This research examined notions of belonging and sense of community through a set of layered lenses that integrated a social model of aging with phenomenology to gain a better understanding of the lived experiences of individuals residing in a long-term care (LTC) home. Conducted in a for-profit LTC home in Ontario, this study analyzed messaging in marketing materials supplied to potential residents and their families in anticipation of a move to a LTC home and in the staff policies and procedures manuals using document and narrative analysis. Themes emerging from this phase were then compared with the first-hand experiences of living in a LTC home as told by residents through the use of a focus group (n=6) and individual interviews (n=6) and experiences of working in a LTC home as described by interviews with staff (n=6). Analysis of marketing documents revealed the theme of let us be your caring community. As messaged in these documents, the LTC home supported residents by caring, embodying the ideals of home through natural living spaces, and supporting meaningful personal connections. This contrasted with messages found in the staff policy manuals. Divided discourses highlighted the tangible complexities of implementing a person-centered philosophy within a business model by describing the industry of care, prescribed customer service, fabricating normalcy and, to a much lesser extent, promoting the practice of person-centered care. Residents’ phenomenological stories illustrated variable un/belonging within a LTC home. Personal experiences of the institutional erosion of belonging, congregate nature of living in a LTC home, changing nature of personal relationships and the prescriptive living environment routinized day-to-day experiences and provided a stark contrast between belonging in community and un/belonging in a LTC home. Weaving belonging into daily tasks described how staff members laboured daily at working to personalize LTC home living, and how they were helpless to prevent losses in community and belonging. After completing the research and analysis of the promotional materials, policy and procedures manuals, and resident and staff transcripts I conducted a broader level analysis of all four sets of themes in order to get a sense of the whole. I concluded there were five tensions of: constructing home from the outside; person-centered care within a biomedical, business model; promoting individuality in a congregate structure; synthetic connections at the expense of long-standing relationships; and fostering living in a death-indifferent culture which justified society’s need to divide and regulate. Incorporating a range of data including promotional materials, policy and procedures manuals, and the voices of both residents and staff, these tensions are not only implicit in the culture of Manor House but within the overarching structure of LTC homes in general and have deep implications on the standing and status bestowed upon older adults in Canadian culture. My intention was to bring to light the contextualized lived experiences of individuals living at Manor House and highlight the structural and social barriers that continue to produce discrimination by “problematizing” aging and subsequently fostering notions of presumably acceptable dividing practices (Foucault, 1982) within society. By examining meanings and experiences of community in a LTC home, and also recognizing the systemic, structural and cultural factors that may shape those experiences, I sought to gain a more comprehensive understanding of the lifeworlds of individuals living within a LTC home.

Diss. (sammanfattning) Göteborg : Univ., 2007. / Härtill 4 uppsatser.

Thesis (M. N.) (Hons.) -- University of Western Sydney, 2003. / A thesis submitted in total fulfillment of the requirements for the degree of Master of Nursing (Honours), Faculty of Nursing and Community Health, Department of Nursing, University of Western Sydney, February, 2003. Bibliography : leaves 190-205.

Diss. (sammanfattning) Umeå : Univ., 2007. / Härtill 4 uppsatser.

Thesis (M.S.)--University of Michigan, 1985.

Thesis (M.S.)--University of Michigan, 1985.

Background: Worldwide one in twelve people are living with diabetes and one in two people do not know they have diabetes. Currently large numbers of the older people live in residential care homes in the UK, and up to one in four older people living in residential care homes present with diabetes. Low vision is one of the complications associated with diabetes in older people. In those aged 75 and over, one in five, and in those aged over 90, one in two people are affected by low vision and they are at an increased risk of developing other eye diseases. Within 20 years of diagnosis nearly all people with Type 1 and almost two thirds of people with Type 2 diabetes (60%) have some degree of diabetic retinopathy. Aims and Objectives: This study aimed to investigate the issues and problems faced by older people living in residential care homes with low vision and diabetes; to evaluate health professionals’ knowledge and understanding of the impact of low vision associated with diabetes in older people living in residential care homes; and to develop an educational toolkit which aimed to educate health care assistants about low vision and diabetes. Methods: This study is an exploratory investigation of older people living in residential care homes with low vision and diabetes. Adopting an open-ended qualitative approach using focus groups, interviews and a health professional’s survey, 116 participants were involved. These included GPs, ophthalmologists, nurses, optometrists, health care assistants and older people with low vision and diabetes. The data was analysed thematically. The educational toolkit was developed in the second part of this study, and 20 healthcare assistants were trained using this toolkit. Their knowledge was tested before the training, immediately after the training and one month after the initial training. Following Kirkpatrick’s model, the skills and practical use of the educational toolkit was assessed using an open-ended qualitative approach. Results: The results found that many older people and the health care assistants had the perception that low vision was a normal ageing process and could not be rectified. The study found that there was evidence to suggest that eye health was not considered to be a priority; instead, it was considered to be a natural part of the ageing process. The results found that 82% of the HCAs had not had any training in the area, and more than half of the nurses and GPs did not have sufficient knowledge of low vision and diabetes. After training, however, their knowledge was increased. This suggested that low vision and diabetes toolkit training could be used to educate healthcare assistants on a regular basis. The study also found that knowledge does decline over time, and therefore regular training for HCAs is required in order to maintain eye health and diabetes in older people, as well as improving their quality of life. Conclusion: In the research findings it was found that 50% to 70% of low vision was preventable or treatable if detected in its early stages and could be avoided by simply wearing appropriate spectacles, or possible surgery. However, in order to identify these 50% to 70% with low vision, everyone concerned should be able to recognise the signs and symptoms of preventable low vision, particularly health care assistants, as according to this study, health care assistants spent large amount of time in the residential care homes compared to the other health professionals.

Long-term care for the elderly people is a widely discussed topic in recent years not only among health professionals but also by the general public. And it will not change in the future. According to the Czech Statistical Office (2012) in 2050, the population aged over 65 will double and the population older than 85 years even quintuple. This work deals with long-term care for the elderly from the perspective of nursing, for the current demographic trends affect it significantly. Long-term hospitalization of the elderly in medical facilities is linked to many complications, not only physiological, but also psychological, social and spiritual. The aim of the thesis entitled "Long-term care for the elderly in nursing perspective" was to find out what the nurses in long-term care for seniors consider as the greatest problems, if they would welcome a change in competences in long-term care for the elderly, and to obtain an opinion about the long-term institutional care and long-term home care. Individual opinions of nurses from different departments were compared; what kind of solution to the current problems of long-term care for the elderly the nurses propose themselves. Objective 1: Find out what the sisters find as the most crucial problem in long-term care for seniors. Objective 2: Determine whether nurses feel the necessity for change in nursing competences in the management of long-term ill elderly. Goal 3: Find out what is the opinion of nurses about long-term institutional care for the elderly compared to long-term community care at home. The main research question based on the research problem and the research objectives was defined as follows: What is the prospect of long-term care for the elderly in terms of nursing? I decided for an exploratory approach. I was looking for another connection to general research question and examined them in depth. I decomposed this relatively broad topic covered by the research questions into several specific questions: 1. Will it be necessary to make additional changes in financing long-term care, due to a growing demographic age of the population increases? 2. Could nurses in long-term care for the elderly take over certain powers previously belonging to doctors? 3. Will the importance of providing nursing care long-term ill seniors at home increase? 4 Should be a long-term care for the elderly moved out of hospitals to specialized facilities? 5. Will it be necessary to increase the number of health care facilities with the focus on long-term care because of the growing number of senior citizens? 6. In connection with the increasing number of hospitalized elderly, will medical facilities have enough of gadgets? For the research was chosen a qualitative interview method. Nurses from various departments were interviewed and the outcomes were processed using the content analysis. Sisters? perspective on a long-term nursing care for elderly is: closer connection of health and social services, to increase quality of care, to strengthen the autonomy of elderly, dignified care for the elderly, increased use of home care and informing the general public about it, streamlining communication with seniors and their families, safer environment and to increase the motivation of nurses to provide the highest quality of nursing care.

Bakgrund: Den psykiatriska vården har förändrats genom historien. En stor förändring skedde i samband med psykiatrireformen på 1990-talet. I samband med detta upplevde de närstående att de fick inta en mer vårdande roll och ett större ansvar för familjemedlemmen med psykisk ohälsa.   I tidigare studier framkommer att de närstående upplever börda i förhållande till sin familjemedlem och att det i sin tur har inverkan på den närståendes eget välbefinnande. Vidare påverkar detta den närståendes relation till familjemedlemmen med psykisk ohälsa.   Syfte: Syftet med denna studie var att beskriva närståendes upplevelser av hur relationen till en familjemedlem med psykisk ohälsa påverkas när familjemedlemmen flyttat till ett HVB-hem.   Metod: Studien genomfördes som en intervjustudie med kvalitativ induktiv ansats. I studien deltog tio respondenter och insamlat material bearbetades av författarna genom en kvalitativ latent innehållsanalys.   Resultat: I föreliggande studie framkommer att de närstående upplever att de befinner sig i en komplicerad situation. Rollen som närstående till en person med psykisk ohälsa kan upplevas som påfrestande och relationen blir på grund av olika anledningar ofta ansträngd. Det resultat som framträdde var att Relationen präglas av ömsesidig påverkan och att HVB-hemmet kan ge trygghet och underlätta relationen.    Slutsats: Att öka delaktigheten och att underlätta för de närstående gör att de kan minska sitt lidande och öka sitt eget välbefinnande. Vilket, ur ett helhetsperspektiv, kan skapa förutsättningar för en bättre relation och ökad livskvalité för samtliga individer i systemet. / Background: Psychiatric care has changed through history. A major change occurred in connection to the psychiatric reform in the 1990s. In relation to this, the relatives also felt that they were taking a more caring role and a greater responsibility for the family member with a mental illness.Previous studies have shown that close relatives to family members with a mental illness, experience a burden related to their family member. This burden is so significant that it affects the relatives own well-being and further influenced their relationship with the family member with mental illness. Purpose: The aim of this study was to describe relatives’ experiences of how the relationship to a family member with mental illness is affected when the family member moves to a residential care home. Method: The study was conducted as an interview study with a qualitative inductive approach. In the study ten respondents were interviewed and collected material were processed by the authors through a qualitative latent content analysis.Results: The present study revealed that the close relatives find that they are in a complicated situation. The role of being related to a person with mental illness can be experienced as stressful and the relationship, due to various reasons, becomes strained. The result that emerged was that the relationship is characterized by mutual influence and the residential care home can provide security and ease the relation.   Conclusion: To increase participation and ease the burden for the close relatives, can reduce their suffer and increase their own well-being. Which, from a holistic perspective, can create conditions for a better relationship and increase the quality of life for all individuals in the system.

This thesis, 'Living with HIV/AIDS: An ethnography of care in Western Kenya', is based upon 18 months of ethnographic fieldwork carried out in Central Nyanza, Kenya, between 2005-2007. It studies practices of care against the backdrop of the HIV/AIDS epidemic, which has impacted the region severely. The thesis explores how home and hospital are established as domains of care through practice. It draws upon ethnographic material collected from within a District Hospital, a Community-Based Organisation and people's homes. The thesis follows practices of care across divergent domains of social life to consider how practices of care within Luo networks of kinship and relatedness intersect with governmental interventions to manage HIV/AIDS. The thesis describes two governmental projects introduced to administer HIV/AIDS care in this region. It considers Home-Based Care, an HIV/AIDS response in which Community Health Workers are trained to support particular aspects of care at home, focusing on the practices of care employed by Community Health Workers as they visit sick people at home and attend organisational meetings. The thesis also describes the landscape of HIV care in the District Hospital, including the delivery of antiretroviral therapy. The focus here is on the relationships between caring practices in the hospital and at home, and the divergent responsibilities to care experienced by hospital staff and family members. The main argument of the thesis is that care is a particularly useful analytical tool for anthropology because practices of care take place across many different domains of social life, cutting across the boundaries that have formed the traditional focus of anthropological study. Studying practices of care illuminates the production of bounded domains of social life whilst simultaneously drawing attention to similarities of practice across different domains. Care provides a way of understanding the complex social landscape that has developed as people in Western Kenya endeavour to live with HIV/AIDS.