87 Abstract This master thesis was focused on Validation method, whose author is an American social worker Naomi Feil, who created this as a help with communication with disoriented elderly people. The aim of the thesis was describe Validation, it's theoretical background which was set by The author herself and find out how is this method used in actual work with the disoriented old people in czech care homes. Thesis was divided in to two parts - theoretical and emipirical. In the first part was mainly concentrated on explaining the method itself. It's principles, reasons for origin, Validation techniques and use of Validation in czech environment. Empirical part was focused on finding out how practical usage of Validation looks like. To find out I used questionnaire that was send to care homes, where the employees finished some Validation training which was also criterion for choosing these respondents. From these results of the research I can say that the theoretical basis created by Naomi Feil is mostly not used in czech care homes. According to the questionnaires most employees of the care homes accepted the principles of Validation mostly it's empatiic communication. As is indicated in discussion, in my opinion it's more important to accept the principles of the method then mastery of the theoretical...

This study has been conducted in southwestern Sweden regarding asylum-seeking unaccompanied refugee children’s health. The aim is to investigate and understand unaccompanied refugee children’s health during their asylum-process based on care homes personnel’s experiences. The focus is on what factors that impact these children’s health the most and the data has been collected through interviews with personnel at care homes. The result showed that asylum-process, health care, anxiety, depression, suicidal thoughts, traumatic events, and PTSD are factors that have a negative impact on these children’s health, and thatsecurity and integration have a positive impact on their health.

The aim of this study is to explore and analyze the employee's experiences of using low arousal approach as a method in residential care homes. It is also done to better understand the employee's experiences, challenges and successes by using low arousal approach as a method with young people who show challenging behavior due to situations that makes them lose control over their behavior. The method used to answer the chosen questions is a qualitative method in the form of semi-structured interviews. This specific method was chosen because it allows for an in-depth exploration of our chosen topic. To answer the chosen questions, we have interviewed 6 employee's from one residential care home. These interviews provided a deeper understanding of their experiences with using the method and the advantages and disadvantages of applying it as a behavior management method. Their experiences with the method indicate that it is helpful when a child or young person with behavioral problems exhibits challenging behavior, as it helps to prevent the situation from escalating. Based on the interviews, we were able to conclude that there are more advantages than disadvantages. The method leads to strong relationships, greater understanding and positive behavioral change. The disadvantages include that over time, employee's may forget how to act in problem creating situations. The focus over time may shift more towards creating a calm working environment rather than helping the children or young people with behavioral problems who need assistance. In conclusion, with the help of the 6 semi structured interviews, the study was able to gain deeper insight into the employee's experiences, situations and the advantages and disadvantages of using the method while working with behavioral problems in residential care homes for children and young people.

Yes / Dementia friendly communities, in which people living with dementia actively participate and those around them are educated about dementia, may improve the wellbeing of those living with dementia and reduce the associated stigma. The Adopt a Care Home scheme aims to contribute towards this by teaching schoolchildren about dementia and linking them with people living with dementia in a local care home. Forty-one children, ten people living with dementia and eight school / care home staff participated in a mixed methods (questionnaires, observations, interviews and focus groups) evaluation to assess the scheme’s feasibility and impact. Data were analysed statistically and thematically. The scheme was successfully implemented, increased children’s dementia awareness and appeared enjoyable for most participants. Findings, therefore, demonstrate the scheme’s potential to contribute towards dementia friendly communities by increasing children’s knowledge and understanding of dementia and engaging people living with dementia in an enjoyable activity, increasing their social inclusion. / University of Sheffield's Faculty of Medicine Dentistry & Health Innovation Fund.

Yes / Acute hospital admission is distressing for care home residents. Ambulatory care sensitive conditions, such as respiratory and urinary tract infections, are conditions that can cause unplanned hospital admission but may have been avoidable with timely detection and intervention in the community. The Better Health in Residents in Care Homes (BHiRCH) programme has feasibility tested and will pilot a multicomponent intervention to reduce these avoidable hospital admissions. The BHiRCH intervention comprises an early warning tool for noting changes in resident health, a care pathway (clinical guidance and decision support system) and a structured method for communicating with primary care, adapted for use in the care home. We use practice development champions to support implementation and embed changes in care. Methods and analysis: Cluster randomised pilot trial to test study procedures and indicate whether a further definitive trial is warranted. Fourteen care homes with nursing (nursing homes) will be randomly allocated to intervention (delivered at nursing home level) or control groups. Two nurses from each home become Practice Development Champions trained to implement the intervention, supported by a practice development support group. Data will be collected for 3 months preintervention, monthly during the 12-month intervention and 1 month after. Individual-level data includes resident, care partner and staff demographics, resident functional status, service use and quality of life (for health economic analysis) and the extent to which staff perceive the organisation supports person centred care. System-level data includes primary and secondary health services contacts (ie, general practitioner and hospital admissions). Process evaluation assesses intervention acceptability, feasibility, fidelity, ease of implementation in practice and study procedures (ie, consent and recruitment rates). / UK NIHR grant number RP-PG-0612-20010.

Yes / . Improving quality of life (QOL) for people with dementia is a priority. In care homes, we often rely on proxy ratings from staff and family but we do not know if, or how, they differ in care homes. Methods. We compared 1056 pairs of staff and family DEMQOL-Proxy ratings from 86 care homes across England. We explored factors associated with ratings quantitatively using multilevel modelling and, qualitatively, through thematic analysis of 12 staff and 12 relative interviews. Results. Staff and family ratings were weakly correlated (ρs = 0.35). Median staff scores were higher than family’s (104 v. 101; p < 0.001). Family were more likely than staff to rate resident QOL as ‘Poor’ (χ2 = 55.91, p < 0.001). Staff and family rated QOL higher when residents had fewer neuropsychiatric symptoms and severe dementia. Staff rated QOL higher in homes with lower staff:resident ratios and when staff were native English speakers. Family rated QOL higher when the resident had spent longer living in the care home and was a native English. Spouses rated residents’ QOL higher than other relatives. Qualitative results suggest differences arise because staff felt good care provided high QOL but families compared the present to the past. Family judgements centre on loss and are complicated by decisions about care home placement and their understandings of dementia. Conclusion. Proxy reports differ systematically between staff and family. Reports are influenced by the rater:staff and family may conceptualise QOL differently / This research was supported by the UK Economic and Social Research Council and the National Institute of Health Research Grant number NIHR/ESRC (S.R., P.R, L.M., G.L., C.C., S.C., ES/L 001780/1); the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care North Thames at Bart’s Health NHS Trust (SR, PP, GL); the UCLH NIHR Biomedical Research Centre (GL, CC); and the Johns Hopkins Alzheimer’s Disease Research Center (C.L., P50AG005146, PI: Albert).

Yes / Quality of residential care for people with severe dementia is in urgent need of improvement. One reason for this may be the assumption that people with severe dementia are unaware of what is happening to them. However, there is converging evidence to suggest that global assumptions of unawareness are inappropriate. This trial platform study aims to assist care staff in perceiving and responding to subtle signs of awareness and thus enhance their practice. Methods/Design: In Stage One, a measure of awareness in severe dementia will be developed. Two focus groups and an expert panel will contribute to item and scale development. In Stage Two observational data will be used to further develop the measure. Working in four care homes, we will recruit 40 individuals with severe dementia who have no, or very limited, verbal communication. Data on inter-rater reliability and frequency of all items and exploratory factor analysis will be used to identify items to be retained. Test-retest and inter-rater reliability for the new measure will be calculated. Correlations with scores for well-being and behaviour and with proxy ratings of quality of life will provide an indication of concurrent validity. In Stage Three the new measure will be used in a single blind cluster randomised trial. Eight care homes will participate, with 10 residents recruited in each giving a total sample of 80 people with severe dementia. Homes will be randomised to intervention or usual care conditions. In the intervention condition, staff will receive training in using the new measure and will undertake observations of designated residents. For residents with dementia, outcomes will be assessed in terms of change from baseline in scores for behaviour, well-being and quality of life. For care staff, outcomes will be assessed in terms of change from baseline in scores for attitudes, care practice, and well-being. Discussion: The results will inform the design of a larger-scale trial intended to provide definitive evidence about the benefits of increasing the sensitivity of care staff to signs of awareness in residents with severe dementia. Trial Registration: ISRCTN59507580 http://www.controlled-trials.com.

Vår studie undersöker tolkens betydelse i kommunikationen mellan handledare på HVB och ensamkommande flyktingbarn. Vi fokuserade främst på möjligheter och brister som finns i tolkning idag, men även för att kunna förbättra handledarnas arbetssätt med barnen.  Vi har genomfört en kvalitativ studie där vi har intervjuat fyra tolkar och fyra handledare på HVB. För att analysera vårt resultat har vi använt oss av tre kommunikationsmodeller och Habermas teori om det kommunikativa handlandet. Modellerna har använts för att förklara specifika tolkningssituationer mellan barnen och handledare, och Habermas teori har vi använt för att förklara tolkningen utifrån samhället. I studien framkommer det att tolkningen ger goda möjligheter för att skapa en kommunikation mellan två individer. De största bristerna är att det saknas tolkar i vissa språk och att det blir fel i dialekter. Många av handledarna menar att tolkarnas kompetens är bristfällig och att tolkarna behöver vidareutbilda sig. Det framkommer även att många upplever att det är en fördel om tolken har kunskap om kultur och samhällen för att kunna överbrygga mellan barn och handledare. I tolkningen förekommer sällan känslomässiga samtal och att det är individuellt om barnet vill visa sina känslor vilket beror på vilket förtroende de har till tolk och handledare. Det finns mycket att förbättra inom tolkningen och det saknas riktlinjer kring hur man ska genomföra tolkning. / Our study investigates the interpreter´s significance in the communication between assistants at residential care homes and unaccompanied refugeechildren. We had our focus mainly on the possibilities and the deficiencies that are in interpreting today, but also to improve the assistants’ way of working with the children. We have implemented a qualitative study where we have interviewed four interpreters and four assistants at residential care homes. To analyze our results we have used three communication models and Habermas´ theory of communicative action. The models were used for explaining specific situations with interpreters between assistants and children, and we used Habermas´ theory to explain interpreting by society. The study reveals that interpreting gives good possibilities to create a communication between two individuals. The largest deficiencies are that there is a lack of interpreters in some languages and there occurs flaws in dialects. A lot of the assistants say that the competences of the interpreters are deficient and that the interpreters need more education. The study also reveals that many of the interviewed experiences that it is an advantage if the interpreter has knowledge about culture and communities to create a bridge between children and assistants. In interpreting, emotional conversations rarely presents and it is individual if the child wants to show its feelings and it depends on the trust they have to the interpreter and assistant. There are a lot of improvements needed and there is a lack of guidelines to how assistants should implement interpreting.

Darbe aptariama neformaliojo meninio ugdymo samprata, jo reikšmė asmens raidai bei taikymo vaikų globos namuose sunkumai; analizuojama meninės veiklos svarba globos namuose augančių paauglių integracijai į visuomenę. Baigiamojo darbo tikslas – ištirti, kaip neformalusis meninis ugdymas padeda globos namuose augantiems paaugliams integruotis į visuomenę. Darbo tikslui pasiekti iškelti šie uždaviniai: išanalizuoti neformaliojo meninio ugdymo sampratą formaliojo švietimo kontekste; apibūdinti neformaliojo meninio ugdymo reikšmę asmens raidai; išsiaiškinti neformaliojo meninio ugdymo taikymo vaikų globos namuose sunkumus; apibūdinti paauglių sėkmingo integravimo/si į visuomenę prielaidas; ištirti, kaip neformalusis meninis ugdymas padeda globos namuose augantiems paaugliams įgyti integravimo/si į visuomenę svarbių įgūdžių. Tyrimo objektas – neformaliojo meninio ugdymo svarba globos institucijoje augančių paauglių integracijai į visuomenę. Tyrimas atliktas trijuose Šiaulių ir Radviliškio rajonų vaikų globos namuose, naudojant anketinės apklausos metodą buvo apklausti 61 juose augantys paaugliai. Išanalizavus mokslinę literatūrą ir švietimo dokumentus gautos šios išvados: neformalusis meninis ugdymas - viena iš švietimo sistemos sričių, tenkinanti individualius auklėtinių meninio lavinimosi ir savirealizacijos poreikius, skatinanti asmens raidą bei kultūros brendimą. Vykdant neformalųjį meninį ugdymą vaikų globos namuose susiduriama su sunkumais: pasigendama socialinio teisingumo... [toliau žr. visą tekstą] / The thesis considers the conception of non-formal art education, its significance to the development of personality and the difficulties of its application in child care homes. The paper also includes the investigation into the importance of artistic activities to the social integration of teenagers raised in child care homes. The aim of the bachelor thesis is to determine how non-formal art education facilitates social integration of teenagers raised in child care homes. The following tasks were set to achieve this goal: to study the conception of non-formal art education in the context of formal education, to characterize the significance of non-formal art education to personality development, to ascertain the difficulties in the application of non-formal art education in child care homes, to describe the preconditions for the successful social integration/self-integration of the teenagers, to investigate how non-formal art education helps teenagers in child care homes to acquire skills necessary for social integration/self-integration. The object of the research is the significance of non-formal art education to the social integration of teenagers in child care homes. The research was conducted in the form of survey (a questionnaire) in three child care homes in Šiauliai and Radviliškis regions. The survey included 61 teenager respondents from these child care homes. The analysis of scientific literature and education documents led to the following conclusions: non-formal... [to full text]

This doctoral thesis deals with the type of architecture that materializes when age-related problems become a long-term condition (LTC) and gradually restrain the individual’s ability to perform activities in daily life (ADL). Their life situation necessitates a support from relatives or municipal eldercare staff in order for them to continue to participate in everyday living. In addition, the architectural space requires a close adjustment to the personal panorama of cognitive or functional impairments. The habitat can be a flat appropriated many years previously or in a residential care home for dependent and frail seniors. Architecture for ageing with dependency demonstrates how space can be used either to affirm or oppress the older person’s attempts to maintain an independent life style. By use of design theory, case study methodology and a heterogeneous research strategy, this study uses a threefold approach—a retrospective, a contemporaneous, and a future-oriented approach—to explore frail older people’s interaction with the architectural space of residential care homes. This has resulted in seven papers that focus on aspects of these human interactions with the built environment. Based on twelve exemplary models, the research paper I concludes that national guidelines result in a homelike, a hotel-like or a hospital-like environment. Research paper II is a retrospective study that examines the use of architecture competitions as a socio-political instrument to define architectural guidelines. Research paper III focuses on dependent seniors’ spatial appropriation of the communally shared space of a ward in a residential care home. Research paper IV employs two environmental assessment methods from the architecture profession and gerontological research (TESS-NH) in order to evaluate the use of interior colouring when refurbishing two residential care homes while the residents remained in place. Research paper V displays a municipal organizer’s considerations to opt for an architecture competition as a means of renewing architecture for the ageing population. Research paper VI examines competition documentation of three municipal architecture competitions organized during the period of 2006 to 2009. Research paper VII, the final study, explores notions concerning the appropriate space for ageing found among a group of municipal representatives, and people from organizations defending older people’s right. It supplies a model for understanding the appropriate space for ageing. This study illustrates the absence of older people with frailties in the public discussion about appropriate architecture for ageing. During the 20th century, the multi-dimensional idea of an architectural space with a homelike appearance has been used to contrast the negatively charged opposite—the complete and austere institution. The overarching conclusion of this study is that architecture for dependent and frail seniors constitutes a particular type of built space that requires an extended dialogue involving dependent seniors, architects, building contractors and care planners in order to conceive appropriate architecture for the ageing society. / QC 20110921