I många år har det stått klart att på grund av ökning av antalet äldre kommer det blir svårt med framtida bemanning i hemtjänsten. Arbeten anses vara låg status och underbetalda. Om arbeten i hemtjänsten anses ge anställda upplevelser av empowerment är det möjligt att flera söker sig till dessa arbeten och att befintlig personal stannar kvar. Syftet med denna uppsats är att få ökad förståelse för hur personal i hemtjänst upplever empowerment i sitt arbete samt att studera på vilket sätt ledare inom hemtjänsten kan arbeta med att stödja upplevelser av empowerment hos sina anställda.   Undersökningen är genomförd som en kvalitativ fallstudie i hemtjänsten i Reykjavík. Med semistrukturerade intervjuer har sex anställda och tre ledare intervjuats och materialet har analyserats med en tematisk analys. Det visar sig att de anställda i hemtjänsten i Reykjavík upplever delvis strukturell empowerment i sina arbeten samt pyskologisk empowerment genom alla fyra kognitionerna; mening, kompetens, självbestämmande och påverkan. Ledarna stödjer personalens upplevelser av empowerment genom tillit, respekt och värdighet samt tillåtelse att göra misstag. / For years it has been foreseen that the increase in number of the elderly living at home will cause difficulties when it comes to providing homecare. The cause of those difficulties are mainly because of difficulties in recruiting new employees and keeping those who are working in the home care. Recruiting problems are mainly because employment in the elderly care is considered low status and underpaid. If the employees are empowered in their work there is a possibility that employment would be considered attractive and would therefore attract more young people.  The purpose of this essay is to gain increased understanding of experiences of empowerment by the employees in home care. Another purpose is to see in what way the leaders in home care can encourage empowerment of their employees.  The survey was conducted as a qualitative case study in home care in Reykjavík. With semi-structured interviews six employees and three managers were interviewed and the material has been analyzed with a thematic analysis.  It turns out that the employees of home care services in Reykjavík experience to a certain degree structural empowerment in their jobs and to a higher degree psychological empowerment. The leaders, can to some extent, support the experience

Multivariable modeling was performed using data from the Nutrition Care in Canadian Hospitals Study, identifying factors independently associated with weight change, and specifically weight loss, prior to, during, and following acute hospitalization in older patients (≥65y, n=503). Male gender (OR=1.83, 95% CI 1.23-2.73) and oral nutrition supplement use (OR=2.1, 95% CI 1.31-3.36) were associated with self-reported weight loss (n=445, R2=0.06). Higher BMI (β=-0.2, p=0.001), occurrence of adverse events (β=-0.15, p=0.008), mean intake <75% of meals during admission (β=-0.19, p=0.001), and antibiotic use during admission (β=-0.11, p=0.049) were significantly associated with weight loss during admission (n=290, R2=0.14). Post hospital weight loss was associated with a poor self-reported appetite at follow-up (OR=3.82, 95% CI 2.1-6.97), eating with others never or rarely (OR=2.48, 95% CI 1.31-4.69), and having been admitted to a surgical ward (OR=1.86, 95% CI 1.03-3.35) (n=279, R2=0.16).

Bakgrund: Politiker och forskare har börjat uppmärksamma övergrepp mot äldre på äldreboende som ett globalt problem. Studier visar att övergrepp sker internationellt som nationellt. Syfte: Denna studie syftar till att uppmärksamma övergrepp av vårdpersonal mot äldre på äldreboende, att ta reda på om det finns några faktorer som bidrar till dessa övergrepp, samt att ta reda på hur detta problem kan hanteras och helst undvikas. Metod: Två fokusgrupper deltog i studien, där ena gruppen bestod av fem undersköterskor och den andra av fem vårdbiträden. Ett snöbollsurval användes för att finna de relevanta personerna. En halvstrukturerad intervjuguide användes i intervjuerna. Resultat: Nästan alla deltagare hade sett kollegor ta till övergrepp mot äldre på äldreboendet, några specifika faktorer som verkade mer bidragande till övergreppen än andra, var framför allt stress, tidsbrist samt dåligt tålamod. Vårdpersonalen ansåg att utbildningar, extra personal och att anpassa sig efter kundens önskemål var åtgärder som skulle minska övergreppen på äldreboendet. Fler och bredare studier behövs för den här typen av ämne. Att lära sig mer om faktorerna som bidrar till övergreppen, kan ett förebyggande arbete påbörjas och en minskning av övergreppen ske. / Background: Politicians and researchers have become to pay more attention to abuse against elderly in retirement home and it has become a global problem. Aim: Therefore was the aim of this study to investigate abuse against elderly by staff in retirement home and it was also to investigate if there were any possible risk factors which contributes the abuse and how to deal with it. Method: Focus group interviews was used, one group consisted of five nurses and the other by five nursing assistants. A snowball selection was used to find the relevant selection. Results: The results showed that almost all participants had witnessed abuse against elderly. It appeared that some risk factors may be more contributory to abuse than others, including stress, lack of time and poor patient. Education, more staff and adaptation to the elderly requirements would reduce the abuse. More and wider studies are relevant and needed for this type of topic. By learning more about the factors that contributes the abuse, it might reduce or learns how to work preventive against this problem.

This study deals with the pastoral counselling of elderly persons after the loss of a mature child by unnatural death. Such a traumatic event leaves a significant void in a person's life, who is already experiencing other losses, and is in the eve of their lives. With the death of a mature child, the natural order of life is turned around: the child who is supposed to live and financially and emotionally support the elderly, is no more, while they who's own passing away is imminent, are alive. Elderly parents in this position experience this situation as an existential conflict, because it is to them as if they are burying the future with their child. Because the death is one of a mature child, the elderly parent does not necessarily receive the appropriate recognition from society for the trauma they experience. To further complicate the issue is the fact that they are not usually the primary care receivers being guided along the path of mourning and acceptance - the focus, on the contrary, is usually upon the spouse and children of the deceased. In the section dealing with basis-theoretical research, it is evident that the exceptional empathy and sympathy of God for the parent who lost a child, is repeatedly stressed by Scripture. Because of Jesus Christ's victory on the cross and also His victory over death, there is the assurance of hope for eventual healing for the traumatized parent finding himself/herself in such a situation. From the section dealing with meta-theoretical research, it is evident that the death of a mature child is one of the most alarming and traumatic experiences any parent can go through. The process of mourning is however a natural reaction and differs from parent to parent, according to circumstances. Specific phases have been identified through which parents will go under these circumstances and it is therefore very important that both the pastoral counselor, as well as the parents, are aware of the pertinent aspects. In the section dealing with empirical research, use has been made of both qualitative and quantitative research methods. In the quantitative section, the results obtained from questionnaires handed to a significant number of elderly parents who have lost mature children, were processed. Thereafter, in the qualitative section of the research, in depth interviews were conducted with two sets of parents from the original group. It became evident that this process of discussion had a significant healing and therapeutic effect on parents dealing with the loss of a mature child. In the section dealing with the practice theoretical research, a model has been formulated by which pastoral counsellors and ministers can generally assist elderly parents after the death of a mature child. / Thesis (Ph.D. (Pastoral))--North-West University, Potchefstroom Campus, 2009.

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This study deals with the pastoral counselling of elderly persons after the loss of a mature child by unnatural death. Such a traumatic event leaves a significant void in a person's life, who is already experiencing other losses, and is in the eve of their lives. With the death of a mature child, the natural order of life is turned around: the child who is supposed to live and financially and emotionally support the elderly, is no more, while they who's own passing away is imminent, are alive. Elderly parents in this position experience this situation as an existential conflict, because it is to them as if they are burying the future with their child. Because the death is one of a mature child, the elderly parent does not necessarily receive the appropriate recognition from society for the trauma they experience. To further complicate the issue is the fact that they are not usually the primary care receivers being guided along the path of mourning and acceptance - the focus, on the contrary, is usually upon the spouse and children of the deceased. In the section dealing with basis-theoretical research, it is evident that the exceptional empathy and sympathy of God for the parent who lost a child, is repeatedly stressed by Scripture. Because of Jesus Christ's victory on the cross and also His victory over death, there is the assurance of hope for eventual healing for the traumatized parent finding himself/herself in such a situation. From the section dealing with meta-theoretical research, it is evident that the death of a mature child is one of the most alarming and traumatic experiences any parent can go through. The process of mourning is however a natural reaction and differs from parent to parent, according to circumstances. Specific phases have been identified through which parents will go under these circumstances and it is therefore very important that both the pastoral counselor, as well as the parents, are aware of the pertinent aspects. In the section dealing with empirical research, use has been made of both qualitative and quantitative research methods. In the quantitative section, the results obtained from questionnaires handed to a significant number of elderly parents who have lost mature children, were processed. Thereafter, in the qualitative section of the research, in depth interviews were conducted with two sets of parents from the original group. It became evident that this process of discussion had a significant healing and therapeutic effect on parents dealing with the loss of a mature child. In the section dealing with the practice theoretical research, a model has been formulated by which pastoral counsellors and ministers can generally assist elderly parents after the death of a mature child. / Thesis (Ph.D. (Pastoral))--North-West University, Potchefstroom Campus, 2009.

PURPOSE:. To determine the effects of blurring vision on whole-body center-of-mass (CM) dynamics and foot-clearance parameters in elderly individuals performing a single step up to a new level. METHODS:. Twelve healthy subjects (mean age, 72.3 +/-4.17 years) performed a single step up to a new level (heights of 73 and 146 mm). Trials were undertaken with vision optimally corrected and with vision diffusively blurred by light-scattering lenses (cataract simulation). CM and foot-clearance parameter data were assessed by analyzing data collected by a five-camera, three-dimensional (3-D) motion analysis system. RESULTS:. When vision was blurred, subjects took 11% longer to execute the stepping task (P < 0.05), mediolateral displacement of the point of application of the ground reaction force vector (i.e., weighted average of all pressures over the area in contact with the ground; the so called center of pressure, CP) decreased from 37.6% of stance width to 28.3% (P < 0.01), maximum distance between the mediolateral position of the CM and CP decreased by 9.8 mm (P < 0.01), and toe clearance (distance between tip of shoe and edge of step) increased in both the horizontal (28%) and vertical (19%) direction (P < 0.05). CONCLUSIONS:. These findings suggest that when vision was blurred, subjects used a twofold safety-driven adaptation: First, to increase dynamic stability they ensured that the horizontal position of their CM was kept close to the center of the base of support and second, they increased horizontal and vertical toe clearance while swinging their lead limb forward to reduce the risk of tripping.

Bakgrund: Delirium är ett sjukdomssyndrom som yttrar sig genom desorientering, problem med minne, perception och akut beteendeförändring. Delirium är en organisk psykisk störning och är ett övergående tillstånd som ofta drabbar äldre med en komorbiditet. Den äldre befolkningen i Sverige beräknas att öka kraftigt och eftersom att risken för delirium väntas öka med åldern finns en risk att andelen med delirium inom sjukhusvården kommer att öka. Orsaker för att utveckla delirium är multifaktoriella, några föreslagna är demenssjukdom, polyfarmaci, infektion, elektrolytiska rubbningar, hjärt- och kärlsjukdom, akut sjukdom eller trauma och miljömässiga faktorer. Syfte: Att beskriva sjuksköterskors erfarenheter av att vårda äldre patienter med delirium inom sjukhusvården. Metod: En litteraturstudie baserad på tio artiklar med kvalitativ ansats. Resultat: Tre teman framkom ur analysen: kännedom om delirium, säkerhetsåtgärder och vårdmiljö. Brister i kunskap om delirium och saknad av evidensbaserade metoder för att vårda äldre patienter med delirium förklarades. Sjuksköterskorna använde sig av mer erfaren vårdpersonal och patientens närstående som hjälp i vårdandet. En kontinuerlig övervakning var en utbredd metod för att kontrollera en äldre patient med delirium. Men vid resursbrist eller behov av ytterligare åtgärder, var användandet av begränsning för att skydda en patient med delirium vanligt förekommande. Det fanns en tvetydighet huruvida fysisk begränsning eller nyttjandet av sederande läkemedel var att föredra vid behov av att kontrollera en äldre patient med delirium. Slutsats: Studien visar ett behov av utbildning och evidensbaserade riktlinjer för att vårda äldre patienter med delirium. Klinisk betydelse: Att behoven av kunskap om delirium bland äldre uppmärksammas. / Background: Delirium is a disease syndrome that manifests through disorientation, problems with memory, perception and acute behavioural change. Delirium is an organic mental disorder and a transient condition that often affects older with a comorbidity. The elderly population of Sweden is estimated to increase considerably and since the risk of delirium is expected to alter with age there is a risk that the proportion of delirium in hospital care will increase. Reasons for developing delirium is multifactorial, some suggestions are dementia, polypharmacy, infection, electrolyte disorders, cardiovascular disease, acute illness or trauma and environmental factors. Aim: To describe nurses experiences of caring for elderly patients with delirium in hospital care. Method: A literature study based on ten articles with qualitative approach. Findings: Three themes emerged from the analysis: knowledge of delirium, safety measure and health care environment. Deficiencies in knowledge of delirium and loss of evidence-based practices to care for elderly patients with delirium were explained. The nurses used the more experienced nursing staff and the patient's family to help in the care. Continuous monitoring was a widespread method of checking up on an elderly patient with delirium. Though when there was a lack of resources or a need for further action, the use of restriction to protect a patient with delirium became common. There was an ambiguity whether physical restriction or the use of sedating drugs was preferable if necessary to check up on an elderly patient with delirium. Conclusion: The study shows a need of education and evidence-based guidelines to care for elderly patients with delirium. Clinical significance: That the needs of knowledge about delirium among elderly gets more attention.

Background: In pace with the increasingly aging population will the number of older people in nursing homes and with care in home grow. This means that the nurse will face related to the older more frequently and more widely. Nurses has overall responsibility over both the care of the elderly as a responsibility of maintaining good relationships with related parties. Related parties are of great importance for the older individual, it is therefore relevant for the nurse to be able to interact in a respectful and sensitive manner to involve the relatives in care. Aim: The aim with this study was to highlight nurse's experiences of interaction with related parties to elderly in community health care. Method: A literature review based on nine qualitative articles was conducted. Friberg design was used with the inspiration of Lundman and Hällgren Graneheim regarding the analysis of Articles. Results: The study resulted in four themes. They included information about nurse's experiences of interaction with related parties. These themes describes the importance of communication in the interaction, the attitudes various expressions, cooperation with related parties and experiences with related parties' participation in care. Conclusion: An important conclusion is that the nurse should take advantage of related parties skills and resources in health care around the elderly. The nurses sometimes has difficulties interacting with related parties. Nurses probably need to see the difficulties from different perspectives and seek help of colleagues.

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