The aging Canadian population is becoming increasingly ethno-culturally diverse primarily due to immigration. This, together with research indicating increased likelihood of long-term residential care (LTRC) use at older ages and challenges in providing these services, prompt important questions about whether LTRC services are prepared to provide culturally responsive and competent care to immigrant and ethno-cultural minority older adults (EMOA). This ethnographic study, informed by a critical theoretical perspective, explored these questions from the perspectives of South Asian older adults (SAOAs) and their family caregivers (FCGs). In-depth interviews with 18 SAOAs in LTRC, assisted living and those at home, their FCGs, and seven key informants from LTRC and the South Asian (SA) community (n=43) were undertaken. These interviews, in addition to 220 hours of participant observation in two LTRC facilities, provided information regarding the needs, preferences, experiences and situation of SAOAs in LTRC as well as how SA families make decisions regarding the use of such services. A select review of provincial policy, residential care regulation, health authority and facility documents, exposed taken-for-granted assumptions in how care and services are provided and the sociopolitical context of LTRC provision. Study findings suggest that LTRC services are challenged to meet the needs of immigrant and EMOA and reflect unequal and inequitable care, illuminated by the differential impact of macro-policies and resource-constrained LTRC environments on SAOAs and their families and on the ability of existing LTRC services to provide person-centred care. This inequity in service provision has implications for immigrant and EMOA and their family members in light of findings that the decision to move to LTRC is essentially a (non) decision influenced by a range of social structural factors that interact to necessitate the move to LTRC. Study findings revealed the salience of socio-economic status and economic resources in particular, in the (non) decision for LTRC placement. The findings from this study along with demographic shifts in the aging Canadian population call for LTRC service providers and policy makers to actively prepare for increasing ethno-culturally diverse resident populations and point to the need for equity informed approaches to the care of older adults. / Graduate / 2022-03-31

Bakgrund: Oro och ångest är vanligt förekommande hos äldre personer på särskilda boenden. Psykofarmaka är en vanlig behandling vid oro och ångest hos äldre personer och behandlingen kan leda till negativa effekter.  Syfte: Syftet med studien var att undersöka sjuksköterskors erfarenheter av att använda omvårdnadsåtgärder vid oro och ångest i vårdandet av äldre personer på särskilda boenden.  Metod: Kvalitativ intervjustudie med induktiv ansats. Intervjuer med åtta sjuksköterskor som arbetade på särskilda boenden genomfördes. Intervjuerna utgick från en semistrukturerad frågeguide. Materialet bearbetades genom kvalitativ innehållsanalys.   Resultat: Analysen resulterade i fyra huvudkategorier; Sammanhang som ökar oro och ångest, arbetssätt för att minska oro och ångest, omvårdnadsåtgärder vid oro och ångest samt utmaningar förknippade med att tillämpa omvårdnadsåtgärder.  Slutsats: Studien visade att sjuksköterskor önskade använda omvårdnadsåtgärder vid oro och ångest i större utsträckning än vad som gjordes, men deras erfarenhet visade på flera faktorer som försvårade tillämpandet av omvårdnadsåtgärder. Samtliga sjuksköterskor var positiva till att använda omvårdnadsåtgärder vid oro och ångest hos äldre personer då de erfor att det var det bästa förstahandsalternativet vid behandling av oro och ångest hos äldre personer. Samtal och ett bra bemötande var några av de mest effektiva omvårdnadsåtgärderna.  Nyckelord: omvårdnadsåtgärder, oro, personcentrerat förhållningssätt, sjuksköterska, särskilda boenden, ångest, äldre personer / Title: “When you avoid medicine the elderly feel much better”.  Subtitle: A qualitative interview study on nurses' experiences of nursing interventions in the care for anxiety at nursing homes.  Background: Anxiety are common in elderly people at nursing homes. Psychotropic drugs are a common treatment for anxiety in the elderly and the treatment can lead to negative effects.  Aim: The aim of this study was to investigate nurses' experience of using nursing interventions in the care for anxiety in elderly people at nursing homes.   Method: Qualitative interviews with an inductive approach. It was conducted through eight interviews by nurses who were working at nursing homes. The interviews were carried out by using a semi-structured questionnaire. The data was then processed by qualitative content analysis.  Results: The analysis of the study resulted in four main categories; contexts that increase anxiety, way of working to reduce anxiety, nursing interventions for anxiety, challenges associated with applying nursing interventions.  Conclusion: The study demonstrated that nurses want to use nursing interventions at anxiety conditions in higher frequency than they currently do. However, their experiences displayed several factors that complicates the development to start using nursing interventions. In summary, all of the nurses were positive to use nursing interventions to address anxiety in elderly people, this because their experience were that this was the best first option in the treatment of anxiety in elderly people.  Keywords: anxiety, elderly people, nurse, nursing homes, nursing interventions, person-centered approach

Coronakommissionen drog 2020 slutsatsen att strukturella samt organisatoriska brister förekommer inom särskilda boenden (Coronakommissionen, 2020). WHO:s (2017) studier inom hälso- och sjukvården visar att misstag ofta beror på bristfälliga system, processer och arbetsförfaranden. Systematiskt förbättringsarbete genomförs inom vård- och omsorg genom avvikelsehantering, egenkontroll och riskanalys med syftet att förbättra verksamhetens kvalitet (Socialstyrelsen, 2012). Studiens syfte var att belysa hur covid-19 påverkat avvikelsehanteringen inom kommunala särskilda boenden samt lyfta hur lärdomar dragits av framgångar och utmaningar kring avvikelsehanteringen och vidare systematiskt förbättringsarbete under pandemin. En kvalitativ studie med semistrukturerade intervjuer genomfördes med undersköterskor och enhetschefer för att fånga faktorer som bidragit till framgång samt utmaningar i pandemin, statistik- och dokumentgranskning utfördes. Empiriska data analyserades genom tematisk analys samt kopplades till teoretisk referensram. Slutsatsen synliggör hur systematiskt förbättringsarbete grundad på inrapporterade avvikelser möjliggörs genom kommunikation i team- att vara en lärande organisation, tydliga rutiner/arbetssätt, tillåtande klimat på arbetsplatsen och tydligt ledarskap. / The corona commission 2020 concluded a prevalence of structural and organisational flaws within nursing homes (Coronakommissionen, 2020). Studies from WHO (2017) within healthcare shows that mistakes often were caused by flawed systems, processes and working procedures. Systematic improvement within healthcare is accomplished by deviation reporting, independent control measures and risk analysis with the goal of quality improvement within the operation (Socialstyrelsen, 2012).  The cause of the study was to illuminate the impact of covid-19 regarding the handlement of deviation reports within municipal nursing homes and to bring forth the lessons learnt through success and challenges regarding handlement of deviation reports and further systematic improvements during the pandemic. A qualitative study with semistructural interviews was conducted with assistant nurses and head of departments to gather factors contributing to success and challenges. Empiric data was analysed through thematic analysis and then attached to a theoretical framework. The conclusion illuminates how systemic improvement based on reported deviations are made possible through communication in a team- to be a learning organisation, explicit routines, accepting environment at the workplace and a thorough leadership. / <p>2021-06-06</p>

The purpose of this qualitative study was to investigate the experience and knowledge from the implementation of animal-assisted therapy as a health-promoting method in nursing homes. This study used a qualitative method with an inductive approach. To collect data, four semi-structured interviews were conducted. The respondents of this study were selected by a meaningful sampling method. The inclusion criteria were that the nursing homes currently used or had used therapeutic animals. The collected data was analyzed with a content analysis. The results were presented in continues text with quotes from the respondents to validate the findings. The main findings of the study displayed that the reasoning behind the respondent’s willingness to implement animal-assisted therapy in nursing homes was that they had previous positive experience with the effects of therapeutic animals. The respondents highlighted that they experienced that the implementation of therapeutic animals was met with few difficulties.  The conclusion of the study was that nursing homes were dependent on receiving therapeutic animals in form of donations to implement them. Lack of funding may be an underlying factor why therapeutic animals have not been implemented to a greater extent in other nursing homes, despite the health-promoting effects previous studies show. / Syftet med denna kvalitativa studie var att undersöka upplevelser och erfarenheter av implementering av terapidjur som en hälsofrämjande metod på äldreboenden. En kvalitativ metod med en induktiv ansats användes för studien. För att samla in data genomfördes fyra individuella semistrukturerade intervjuer. Urvalet av respondenter till studien gjordes genom ett meningsfullt urval. Inklusionskriteriet för urvalet var att respondenterna hade använt eller använde sig av terapidjur på äldreboendet. För att analysera data genomfördes en innehållsanalys där ett kodningsschema tillämpades. I innehållsanalysen identifierades sex kategorier vilka formades utifrån respondenternas svar. Resultatet presenterades i flytande text med stärkande citat från respondenterna. Resultatet visade att respondenterna hade erfarenheter av en variation av terapidjur; mjukis- och robotdjur, terapihundar, höns, marsvin, kaniner, häst och orm. Huvudresultatet för studien visade att bakgrunden till respondenternas vilja att implementera terapidjur på äldreboenden var att de erhöll kunskap och erfarenheter av de effekter som terapidjur kan ge. Att det ansågs som att något saknades på äldreboenden när det inte fanns terapidjur samt att det bedömdes vara ett behov hos de boende. Möjligheterna för att implementera terapidjur var tack vare bidragande ekonomiska resurser. I sin helhet upplevdes få svårigheter av respondenterna om att implementera terapidjur. Slutsatsen för studien var att äldreboendena var i stor utsträckning beroende av att få terapidjur i form av bidrag för att implementera dem. Brist på bidrag kan vara en bakomliggande faktor till att terapidjur inte har implementerats i större utsträckning på andra äldreboenden, trots de hälsofrämjande effekterna tidigare forskning visar. Denna studie belyser de fördelar som kan upplevas i samband med terapidjur och hur en implementering av terapidjur kan antas. I takt med en ökad livslängd bland befolkningen finns det ett behov av ytterligare hälsofrämjande metoder, där terapidjur är en väl anpassad hälsofrämjande metod för äldres hälsa och ett hälsosamt åldrande.

ABSTRACT  Background: During the past years the authorities and the dental care in the world have begun to realize the importance of maintaining a good oral health of the seniors. The care staff at special residences have an essential role in the daily oral care of the elderly. The oral state of health is also important for the rest of the health. Studies show that oral care is deficient in the elderly and needs to be highlighted as the elderly population is expected to increase.   Aim: The aim of this literature review is to evaluate the potential improvement regarding the staff's work with oral care in elderly care.  Methods: Literature study search was performed with MeSh terms in the database PubMed and Scopus. The following keywords have searched:Dental care for aged, Education, Nursing homes, Nursing staff, Oral health, Oral care.    Results: Several studies have found improvements that are beginning to emerge to develop the oral care of the elderly. These improvements can be achieved by a convenient oral care training that is designed for the elderly. The training programs for the care staff working with the elderly positively affects their attitudes, routines and documentation of the patient’s information, which benefits the elderly oral health.    Conclusion:To achieve good oral care for the elderly, several improvements are needed to be done by the governments involving nursing and working staff´s routines. A little different has been done, but there is significant work still to be done to improve the elderly dental health.

No description available.

Bakgrund När coronaviruset spred sig runt om i världen var det särskilt äldre personer som ansågs vara i riskgrupp för att bli allvarligt sjuka av viruset. Smittskyddsåtgärder infördes på särskilda boenden där äldre personer behövde begränsa sina sociala kontakter, aktiviteter ställdes in och besöksförbud genomfördes. Att begränsa sociala relationer och inte ha kontakt med anhöriga leder till social isolering. Syfte Syftet med denna litteraturöversikt var att beskriva äldre personers psykiska upplevelser av att vara socialt isolerade på särskilda boenden under covid-19 pandemin. Metod Studien genomfördes som en strukturerad litteraturöversikt. Artiklarna hämtades i databaserna CINAHL och PubMed och resultatet är baserat på 12 originalartiklar publicerade mellan år 2020–2023. Resultat I resultatet framkommer två huvudkategorier: Negativa känslor till följd av isoleringen och Bevarad psykisk hälsa vid isolering. Social isolering på särskilda boenden genererade i känslor av frustration och maktlöshet när de äldre inte blev lyssnade på eller fick sina känslor bekräftade. Brist på kontakt med familj och vänner samt att inte längre ges möjlighet att delta i gemensamma aktiviteter skapade känslor av ensamhet. När smittspridningen ökade skapades rädslor över att tvingas bli isolerade igen och riskera att dö ensamma. Sjuksköterskan närvaro och stöd gav en trygghet för de äldre. Slutsats Litteraturöversikten visade att flera av äldre personer som bodde på särskilda boenden upplevde negativa känslor till följd av isoleringen på grund av en förändrad vardag. Vid förändrade livssituationer ställs krav på sjuksköterskan att uppmärksamma de äldres psykiska hälsa samt att se och bekräfta deras känslor / Background When the coronavirus spread around the world was it especially older people who were considered to be at risk of becoming seriously ill from the virus. Infection prevention measures were introduced in nursing homes where elderly people needed to limit their social contacts, activities were canceled and visitor bans were implemented. Limiting social relationships and not having contact with relatives leads to social isolation. Aim The aim of this literature review was to describe older people's psychological experiences of being socially isolated in nursing homes during the covid-19 pandemic. Method The study was conducted as a structured literature review. The articles were retrieved from the CINAHL and PubMed databases and the results are based on 12 original articles published between 2020-2023. Results The results show two main categories: Negative feelings as a result of the isolation and Preserved mental health during isolation. Social isolation in nursing homes generated feelings of frustration and powerlessness when the elderly was not listened to or didn’t get their feelings validated. Lack of contact with family and friends and to no longer be given the opporunity to participate in social activities created feelings of loneliness for the elderly. As the spread of infection increased, fears were created of being forced to become isolated again and risking dying alone. The nurse's presence and support provided safety for the elderly. Conclusions The literature review showed that several of older people who lived in nursing homes experienced negative feelings as a result of the isolation due to a changed everyday life. In the case of changed life situations, demands are placed on the nurse to pay attention to the mental health of the elderly and to see and confirm their feelings.

This bachelor's thesis explores the integration of digital technology in elderly care, specifically nursing homes, within a medium-sized municipality in Sweden. The aging global population presents significant challenges, notably in elderly care where digital technologies are increasingly being utilized to enhance residents' quality of life and streamline operations. This qualitative study employed semi-structured interviews with municipal employees to examine how digital technologies are utilized, the attitudes of decision-makers towards these technologies, and the challenges and opportunities associated with their implementation. Findings indicate that digital technologies can potentially improve mental health, social interactions, and the overall well-being of elderly residents. However, the study also identifies significant barriers, including insufficient training of staff, procurement issues, and the lack of robust infrastructure, which hinder effective implementation. The results underscore the need for strategic planning and further research to effectively integrate digital solutions in elderly care settings, aligning technological advancements with the practical needs and capabilities of the elderly population.

Bakgrund: Personcentrerad vård är en förutsättning för att omvårdnad ska bedrivas utifrån den enskilde patientens önskemål och för att patienten ska ses som en helhet och inte som en sjukdom. Sjuksköterskor på SÄrskilt BOende för äldre (SÄBO) har en viktig funktion i att leda omvårdnadsteamet för att nå gemensamma mål och utveckla det personcentrerade förhållningssättet. Syfte:  Att beskriva sjuksköterskors erfarenheter av att bedriva personcentrerad vård på SÄBO utifrån McCance och McCormacks (2021) ramverk för personcentrerad vård.  Metod: Genom semistrukturerade intervjuer samlades data in från tio sjuksköterskor på SÄBO. Datan analyserades genom riktad kvalitativ innehållsanalys med en deduktiv ansats med utgångspunkt i McCances och McCormack ramverk för personcentrerad vård.  Resultat: Resultatet är framställt i kategorierna: Förutsättningar, vårdmiljö, personcentrerade processer och personcentrerade resultat.  Sjuksköterskorna hade liknande uppfattning om vad personcentrerad vård innebär på SÄBO och att det handlar om att individanpassa vården utifrån varje patient man möter. Den personcentrerade vården påverkas av olika faktorer så som omvårdnadspersonalens attityder, tid- och personalbrist samt sjuksköterskans ledarskap.    Slutsats: Personcentrerad vård är ett komplext begrepp och det är svårt att tydligt beskriva vad som krävs för att personcentrerad vård ska vara möjlig på alla plan. Sjuksköterskor på SÄBO behöver stötta, motivera och skapa möjlighet för reflektion för att medvetandegöra det personcentrerade förhållningssättet. Vidare behövs organisatoriska resurser för att kunna införa en mer personcentrerad vård. / Background: With the increasing aging population, it is of great importance that person-centered care is implemented within nursing homes for older people. Person-centered care is a prerequisite for nursing care to be carried out based on the wishes of the individual patient and for the patient to be seen as a whole and not as a disease. Nurses at nursing homes have an important function in leading the nursing team to reach common goals and develop the person-centered relationship approach. Aim: To describe nurses' experiences of providing person-centered care at nursing homes based on McCance and McCormack’s (2021) framework for person-centered care.   Method: Through semi-structured interviews, data was collected from ten nurses working at nursing homes. Data were analyzed through targeted qualitative content analysis with a deductive approach based on McCance and McCormack’s framework for person-centered care.  Results: The results are presented in the categories: Prerequisites, care environment, person-centred processes and person-centred results. The nurses had a similar idea of ​​what person-centered care means at nursing homes and that it´s about customizing care based on each patient. Person-centered care is affected by various factors such as the nursing staff's attitudes, time, and staff shortages as well as the nurse´s leadership. Conclusion: Person-centered care is a complex concept, and it is difficult to clearly describe what is required for person-centered care to be possible on all levels. Nurses at nursing homes need to support, motivate and create opportunities for reflection in order to raise awareness of the person-centered approach. Furthermore, organizational resources are needed to be able to introduce a more person-centered care.

No / AIMS: The aims of this study were to determine the recording of drug sensitivities of elderly care home residents, to describe the nature of sensitivities and to identify and describe discrepancies in the documentation of drug sensitivity status in general practices, pharmacies and care homes. METHODS: A random sample of residents within a purposive sample of care homes (nursing and residential) was selected. A clinical pharmacist inspected the GP medical record, the medicines administration record, and the care home record for each resident to identify drug sensitivities and discrepancies between records and to describe the nature of the recorded sensitivities. RESULTS: The records of 121 residents in 31 care homes were studied. Thirty-one (26%) residents had at least one documented drug sensitivity in one of the sources inspected, with 48 sensitivities in total recorded. There was no description of the nature of the sensitivities recorded in 39/48 (81%) cases. The number of sensitivities recorded on the medicines administration record, care home record and the GP record were 3 (6%), 29 (60%) and 35 (73%), respectively. Only two sensitivities were simultaneously recorded on all three records. CONCLUSIONS: It was of concern that over 90% of drug sensitivities were not recorded on the medicines administration record which is the final checking document when administering medication. The reason for this was that the dispensing pharmacy was responsible for generating the medicines administration record; however, drug sensitivity status is seldom shared between the GP and the dispensing pharmacy. Printing sensitivities on prescriptions would help to resolve this.