Bakgrunden till denna c-uppsats är den utredning som resulterade i bland annat införandet av en nationell värdegrund för äldreomsorgen. Enligt denna ska äldreomsorgen bland annat vara personcentrerad. I verkligheten är den dock ofta mer uppgiftscentrerad. Genom att intervjua fem personer som har jobbat/jobbar på äldreboenden har jag undersökt vad som behövs för att äldrevården ska vara personcentrerad. Jag har fått veta vilka organisatoriska förutsättningar som finns för att vårdbiträden ska kunna ha ett personcentrerat arbetssätt samt vilka arbetsmetoder och förhållningssätt som kan göra vårdbiträdets arbete mer personcentrerat. Min teoretiska referensram har varit Nightingales omvårdnadsteori samt Orlandos teori om en reflektiv omvårdnadsprocess.     De organisatoriska förutsättningarna visade sig vara att hela arbetsgruppen strävar efter ett personcentrerat arbetssätt. I annat fall kan det vara svårt för det enskilda vårdbiträdet att göra det. Att chefen inte är motsträvig till ett sådant sätt att arbeta är även det en faktor som kan påverka hur personcentrerad vårdbiträdenas arbete är, men chefens åsikter verkar inte påverka lika mycket som kollegornas åsikter och arbetssätt. En tillräcklig personaltäthet är även det viktigt. När det gäller arbetsmetoder eller arbetssätt som främjar en personcentrerad äldrevård, kom jag fram till att ett mer flexibelt till skillnad från ett mer rutinfast arbetssätt är främjande. Att ha som rutin att varje vårdbiträde läser varje vårdtagares nedskrivna ”livshistoria” är en annan arbetsmetod som gör det lättare att personcentrera vården till varje individ. Ytterligare sätt är att använda sig av de nationella riktlinjerna som ett verktyg i sitt arbete, att man lär av varandra samt reflekterar över sitt eget arbetssätt och att man utnyttjar erbjuden extern hjälp. Attityder och förhållningssätt hos personalen, som kan främja en personcentrerad äldreomsorg visade sig vara att fokusera på människan bakom arbetsuppgiften och att prioritera vårdtagarens behov och önskningar före ens egna. Ett annat förhållningssätt som främjar en personcentrerad vård är att vårdbiträdet ser äldreboendet som vårdtagarens hem, inte enbart som sin arbetsplats.

<p>A publicly funded elderly care that is widely available at people’s homes has been described as unique for the Nordic countries. There is much research that focuses on the relationship between caregivers and <em>care receivers</em>, and also about how work is organized in these organizations. However, research into how care work is organized in organizations that have implemented a salutogenic approach is limited. This is a qualitative study aimed to <em>examine how caregivers feel that the organization of work in elderly care change after implementation of salutogenic elements in their daily work.</em> The study conducted six semi-structured interviews with caregivers that have experienced different ways of organizing care work. Study shows that the organization of care work has gone from a Tayloristic, task-oriented and routinized work towards a salutogenic, person-oriented and personalized approach. The study also shows that dilemmas may arise in the new way to organize care work when caregivers and <em>care receivers</em> values and opinions differ. Caregivers then orient between sins of omission and abuse.</p>

A publicly funded elderly care that is widely available at people’s homes has been described as unique for the Nordic countries. There is much research that focuses on the relationship between caregivers and care receivers, and also about how work is organized in these organizations. However, research into how care work is organized in organizations that have implemented a salutogenic approach is limited. This is a qualitative study aimed to examine how caregivers feel that the organization of work in elderly care change after implementation of salutogenic elements in their daily work. The study conducted six semi-structured interviews with caregivers that have experienced different ways of organizing care work. Study shows that the organization of care work has gone from a Tayloristic, task-oriented and routinized work towards a salutogenic, person-oriented and personalized approach. The study also shows that dilemmas may arise in the new way to organize care work when caregivers and care receivers values and opinions differ. Caregivers then orient between sins of omission and abuse.

Det övergripande syftet med studien har varit att skildra hur personal på fyra kommunala äldreboenden definierat begreppet värdegrund samt hur de tillämpat den i det praktiska arbetet med de äldre. I studien har begreppen KASAM, Empowerment samt en problematisering av värdegrundskomponenterna använts för att analysera resultaten av interjuverna. Resultat av studien visade på att det finns en enighet bland personalen i hur man definierar värdegrundskomponenter. De gav dock samtidigt uttryck för komplexiteten i att komponenterna kan ha flera betydelser, vara nära besläktade och i vissa fall motsägelsefulla. Personalen såg på begreppen som mål för sitt arbete och menade på att uppfyllelse av målen genererar en bättre hälsa och välbefinnande för den äldre. I tillämpning av värdegrundskomponenterna talade personalen om främst två sätt de arbetade utifrån, motivering och aktivering. Motivering innebar att utifrån de boendes eget självbestämmande ska personalen uppmuntra dem till självständighet. Aktivering i sin tur hängde i hop med motivering och innebar att den boende har kontakt med sina anhöriga och sin omgivning likväl som ett deltagande i aktiviteter som personalen försåg de boende med efter deras önskemål. / The pupose of this bachelor´s thesis have been to depict how staff from four diffrent municipal nursing homes define the concept of value base and how they apply this in their practical work with the elderly. In the study the scentific concepts KASAM and Lee´s definition of Empowerment in addition to a problematisation of the value base components have been used to analyze our qualitative interviews. The results of study showed that there is a consensus among the staffon how to define the value base components. At the same time they gave, however, expression of a complexity in the components and the fact that they may be closely related and in some case contradictive. The staff saw the components as a goal for their work and said that achieving these goals generated a better health and well-being of the elderly. In applying the value base staff talked about two main ways they worked on. These were motivation and activation. The reasoning was that by the residents own self-determination the staff should encourage them to independence. Activiation in turn was related to the staff motivating the elderly. This meant that the residents have contact with their families, their enviornment as well as participation in activities that staff provided the residents based on the elderlys own wishes.

Organisatoriska, ekonomiska och individuella faktorer har betydelse för huruvida omsorgspersonalen har intentioner till att lämna sin arbetsplats eller faktiskt sluta på arbetsplatsen. Syftet med studien var att finna faktorer som påverkar omsorgspersonal att stanna eller lämna sin arbetsplats, samt hur vårdyrket inom äldreomsorgen kan göras mer attraktivt. Sexton kvinnor inom äldreomsorgen i Mellansverige intervjuades. Systematiska jämförelser mellan dem som hade för avsikt att stanna och dem som hade för avsikt att sluta på sin arbetsplats utfördes, även en eftersökning av faktorer som kunde göra yrket mer attraktivt genomfördes. Faktorer som att utvecklas var avgörande för de som hade för avsikt att lämna och kollegorna samt ett omväxlande arbete var viktigt för de som hade för avsikt att stanna. Medias negativa skildring av äldreomsorgen samt lönen rapporterades påverka vårdyrkets attraktionskraft. Framtida undersökningar bör fokusera på hur media påverkar möjligheten att attrahera ny personal inom vårdyrken.

Diss. Linköping : Univ., 2004.

Care manager are using different methods to investigate the needs of the elderly. There is a lot of challenges and opportunities with the work as a care manager during crises. This study has deepened into the process to managing eldery care and illuminates its challenges and opportunities during the covid-19 pandemic. The process to managing elderly care is based on meetings with the individual for investigate the needs of the elderly. The results show that the assessment process of the needs of the elderly has had to go through some challenges. The challenges has been about not being able to carry out physical visits at the meeting with the individual, which has led to difficulties in obtaining information for assessment. Furthermore, there were some challenges for many older people who was choosing to withdraw their help from various actors in order to minimize the risks of becoming infected of the virus. This entailed difficulties for the care manager to be able to motivate elderly to receive help, in order to meet the needs of the elderly. Despite its challenges, the covid-19 crisis has also brought opportunities to care managers. The Covid-19 pandemic has provided the opportunity to work home with digital tools and to conduct meetings with the indivdiual by telephone, which has leads to effectivity in their work with investigating the needs of the elderly.

The Swedish Agency for Higher Education evaluated in 2007 the nursing programs at Swedish Universities, and confirmed that several programs lacked definition of the main subject of the discipline;- namely caring- and/or nursing. The caring science disciplines showed indications of increasing signs of fragmentation, in that sub-disciplines were evolving. There is a unique foundation of theoretical knowledge that is specific for the caring professions grounded in caring theory and philosophy. For some reason the theoretical foundation and contexture of providing care seems to fade off with time in clinical practice, as well as an explicated theory-practice gap; that theory does not go along with clinical practice. An assumption in this thesis is that caring theory somehow seems to evaporate; as nurses become clinically active- caring theory does not seem to be much reflected upon.The overall aim was to investigate into the meaning of caring to nurses in municipal elderly care, and into their explicit and implicit understanding of caring theory in their daily practice.The theoretical perspective was caring science, while the epistemological frame was of a phenomenological hermeneutical life world approach. Data was gathered by interviews with nurses working in elderly care and analyzed to grasp the structure of the phenomenon of caring in theory and practice. The thesis comprises four studies of which three empirical was consolidated with a Jean Watson’s specific caring theory, ending up in a better understanding of the approach of caring in nursing and the role of theory in practice. The findings of the studies show that the lived experience of caring as narrated by the participating nurses comprises both implicit and explicit theoretical foundation to existential caring theory. The explicit use of theory or certain theoretical affiliation was not obvious; rather what may be theoretical inputs was expressed as the importance of being present and the necessity of having a health perspective in caring. By illuminating caring and concepts from caring theory, the meaning of caring in their professional lived experience, the primary intention or choice of working as nurses became apparent again. There seems to be different perspectives related to caring theory, but as the empirical findings shows, there is a consensus behind what caring is, both in theory and in practice. As a result from the analysis the aim of caring itself may be more salient and focused if based on existential phenomenological caring concepts and theory, as this corresponds with the nurses understanding of holistic intentional caring with a health perspective. A gap exists, but is more related to organizational restrictions such as role constraints and time pressure than to the meaning of caring in theory and practice. Mediating care is a concept that embraces the implications of all the outcome concepts of the analysis and it has the possibility of being the expression of immanent and transcendent dimensions in caring. Mediating care represents the expression of our understanding of life, our values and norms. It is given expression through the insights into, and the ways we connect to one another, our ability as carers (nurses) to reach out to another in his or her being, as well the understanding of ones own being in caring. Theoretical and practical reflection and cultivation of clinical sensibility has the opportunity of inspiring for an expanded caring consciousness, manifested in the mediation of care.

Syftet med studien var att undersöka hur enhetschefer i kommunal äldreomsorg hanterar sjukskrivningar bland omsorgspersonal. I studien användes en kvalitativ metod och sammanlagt genomfördes fem intervjuer med yrkesverksamma enhetschefer inom kommunal äldreomsorg. Vi har inspirerats av kritisk teori som analysmetod. Den teoretiska referensramen i studien är handlingsutrymme, handlingsfrihet och klämsits. Studiens resultat visar att sjukskrivningar bland omsorgsarbetare enligt enhetscheferna är ett omfattande problem. Resultatet visar att enhetschefer själva är ett viktigt verktyg i hanteringen av sjukskrivningar. Samtliga enhetschefer är medvetna om den ram som styr deras handlingsutrymme i form av lagar, regler och organisatoriska förutsättningar, men resultatet visar att de hanterar sjukskrivningar på olika sätt. Hur man skall hantera sjukskrivningar är upp till varje enskild enhetschef att avgöra och det kan ibland vara svårt att parera de olika förväntningar som de har på sig själva och sitt uppdrag. Enhetscheferna beskriver bristande stödfunktioner som en orsak till att det blir svårt och menar att de tvingas utveckla egna strategier för att kompensera för dessa. Resultatet visar också att det finns bristande resurser, både i form av tid och av pengar för att kunna möta de juridiska skyldigheter som enhetscheferna har i sitt arbetsgivaransvar. / The purpose of this study was to examine how first line managers in municipal elderly care manage sick leave among care workers. The study uses a qualitative method and five interviews were performed with first line manager professionals in municipal elderly care. We have been inspired by critical theory when analyze the result. The theoretical framework is space of action, freedom of action and conflict of interest. The result of the study shows that according to first line managers sick leave among care workers is an extensive problem. The result shows that first line managers themselves are an important tool while managing sick leave. They are all aware of the framework that controls their space of action and the framework consists of laws, rules and organizational conditions. The result shows that first line managers manage sick leave in different ways. How to manage sick leave is up to each and every one of them and it can sometimes be difficult to parry the different expectations they have on themselves and on their mission. First line managers describe lack of support functions as a reason why it can be difficult and they say that they are forced to develop their own strategies to compensate for these. The result also shows that there is a lack of resources, in both time and money to meet the legal obligations that first line managers have by their employer's' responsibility.

The aim of this study was to understand how assistant nurses in the care of elderly experiences partial shifts. It was based on six different semi-structured interviews with assistant nurses in the elderly care and then analyzed. It is a qualitative research of subjective thoughts and experiences from assistant nurses. The study shows that the assistant nurses experienced dissatisfaction with the work environment due partial shifts and low fact of influence on the schedule. The assistant nurses complained of deficiencies in care of the elderly, which ought to be correlated with the structure of partial shifts and the lack of energy and patience that brings with it. On the other hand some participants could find positive aspects of partial shifts regarding time to rest and be there for the caretakers. The impact of the private life was palpable, and despite some aspects to have time to rest, the work-life balance was hard to fulfill and all assistant nurses with schedules containing partial shifts on the weekdays wanted a schedule without it.