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Syfte: Syftet med litteraturöversikten var att beskriva arbetsterapeuters erfarenheter av reablement som tillvägagångsätt i vardagsrehabiliteringen hos hemmaboende äldre personer. Metod: En allmän litteraturöversikt av kvalitativa studier valdes som design för att sammanställa den tidigare forskningen som besvarade studiens syfte. Datainsamling skedde från två databaser inom medicin och hälsa. Data från tio kvalitativa artiklar sammanställdes och analyserades utifrån en kvalitativ innehållsanalys. Resultat: Analysen resulterade i fem kategorier; att kartlägga, bedöma och strävan efter att sätta upp aktivitetsfokuserade mål, att stödja den äldre personen till självständighet och delaktighet i meningsfulla aktiviteter, att följa upp och att motivera till en fortsatt rehabilitering, att samarbeta i ett interdisciplinärt team och att samarbeta med anhöriga samt ett övergripande tema; betydelsen av ett personcentrerat förhållningssätt och att ha en samsyn. Slutsats: Essensen med reablement var att i ett interdisciplinärt samarbete stödja de äldre personernas självständighet och delaktighet i de dagliga aktiviteterna. Arbetsterapeuterna hade en grundläggande roll med att förverkliga ett personcentrerat förhållningsätt och en samsyn i det interdisciplinära teamet inklusive den äldre personen och anhöriga. Enligt arbetsterapeuterna förutsatteförverkligandet en gemensam målsättning, ett välorganiserat interdisciplinärt samarbete med avsatta resurser under en begränsad tid och goda kommunikationsstrategier. / Purpose: The purpose of the literature review was to describe occupational therapists’ experiences of reablement as an approach in everyday rehabilitation of home-dwelling older adults. Method: A general literature review of qualitative studies was chosen as a design to compile the previous research that answered the purpose of the study. Data collection took place from two databases in medicine and health. Data from ten qualitative articles were compiled and was analyzed with a qualitative content analysis. Results: The analysis resulted in five categories; to map, assess and strive to set activity-focused goals, to support the olderperson to independence and participation in meaningful activities, to follow up and motivate to a continued rehabilitation, to collaborate in an interdisciplinary team and to collaborate with relatives and an overarching theme; the importance of a person-centred approach andhaving a consensus. Conclusion: The essence of reablement was to support the older people’sindependence and participation in daily activities in an interdisciplinary collaboration. The occupational therapists had a fundamental role in realizing a person-centered approach and a consensus in the interdiciplinary team including the older person and relatives. According to the occupational therapists, the realization required a common goal, a well-organized interdisciplinary collaboration with allocated resources for a limited time and good communication strategies.

This sequential study explores the perceptions of older adults and careworkers in Sweden regarding the benefits and challenges of smart vacuumcleaners. With a rapidly ageing population, understanding attitudes towardsthe use of such technology becomes essential. A mixed-methods approach,including questionnaires and semi-structured interviews, was used to gatherdata and provide a detailed understanding of the perceived benefits andchallenges associated with these devices. Findings suggest that older adultsperceive smart vacuum cleaners as beneficial in reducing cleaning assistancedependence and enhancing life quality. Concerns centred around affordabilityand fear for social isolation. Care workers saw potential for time-saving,leading to improved care. Despite some reservations, both groups recognizedthe potential benefits of smart vacuum cleaners. The study suggests the needfor larger, longitudinal studies to further explore these perspectives anddetermine the potential of smart vacuum cleaners in supporting ageing inplace.

Bakgrund: Depression och nedstämdhet är idag en våra största folksjukdomar tillsammans med hjärt- och kärlsjukdomar. Nästan ent redjedel av befolkningen kommer någon gång under sin livstid lida av en depressiv episod och stor del av dessa personer tillhör den äldre befolkningen. Samtidigt är avsaknaden av kunskap inom området störst bland denna åldersgrupp. Personcentrerat förhållningssätt med vård anpassat för personen kan leda till snabbare hjälp för personer med depression eller nedstämdhet.  Syfte: syftet var att utforska sjuksköterskors erfarnehet av att möta äldre personer med deprresion och nedstämdhet i primärvården.  Metod: Litteraturöversikt med kvalitativa artiklar med induktiv ansats. Sökning skedde i databaserna CINAHL och PUBMED och resulterade i 11 vetenskapliga artiklar om ämnet. Analysen genomfördes enligt Fribergs fem steg.  Resultat: Bristande kunskap om äldre med depression och en osäkerhet i sin yrkesroll var en bidragande faktor till att äldre personer inte fick tillräcklig vård för att moverka depression. Resultatet visa att sjuksköterskors bemötande,kommuniktion med äldre personer samt betydelsen av interventioner spelade en stor roll i att motverka det.  Slutsats: Det fanns flertalet utmaningar för sjuksköterskan i att identifiera depression och nedstämdhet och det är betydelsefullt att bemöta dessa patienter på rätt sätt, att avsätta tid för samtal där sjuksköterskan ska vara lyhörd och bekräftande. / Background: Depression and melancholy are together with cardiovascular diseases the most widespread illnesses today. One third of the population will at some point experience a depressive symptom and a large proportion of these individuals belong to the elderly population. Simultaneously, the lack of knowledge in the area is paramount among this group. A person-centered approach with care adjusted for everyone can ensure that help reaches individuals with depression or melancholy quicker. Aim: The aim was to explore nurses’ experience of meeting older adults with depression and low mod in primary care. Method: Literature review of qualitative articles with an inductive approach. A search was made in CINAHL and PUBMED and resulted in 11 scientific articles on the subject. The analysis was carried out according to Friberg’s five steps. Result: A lack of knowledge about older people with depression and an uncertainty in their professional role was a contributing factor to older people not receiving sufficient care to counteract depression. The results showed that nurses' treatment, communication with the elderly person and the importance of interventions played a big role in counteracting it. The results showed that nurses' treatment, communication with the elderly person and the importance of interventions played a big role in counteracting it. Conclusion: The challenges nurses face in identifying depression show that it's important to respond to these individuals and set aside time for conversations where the nurse must be responsive and confirmatory.

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Purpose/Hypothesis: Falls in the older adult population are the leading cause of fatal and non-fatal injuries in America. Polypharmacy, the use of multiple medications, has been identified as a major risk factor for falls in older adults. A variety of medication screens exist that identify adverse effects of medications which can directly impact fall risk; however, current screening measures have limitations. The Quantitative Drug Index (QDI) is a new, clinically anchored index to quantify all potential adverse effects associated with drug-mediated fall risk. The purpose of this study was to validate the QDI as a fall risk screening tool. Number of Subjects: 138 adults were recruited from local senior centers and screened. Inclusion criteria: community-dwelling, age 60 to 89 years, and currently prescribed at least one medication. Exclusion criteria: progressive neurological disorders, unstable medical conditions, cognitive impairment, severe depression or anxiety, severe lower extremity impairment that would impact mobility, and severe vision impairment. Materials and Methods: Mobility and balance outcome measures related to fall risk included: 30-second chair stand test, 10-meter walk test, Timed Up and Go (TUG) and Dynamic Gait Index (DGI). Self-report measures of fall risk included fall history, Fall Risk Questionnaire (FRQ) and Activity-specific Balance Confidence scale (ABC). The QDI was derived from each participant's medications. Participants were classified as either fallers or nonfallers based on self-report history of falls within the past year. Nonparametric Spearman’s Rho correlations were used to determine relationships between faller status and measures of fall risk. A receiver operating characteristic (ROC) curve analysis determined cutoff scores for outcome measures related to faller status. Results: A fair to moderate relationship between the QDI and several physical performance and self-report measures was identified: FRQ (r=0.363), ABC (r=-0.401), DGI (r=-0.360). However, little to no relationship was found between faller status and QDI score (r=0.221). The ROC analysis determined the area under the curve for QDI was 0.63 with a cutoff score of 2.5 yielding sensitivity of 78% and specificity of 47%. Conclusions: The development of the QDI was an interdisciplinary effort between pharmacists and physical therapists to screen for fall risk in older individuals. The QDI offers a better way to quantify the adverse effects of drugs on mobility compared with simple drug counts. The QDI alone does not identify individuals at fall risk; however, the QDI is significantly correlated to several measures of fall risk, including FRQ, ABC, and DGI. The ROC Curve Analysis identified a cutoff score for fall risk for the QDI which was found to have similar sensitivity and specificity to the TUG. Clinical Relevance: The QDI could be incorporated into electronic medical records to identify patients who may be at fall risk and would be appropriate for further balance and mobility evaluation.

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This feasibility study reports on the first experimental experiences with the BASt bicycle simulator. Since older cyclists represent an important target group in road safety due to their increased vulnerability, both cyclists aged 65 and over (experimental group: EG) and, by way of comparison, middle-aged test subjects aged 25--50 (cont.rol group: CG) were included in the study. The study aims to gain initial insights into the prerequisites, possibilities and limitations for using the bicycle simulator to observe cycling behaviour. In addition to the actua1 test ride the three preceding pra.ctice rides were also evaluated. A comparable study with older adults has already been conducted with the BASt car simulator.

Winter conditions, characterized by snow and lowered temperatures, can make travel by foot difficult. Older adults aged 65 and above are especially at risk of slipping and falling on icy or snowy surfaces. Minor falls can result in severe injuries due to their frailty. Traditional methods of reducing this risk, like plowing or using sand and salt, may not always be effective preventive measures. Several municipalities in Sweden have taken action to combat this issue and introduced subsidized ice cleat distribution programs for older adults. It is unclear how these programs are designed and whether they are effective in promoting the use of ice cleats. This thesis uses a mixed-method approach drawing on data collected from multiple sources to analyze and evaluate the programs. Paper I presents a program theory model, outlining the essential components required for implementing a program and describing the causal connections from the program's introduction and necessary conditions to its anticipated impact. Survey data from intervention municipalities suggest that about 40% of the target group participated by retrieving a pair of devices, and 90% of all ice cleats were eventually distributed. Paper II presents an outcome evaluation suggesting that individuals exposed to a distribution program increase ice cleat use. Analyses of the self-reported data on ice cleat use show an increase of 7.5 percentage points. Estimations suggest that general use could be 17.3% if one pair of cleats were distributed to all eligible citizens. Future research is needed to investigate the programs' effect on fall-related injuries on ice and snow. In addition, in-depth interviews with program policymakers should be considered to provide further insights into the design and implementation of these programs. / Vinterförhållanden, som kännetecknas av snö och låga temperaturer, kan göra det svårt att resa till fots. Äldre vuxna, i åldern 65 och äldre, löper större risk att halka och falla på isiga eller snöiga ytor, där även mindre fall kan leda till allvarliga skador på grund av deras sårbarhet. Traditionella metoder för att minska denna risk, som snöplogning eller spridning av sand och salt, kanske inte är tillräckligt effektiva. Flera kommuner i Sverige har vidtagit åtgärder för att bekämpa detta problem och infört subventionerade program som delar ut broddar till den äldre befolkningen. Det är oklart hur dessa program är utformade och om de är effektiva när det gäller att främja användningen av broddar. Denna avhandling använder en blandad metod som bygger på data som samlats in från flera källor för att analysera och utvärdera programmen. I Paper I presenteras en programteoretisk modell som beskriver de väsentliga komponenter som krävs för att implementera ett program och beskriver orsakssambanden från programmets introduktion och nödvändiga förutsättningar till dess förväntade effekt. Undersökningsdata från interventionskommuner tyder på att cirka 40 % av målgruppen deltog i programmen genom att hämta upp ett par broddar, och 90 % av alla halkskydd distribuerades. Effektutvärderingen som presenteras i Paper II tyder på att exponering för ett distributionsprogram ökar användningen av broddar. Självrapporterade data om användning av halkskydden tyder på en ökning med 7,5 procentenheter, och ytterligare skattningar visar att den totala användningen kan bli 17,3% om ett par broddar distribuerades till alla berättigade medborgare. Framtida forskning behövs för att undersöka programmens effekt på fallrelaterade skador på is och snö. Dessutom bör djupintervjuer med programpolitiska beslutsfattare övervägas för att ge ytterligare insikter om utformningen och genomförandet av dessa program. / Several Swedish municipalities have introduced subsidized ice cleat distribution programs to combat the risk of fall-related injuries on icy or snowy surfaces, especially among older adults aged 65 and above. Using a mixed-method approach and data collected from multiple sources, the thesis evaluates the effectiveness of these programs. The thesis presents a program theory model outlining the components required for implementing a program and its anticipated impact. Survey data from intervention municipalities show that 40% of the target group participated in the programs by retrieving a pair of devices, and 90% of all ice cleats were distributed. The outcome evaluation suggests that exposure to a distribution program increases ice cleat use by 7.5 percentage points. If one pair of cleats were distributed to all eligible citizens, about 17.3% would use the devices. The thesis calls for future research to investigate the programs' effect on fall-related injuries and suggests in-depth interviews with program policymakers to provide further insights into the design and implementation of these programs.