No / The use of neuroleptic drugs to mediate the behaviour of people with dementia living in care homes can lead to them being deprived of their liberty. Whilst regulation has been successful in reducing neuroleptic prescribing in the USA, policy guidance has been unsuccessful in reducing the use of these drugs in the UK. Yet the Mental capacity act 2005 aimed to protect the liberty of people lacking capacity and provided safeguards to ensure that they are not inappropriately deprived of their liberty in institutions. This article highlights the potential for using this law to identify when neuroleptic prescribing in care homes would deprive people with dementia of their liberty and, in turn, to act as a check on prescribing levels. However, the extent to which the Act can promote and protect the right to liberty of people with dementia is constrained by a lack of access to social rights.

People with dementia are commonly in need of some form of social care from the social services in order to manage their everyday situations. However, social services are shaped by the construction of policy targets. The aim of this dissertation is to explore the social citizenship for people with dementia. Social citizenship for people with dementia is explored by studying how people with dementia, in policy documents, have been constructed as a target group and also by studying how policies are enacted in practice by care managers, in their work and in their meetings with people with dementia. This is illustrated by studying policy documents from national level which range over nearly 40 years and 19 interviews with care managers. It is shown that, if and when, people with dementia are visible in policy documents, they commonly have a negative construction based on their cognitive and communicative abilities, as a burden, disturbing and incapable. It is further investigated how street-level bureaucrats, in this case care managers, experience meeting with people with dementia when they apply for social services. It is shown that care-managers experience difficulties concerning this group comprised of the exchange of information between care managers and people with dementia, refusal of social services by the person, the influence of relatives and other professions as well as moral dilemmas, such as the relations between the person with dementia and their relatives. The study shows that care managers have little support from policies, e.g. legislation and guidelines, in how to handle these dilemmas, and must thus create their own local ways of handling these situations. Care managers are thus influential policy actors concerning the policy target group of people with dementia. The policy processes which this dissertation illustrates, affect the social citizenship of people with dementia. It is shown that they, to an extent, have difficulties in influencing their own everyday situation concerning social services. Finally, the policy processes, will affect their possibility to influence their social citizenship. / Personer med demenssjukdom behöver vanligtvis någon form av socialt stöd från socialtjänsten för att kunna hantera sin egen vardag. Emellertid så är socialt stöd format av konstruktionen av policymålgrupper. Syftet med denna avhandling är att undersöka det sociala medborgarskapet för personer med demenssjukdom genom att studera hur dessa personer, som policymålgrupp, har konstruerats i policydokument samt hur policys iscensätts i praktiken av biståndshandläggare inom socialtjänsten, i deras arbete och i deras möten med personer med demenssjukdom. Detta belyses genom studier policydokument på nationell nivå som spänner över nästan 40 år samt intervjuer med 19 biståndshandläggare. Studien visar att om och när personer med demenssjukdom är synliga i policydokument så har de vanligtvis en negativ konstruktion som baseras på deras kognitiva- och kommunikativa förmågor, som betungande, störande och inkapabla. Vidare undersöks i denna avhandling hur gräsrotsbyråkrater, i form av biståndshandläggare, upplever mötet med personer med demenssjukdom då de ansöker om socialt stöd från socialtjänsten. Det visas att handläggare upplever svårigheter i deras möten med denna grupp. Svårigheterna ligger i utbytet av information mellan handläggare och personen med demens, vägran från personen att ta emot stöd, inflytande från anhöriga och andra professioner samt moraliska dilemman som relationen mellan personen med demenssjukdom och anhöriga. Handläggare har lite stöd från policys, såsom lagar och riktlinjer, i hur de ska hantera dessa svårigheter och måste således hitta egna, lokala, sätt att hantera dessa situationer. Handläggare är således inflytelserika policyaktörer rörande policymålgruppen personer med demenssjukdom. De policyprocesser som avhandlingen berör påverkar det sociala medborgarskapet för personer med demenssjukdom. Det visas att de, till viss del, har svårigheter att påverka sin egen vardag i relation till stöd från socialtjänsten. Slutligen påverkar policyprocesser möjligheten för personer med demens att påverka sitt sociala medborgarskap.

This dissertation deals with the concept of Sensory Activation, a new approach practised in the Czech Republic focussing on the elderly and people with dementia synrome, in relation to monitored psychological aspects. The work has four main parts. In the first part the target group is defined the elderly and people with dementia syndrome, with emphasis being placed on a holistic approach to treatment. The second part presents selected psychological aspects, specifically communication, emotions, memory and sensory processes and their interconnection with the practice of Sensory Activation. Contained in the following chapter is the concept of Sensory Activation itself and a synopsis of its methods which can be applied in work with the target group. The last chapter presents the results of my research. These results come from an analysis of eight case histories of randomly selected activated people. The full versions of the case histories can be found in the Appendices of this dissertation.

Bakgrund: I Sverige beräknas att cirka 40% av personer med kognitiv sjukdom vårdas på särskilt boende och innan de flyttar dit är det ofta anhöriga som ger informell om­vårdnad i hemmet. Tidigare forskning har visat att vården av en person med kognitiv sjukdom och processen att flytta denne till särskilt boende är påfrest­ande för anhöriga, med stor risk för att utveckla egen ohälsa. Regeringen har under 2022 beslutat om en anhörig­strategi för att stärka anhörigas rätt till stöd, och Socialstyrelsen publicerade ett kunskapsunderlag för vårdgivare under 2023 i syfte att underlätta implementering av anhörigperspektivet. Därför är det intressant att studera hur sjuksköterskor idag stöttar anhöriga under denna process. Syfte: Studiens syfte är att utforska hur sjuksköterskor i kommunal verksamhet beskriver stödet de ger till anhöriga till personer med kognitiv sjukdom under transitionsprocessen från ordinärt boende till särskilt boende, samt om de upplever att det finns förbättringsmöjligheter.  Metod: En kvalitativ intervjustudie med induktiv ansats genomfördes. Det gjordes 13 semistrukturerade intervjuer med sjuksköterskor inom kommunal hemsjukvård och särskilt boende, med minst ett års erfarenhet från ena eller båda verksamheterna. En kvalitativ innehållsanalys med en manifest tolkning gjordes för att få fram ett resultat.  Resultat: Analysen resulterade i fyra huvudkategorier: 1. Att hjälpa anhöriga ur en ohållbar situation. 2. Att skapa en god relation. 3. Att samverka. 4. Att förhålla sig till brister i verksamheten. Resultatet visade att sjuksköterskorna börjar stötta anhöriga i processen långt tidigare än förväntat och är medvetna om de svåra känslor som anhöriga brottas med innan de fattar beslut om flytt. Sjuksköt­erskorna på särskilt boende arbetar ofta hårt med att öka tryggheten för anhöriga och göra dem delaktiga, och ett väl fungerande teamarbete är viktigt för ett gott samarbete med anhöriga, liksom att det finns anhörigstödjare att tillgå. De pekade också på att det finns brister i verksamheten, både av organisatorisk och kulturell art, som påverkar stödet till anhöriga negativt.  Slutsatser: Studien visade att sjuksköterskor i hög grad är medvetna om de problem och utmaningar som anhöriga står inför när de måste separera från en familje­medlem med kognitiv sjukdom. Studien pekar på förbättringsbehov avseende sjuksköterskors kompetensnivå, rutiner som verkar för ett mer jämlikt tillhanda­hållande av stöd för anhöriga, samt att sjuksköterskor får mer resurser för denna folkhälsofrämjande verksamhet. / Background: Some 40% of persons with dementia in Sweden live in care homes, and before they move there, are cared for by informal family caregivers in the home. Previous research has shown that the process of caring for a person with dementia and moving them to a care home is taxing for family caregivers, with increased risk of developing health problems of their own. The Swedish government has in 2022 presented a national next-of-kin strategy aiming to strengthen the right to support for family caregivers and Socialstyrelsen published a guide for healthcare providers to implement the next-of-kin perspective in 2023. In this light, it is of interest to study how registered nurses working in homes and care homes support family caregivers today.  Aim: The aim of the study is to investigate how registered nurses in the context of elder care, both in ordinary homes and in nursinghomes, describe the support they give to relatives of persons with dementia during the transitionprocess from ordinary living to care home living, and if they see possibilities for improvement.  Method: A qualitative interview study with inductive approach was made. There were 13 semistructured interviews made with registered nurses working in home care and care home settings, having at least one year of experience from one or both of the settings. A qualitative content analysis with a manifest interpretation was made to generate a result.  Results: The analysis resulted in four main categories: 1. Helping family caregivers in an untenable situation. 2. Creating a good relationship. 3. Cooperation. 4. Relating to the shortcomings of the area of care. The result showed that registered nurses support family caregivers long before expected and are aware of the difficult feelings relatives deal with before they decide on care home living. The nurses in care homes often work hard aiming to create a sense of security and participation for relatives. A well functioning team is a foundation for a good collaboration with relatives, and access to external support is an important resource. The nurses also identified organizational and cultural problems, affecting the support negatively.  Conclusions: The study shows that registered nurses are highly aware of the problems and challenges facing family caregivers when needing to separate from a family member with dementia. The study indicates areas of improvement concerning the nurses need for further education, routines that facilitate a higher degree of equal opportunities for relatives, and that the nurses have more resources allocated for this area of preventative public health care.

The diploma thesis deals with the possibilities and limitations of the planning care and support to people with dementia. Diseases that lead to the dementia syndrome causing difficulties in almost all areas of life of the person who suffering from the syndrome. A person with dementia then requires specific approaches by others. The aim of this thesis is to identify the specifics of individual planning of social services with people with dementia and find out how is the individual planning with these persons done in selected homes with the special regime in the Capital City Prague and Central Bohemia.The first part provides an overview of current knowledge in the field of related topics. The second part contains the research which was carried in selected nine special regime homes in the Prague and Central Bohemia. In the research were used methods of semi- structured interviews and analysis of documents. In the research was found that the planning with people with dementia is in some aspects different from the planning with people without cognitive impairment. In this planning are more used methods that allow to establish contact with the client and identify and transmit information among employees. There was also found other specifics that are shown in the results section and at the end of this...

This research examines narratives about the quality of everyday life with dementia. The aim of the study is to compare and contrast differing perspectives about the impact of ageing and dementia upon the lives of older people with dementia. A total of 50 interviews with six older people with dementia and ten family and paid carers were conducted over a two-year period. Narrative analysis was used to examine the content and structure of their accounts to understand their perspectives on what matters most to people living with dementia. This in-depth analysis enabled an exploration of different social concepts and narrative constructions that people draw upon in making sense of their experiences of caring and living with dementia. The analysis demonstrated that older people incorporate ageing and dementia into a continuing sense of self. Positive constructions of living with dementia involve the ability to lead a meaningful life that supports pre-existing social roles and relationships and active engagement within the family and community. The emphasis is on living an ordinary life while responding to the challenges associated with cognitive impairment and social stigma. For family and paid carers, perceptions of a meaningful life depend on how the identity of the older person with dementia is positioned relative to past social roles and relationships. Positive constructions assume continuity as opposed to focusing on disruption in the person’s identity and life. Carer perspectives are also influenced by how the person is perceived to conform to social standards of normality. The narratives of older people with dementia reflect their active struggle to find meaning in terms of realising their sense of self within a social world that largely defines them as different and out of the ordinary. The narratives of carers resonate with emotional difficulty, reflecting their struggle to make sense of a life that is not represented as essentially normal. These findings show that, for all, finding meaning in everyday life depends upon making sense of that life as normal and ordinary.