Increases in the proportion of older people in Canada have focussed needed attention on the issues and concerns for this group. One prevalent issue is the nature of experiences of intimate partner violence (IPV) for older adults. These experiences have been overlooked in the domestic violence theory and research where the focus has been on the needs of younger women and also within the elder abuse research and literature where the emphasis has been placed on aging (dementia) and caregiving. As a result, less is known about the experiences of older adults in intimate relationships and how the power and control dynamics manifest and shift within the context of long-term relationships. How do these dynamics change or remain the same in intimate relationships of older adults? How do the victims resist the violent and controlling tactics of perpetrators and how does this resistance influence and shift the nature of power and control in these intimate relationships? Using techniques borrowed from grounded theory, this study was undertaken with the aim of exploring power and control dynamics in intimate relationships of older adults in long-term abusive relationships. The findings demonstrated by the victims reported that their partners used different forms of violent tactics in the early years of these intimate relationships and typically used more nonviolent coercive controlling tactics in later years. In some of the relationships, control continued past the period of separation and divorce. Victims presented themselves as active agents and demonstrated resistance that was more overt in the early years, which became more subtle and discreet as these relationships matured. For victims, resisting their partners’ efforts to control them provided them with some momentary power in the relationship; however, the participants’ control was mostly situation-specific and temporary. For victims who were still living with their abusive partners, resistance allowed them to set boundaries with their partners and provided them with some space of their own within their relationships to engage in activities of their choice. These boundaries, however, are under constant scrutiny by the abusive partners and although victims demonstrate resistance to assert their dignity, the overarching control continued to be with the abusive partner. Narratives also provided by the participants also demonstrated the impacts of intimate partner violence to their sense of health and well-being. / October 2015

Syftet med studien har varit att få klarhet i vilka faktorer som påverkar personalens handlande i mötet med äldres upplevelser av ensamhet, oro och ångest inom äldreomsorgen. Studien är kvantitativ och en enkätundersökning har genomförts på omsorgsavdelningar med personal som arbetar på särskilt boende. Jag har varit intresserad av att studera hur personalen möter de äldres upplevelser samt om brister kan identifieras som påverkar personalens handlande gentemot äldres behov. Den här studien har sin utgångspunkt i Socialstyrelsens nationella enkätundersökning 2012. Socialstyrelsens undersökning visade höga siffror vad gäller äldres upplevelser av ensamhet, oro och ångest på särskilt boende, vilket jag valt att studera vidare kring. Urvalet i min studie har bestått av 50 omsorgspersonal varav 31 svarade på enkäten vilket gav en svarsfrekvens på 62 procent. Den teoretiska utgångspunkten för studien har varit analysmodell med faktorer som utgår från individuella och organisatoriska områden. Studien påvisar utifrån personalens perspektiv att äldre upplever oro och ångest i hög grad vilket personalen anser orsakas av känslor av ensamhet. Resultaten utifrån analysmodellen visar huvudsakligen brister inom organisatoriska områden som brist på tid, arbetssätt, resurser, mål och arbetsledning. Personalens individuella resurser såsom empati, engagemang och värderingar visar tillfredsställande resultat. Däremot personalens kompetens vad gäller bemötande och arbetsmetoder visar genomgående brister. Detta påvisas genom avsaknad av utveckling och mål på det personliga, arbetsmässiga samt utbildningsmässiga planet. De äldres sociala tillfredsställelse har i studien gett paradoxala svar angående deras behov av samtal, stöd och gemenskap. Å ena sidan anses de äldres sociala behov vara tillfredsställda. Å andra sidan anses de äldre inte kunna påverka sina känslor av ensamhet, oro och ångest då personalen hänvisar till brist på tid och kompetens. / The purpose of this study was to ascertain the factors affecting employee behavior when meeting older people's experiences of loneliness, worry and anxiety in elderly care. The study is quantitative and a questionnaire survey has been conducted with staff working in elderly care. My scope has been based on the staff´s perspective to find out the situation of the elderly and needs from social satisfaction and the older people´s opportunities for meaningful conversations in retirement home. The study is based on the 2012 national survey, performed by the Swedish National Board of Health and Welfare (Socialstyrelsen). The survey is showing high numbers of older people`s experience of loneliness, worry and anxiety in retirement home, which I have chosen to study futher about. The sample of the study consisted of 50 care staff employees, 31 of which responded to the questionnaire giving a response rate of 62 percent. The theoretical starting point for the study is an analysis model with prepared factors. Factors based on individual and organizational areas acquired from the theory of the elderly care. The study demonstrates from the perspective of the staff members, that the elderly are experiencing a high grade of worry and anxiety, which is considered to be caused by feelings of loneliness. The results based on the analysis model shows mainly deficiencies in organizational areas such as lack of time, work methods, resources, goals and management. The employees individual resources such as empathy, commitment and values show satisfactory results. However the staff's competence in treatment and working consistently show deficiencies. This is demonstrated by the lack of development and aims at the personal, labor, and educational level. Older people's social satisfaction has in the study yielded paradoxical response regarding older people's need foriiconversation, support and fellowship. On the one hand the social needs of the elderly is considered to be satisfied. On the other hand, the elderly are considered not to be able to influence their feelings of loneliness, worry and anxiety as the staff refer to the lack of time and expertise.

Elder abuse has traditionally been a silent social issue in America. However, with an estimated increase in the older population over the next 50 years, and given the preventable nature of violence, it is quickly becoming a major public health priority area. Each year hundreds of thousands of elderly are abused, neglected, or exploited financially worldwide. In the United States alone, it is estimated that 500,000 cases of elder abuse occur annually—with research indicating that substantiated cases are a mere underreport of the true problem. The US federal government has appointed State Units on Aging to address elder abuse. Georgia’s Division of Aging Services (DAS) is located within the Department of Human Services and administers various services to elderly including advocating for their safety and well being. DAS carries out its work through locally appointed Area Agencies on Aging (AAA). While AAAs serves as a first point of entry for elderly population locally, their involvement in reporting and intervening in elder abuse cases has been limited. The purpose of this capstone project is to examine the AAAs’ stage of readiness to address elder abuse using the Community Readiness Model, developed by researchers at the University of Colorado. Telephone administered surveys were completed with 7 out of the 12 Georgia AAAs. Through a double rater review process, transcripts were coded according to diverse constructs of the Community Readiness Model and ultimately a readiness score was produced. The Community Readiness Score provides insight into evidence-based strategies that can be implemented in order to advance elder abuse intervention and prevention within the AAA communities. The findings from this study provide insights into cost-efficient, tailored strategies that can maximize the use of DAS funding for AAA elder abuse case response and service delivery.

Elder Olson has said that at the Biblical Tower of Babel the people did not begin to talk nonsense but only what seemed like nonsense. This paper concerns an intellectual tower where important debates are held, but unfortunately the language is not a universal one; therefor, because all too often terms have evolved without adequate definition, disagreement occurs where reconciliation appears impossible. The very title of this thesis could be misleading to the reader if he considers debate in its formal sense. What is here intended is the controversy in the efforts of respected scholars to understand and establish the nature of poetry, and for me it is also a personal debate as I follow their assumptions in order to make some judgments in the concluding chapter about their successes and limitations. The informality of the structure of the debate does not diminish the seriousness of its dialectic. To the contrary, the debate is very serious not only to those involved but to any person who concerns himself with the state of the literary arts in the modern world. The debate is among critics representing certain generally defined schools of criticism; however they are not primarily spokesman for a school: they are among the mainstays. Each represents high scholarship, and each is deserving of praise solely as an isolated critic – or a critic without a collective classification. At the same time they each acknowledge themselves to be members of their respective schools of criticism. The debate is not constructed on the basis of two teams, negative and affirmative, with two members for each side. Instead there will be three positions presented by four critics. The essence of the debate is their scholarly struggle to bring to the poetic arts the most responsible and valuable critical approach and their sincere disagreement among themselves as to what the nature of poetry is and how the critic should deal with its subject matter.

The general objectives of the study were to evaluate a social work support group programme with informal caregivers that aimed to enhance the quality of care provided to older persons in an urban and rural community setting in Namibia. In order to achieve the general objectives of the study, the following specific objectives were formulated: * To explore how informal caregiving situations in urban and rural communities lead to elder abuse and neglect. * To describe existing literature on the various factors that contribute to elder abuse and neglect within community settings. * To develop a support group programme for informal caregivers of older persons in urban and rural community settings that aimed at preventing elder abuse and neglect. * To implement and evaluate the effectiveness of the support group programme for informal caregivers that aimed at preventing elder abuse and neglect. The thesis consists of 5 sections: Section A consists of the problem statement, research objectives, central theoretical argument and the theoretical approaches that underpin the study. Furthermore, the research methodology, the definition of key concepts and the limitation of the study are presented. Section B contains four articles that together formed part of the research outcomes. Each article can function independently with it’s own objectives and distinctive content. However, each article is also a sub-project of the umbrella research study. Therefore, some of the data have to be repeated in different sections. The four articles are: Article 1: Informal caregiving, elder abuse and neglect in urban and rural areas of the Khomas region in Namibia: A needs assessment A needs assessment on informal caregiving situations and how it may lead to elder abuse and neglect of older persons from an urban and rural constituency in the Khomas region was explored. Data was collected through in-depth interviews with professional and community leaders. In addition, focus group discussions were held with older persons and informal caregivers in the urban and rural constituency. Article 2: Factors contributing to elder abuse and neglect in community settings In this article, a comprehensive review of the literature pertaining to the risk and protective factors to elder abuse and neglect was done. The ecological theory was worthwhile to describe the risk factors to elder abuse and neglect. Article 3: Designing a social work support group programme with informal caregivers of older people in Namibia A social work support group programme was developed for informal caregivers of older persons in community settings. The eight-week support group programme was developed based on a needs assessment and a comprehensive literature review, and included the following topics; the normal processes of aging, handling of difficult caregiving situations, caregiver stress, self-care of the caregiver, elder abuse and neglect and caregiver grief and loss. The planning model for group work was also utilised to design the group. Article 4: Evaluation of the effectiveness of a support group programme with informal caregivers to prevent elder abuse and neglect An eight-week support group programme with ten female informal caregivers from an urban group and twelve informal caregivers from a rural group setting was implemented and evaluated. Standardized measuring instruments that assessed the outcome of the group at pre-test, post-test and postponed post-test were the Zarit Burden Interview (ZBI), Potentially Harmful Behaviour (PHB) scale and the Caregiver Abuse Screen (CASE). The Group Engagement Measure (GEM) assessed the group processes at the fourth, sixth and eight group sessions. In addition, open-ended questions were used to collect qualitative data. The quantitative and qualitative evaluations indicated that both the urban and rural groups gained knowledge on aging and caregiving, and caregivers acquired vital qualities such as patience, compassion and communication skills. The process evaluation showed that caregivers from the urban group were more engaged in the group process than the rural group. Elder abuse was underreported in the study, while personal stress of caregivers reduced significantly because of the intervention. Section C consists of the summary of the most important findings and conclusions to the research study. In addition recommendations are provided. Section D consists of the annexures to the research report, such as the measuring instruments and interview schedules used for data collection. Section E contains a consolidated list of references. / PhD (Social Work), North-West University, Potchefstroom Campus, 2014

The restructuring of Canadian health care for more than twenty years has ushered in opportunities for growth in private home care services. Within this socio-economic reality, some seniors and families feeling the impacts of the cutbacks to health and social services have turned to other alternatives of care to fill care gaps. A new type of caregiver, the paid companion, has surfaced in this respect. Operating either independently or through private health care agencies, paid companions resemble surrogate family members or friends who perform a variety of services for the elderly who can afford to pay for private home care and support. My research objective has been to explore and develop an understanding of the experiences and relationships of paid companions and their clients within the context of the political-economic climate of neoliberalism that has supported the development of paid companions. This thesis presents research conducted between 2009 and 2010 in the Greater Victoria area with 30 participants: 15 companions, 8 clients, and 7 key informants. The two qualitative methods of qualitative (semi-structured open-ended) in-person interviews and autodriven photo elicitation were utilized in order to examine the subjective experiences of paid companions and their clients. The research revealed the ambiguity and divergence of opinion around the terms ‘companion’ and ‘paid companion,’ which are inherent in the nature of the work itself. The majority of participants emphasized that friendship and fictive kinship often form the core of a relationship that has been built on caregiving and trust. While paid companions derive fulfillment by providing care for clients, the relationships they develop with them are intrinsically linked to the companionship and care they give. Although clients’ care needs most often stem from general health and mobility issues, the relationships that are gradually formed with their companions often become as important as the task-based assistance their companions provide to them. / Graduate

The aim of this study was to investigate if the experiences of work environment of employees in the elder care in the municipality of Umeå can be linked to high or low sickness absence. The method used was semi-structural qualitative interviews. Six retirement homes participated in the study and were divided into two groups, based on whether they had high or low figures of sickness absence. 28 elder care workers of different educational levels were interviewed. The interview questions were divided into categories. For the key phrases; “Have great possibilities of influencing one´s schedule” (category influence), “Is offered education” (category development and challenge), “The work pace depends on the wellbeing of the residents” (category physical and psychological workload), “Reflect/Do not reflect on work at home” (category physical and psychological workload), “Difficult to resolve conflicts” (category working climate and wellbeing) and “Stressful work” (category working climate and wellbeing) statistically significant differences between the groups were detected. Risk factors in the work environment, such as, time pressure, conflicts and physical and psychological strain are described by employees at retirement homes with both higher and lower figures of sickness absence. Differences between the sexes could not be investigated, but that does not exclude possible differences. Based on the results the conclusion is drawn that aspects of influence, development and challenge, physical and psychological workload and working climate and wellbeing can be factors that impact on sickness absence in the elder care in the municipality of Umeå.

本研究將主要在探討高齡者參與志願服務的充權經驗，本研究不是從運用高齡人力資源的角度出發，而是試圖尋找更多協助高齡者的途徑，所以把焦點放在志願服務對高齡者的影響，並深入探討高齡者在參與志願服務過程中的充權經驗，研究目的有下列幾點： 第一：瞭解高齡志工參與志願服務的動機。 第二：分析高齡志工參與志願服務後的影響及充權結果。 第三：探討高齡志工參與志願服務的過程中，有哪些促成因素促成充權的出現。 本研究採質化研究進行，以深度訪談法來收集資料，主要以台北市三間老人福利服務機構中的高齡志工和志工督導為研究對象，一共訪問了十三位高齡志工和五位主責志工業務的督導，研究發現如下： 一、在充權表徵方面，分為個人、人際和環境層面。個人層面上包含：跳脫「老而無用」負面標籤的形象、自我效能感的提升、不再恐懼老年生活、對生活的掌控感、多元批判性思考的出現，及女性自我意識的發展。在人際層面上包含：積極而正向的家庭互動、試圖開展人際網絡、獲得社會支持，及改善人際溝通的技巧。而環境層面上包含有：開始關心所處環境的議題、能對環境採取控制或行動，以及積極參與政治活動。 二、充權的促成因促方面，分別有人際「互動」中產生的因素。由人際互動中產生的因素包含有：與志工夥伴的互動、與督導或其他工作人員的互動、和服務對象互動的經驗，以及家人、鄰居朋友對志工活動的鼓勵和肯定。由服務過程中產生的因素包含有：「參與」處理問題的過程，及獲得重新省思問題的機會。接觸機構相關資源的因素包含有：參與志工培訓課程，以及得知機構內或外的其他資源。 在研究建議方面，認為高齡志工要能適時轉換對自我的期待，並以自身充權之經驗鼓勵其他高齡朋友參與志願服務；而社會工作者應要多提供高齡志工正向接納老化的相關訊息、重視高齡志工的個別性差異、促進高齡志工批判性思考、瞭解「團體」對高齡志工的充權有關鍵性影響，最後還要常帶動高齡志工關心環境層面的相關議題，並改變社會工作者對自我的定位；而機構要重視運用高齡志工的重要性，並重新瞭解運用志工的益處。

Una de las formas de violencia más ocultas es la que padecen las personas de edad avanzada. La tesis expone información relacionada con el problema. Se aporta una comprensión teórica y los elementos necesarios para describir esta realidad. La detección, la prevención y la intervención son parte importante del material aportado. Se trata de un estudio exploratorio llevado a cabo con una muestra de 178 personas de 65 años y más, que viven en su domicilio y que han sido víctimas de maltrato durante el año 2002. Se han explorado datos cuantitativos y cualitativos. El objetivo general se centra en identificar, describir y explorar las características y aspectos principales que intervienen en las situaciones de maltrato a las personas mayores. A su vez se persiguen cinco objetivos específicos: A,- Describir los principales problemas asociados al abordaje de los malos tratos, conceptos y tipologías. B,- Elaborar un perfil de la víctima y de la persona que comete el maltrato. C,- Conocer e identificar los factores de riesgo, tanto los que se relacionan con la víctima como con el agresor. D,- Conocer la existencia y la aplicabilidad de la red pública de servicios sociales, sociosanitarios, salud y jurídicos para acceder en situación de maltrato a personas mayores. E,- Obtener un fondo de datos para estimular la investigación.

Sammanfattning Syftet med denna studie var att beskriva äldre änkors/änklingars uppfattningar kring det eventuella stöd som erbjudits eller saknats dem, samt övriga underlättande faktorer under perioden de vårdade sin livspartner i hemmet.   Metoden som användes var kvalitativ och datainsamlingen bestod av semistrukturerade intervjuer. Informanterna var 4 kvinnor och 2 män i åldern 60-79 år med anknytning till anhörigcenter, ett kommunalt stöd för anhörigvårdare. Data analyserades med manifest innehållsanalys enligt Graneheim och Lundman (2004). Analysen identifierade två teman; Uppfattningar kring stöd från samhället, släkt och vänner samt Övriga underlättande faktorer.   Resultatet gav sex kategorier som informanterna framhöll som viktiga; Känsla av stöttning, Praktisk assistans, Information, Fokus på anhörigvårdaren, Upplevelse av hur den närstående mår, samt; Miljöombyte. I huvudsak visar resultatet på vikten av information och tillvägagångssättet som information ges på. Även samtalsterapi och en kontaktperson knuten till offentlig sektor efterfrågas för att underlätta i anhörigvårdarens vardag. Vidare är stöd som bidrar till att bibehålla ett socialt och varierande liv av stor vikt.   Slutsatsen är att de före detta anhörigvårdarna påverkas mycket av känslan av att de fått direkt eller indirekt stöd. Denna känsla är till stor del kopplad till vilket bemötande och vilken information som getts från i första hand offentlig sektor. Väsentliga skillnader för anhörigvårdarna kan därför uppnås med relativt små medel. / Bodin, A. (2013) Elderly informal caregivers perception about support and other relieving factors. Bachelor’s thesis in public health. The faculty of health and occupational studies, University of Gävle, Sweden.   Abstract The purpose of this study was to describe widow’s/widower’s perception of the support they had been offered or missing from society and relatives/friends during their time as informal caregiver to their spouse. The purpose was also to describe other possible relieving factors.   The method used was qualitative semi structured interviews that were held with 4 women and 2 men. Data was analyzed according to Graneheim & Lundman (2004). Two themes were identified; “Experiences of support from society, relatives and family” and “Other relieving factors”.   The main results showed that the way information is given is important both when it comes to approach and procedure. A contact person is desirable. Support that benefits the informal caregiver’s social life is highly appreciated by the informants.   The conclusion is that the feeling of support is crucial and is connected to the way personnel is treating the informal caregiver. The ideal solution could proposedly be for the society to introduce a long-term course, giving adequate information and discussing the majority of aspects of being an informal caregiver, such as care, the spouse’s state of ill-health and how to preserve your own quality of life.