svensk population. En kvalitativ och en kvantitativ analys gjordes. Tjugo personer med afasi och nitton närstående deltog. Det var inga större skillnader mellan skattningarna av deltagarna med afasi och deras närstående. Skattningarna stämde även till stor del överens med den språkliga bedömningen även om de närstående överlag skattade svårigheterna som störst. Livskvaliteten var negativt påverkad för de flesta deltagarna. Studiens resultat ökar insikten om de olika upplevelserna vilket kan vara av betydelse i den kliniska verksamheten. Valideringen av COAST och Carer COAST kan innebära att skattningsskalorna i större utsträckning kan användas kliniskt och inom forskning.   Nyckelord: afasi, stroke, närstående, upplevelser, logopedi, Communication Outcome after Stroke, Carer Communication Outcome after Stroke

<p>The aim of the study was to examine the background and prerequisites for social services responsibility for carers according to the carers’ section in the Social Services Act. How the legislation is perceived and implemented in practice was also studied. The study’s theoretical basis was jurisprudence and the sociology of law. Preparatory work and other sections of importance for the interpretation of the carers’ section in the Social Services Act were also scrutinized. Interviews with four municipal politicians and four local civil servants were conducted. Various factors which affect the prerequisites for the social services duty of care towards carers were identified in the study. By studying the direct effects of legislation various indirect effects were also highlighted. The results showed that legislation is a weak instrument of control in municipalities’ planning and implementation of support for carers. Therefore social services responsibility for carers is unclear and imprecise. For carers themselves it is difficult to know what support they can demand or ask for from social services – municipalities have to offer support for carers but the carers’ section does not give carers any legal right to support.</p>

The thesis deals with the modern phenomenon of the sandwich generation focusing on managers. First part focuses on knowledge related to demographic pressures. It also defines the role of children and senior carers in the context of social policy in the Czech Republic. Based on the initial findings of role conflict of carers and staff my research was realized and it deals with the identification of impacts of experienced situation on the individual, who simultaneously finds himself in the role of a manager and children or senior carer, in his personal and professional life. The participants of the qualitative research underwent semi- structured interviews in which thematic areas related to the causes and circumstances of their role as caregivers and chief executive were included. Data analysis showed the impacts of factors influencing harmonization on personal and professional lifes of executives in the sandwich generation. Key words: sandwich generation, carer, harmonization, senior, child, manager, personal life, work