Carer-employees are defined as individuals who provide unpaid care to a disabled / ill dependent person(s) while working full-time in the paid labour force. In Canada, there are 6.1 million carer-employees, many of which are experiencing work-life balance struggles, which may result in ill-health. To minimize negative impacts, there is interest in developing caregiver-friendly workplace policies (CFWPs) as an intervention strategy to improve CEs’ work-life balance. However, the effectiveness of CFWPs are still in their infancy and often only focus on the work dimension. One of the most critical dimensions that have not yet been assessed is the activity-travel behaviour of carer-employees, which is largely impacted by the assisted-transport demands of their care-recipient. To contribute to filling in this gap, this dissertation addresses the following objectives: 1) develop an activity-travel behaviour profile of carer-employees using sociodemographic and caregiving characteristics; 2) identify spatial locations with potentially high assisted-transport demand while suggesting new areas to improve mobility independence of care-recipients, and; 3) create and apply a mixed-methods framework that classifies the actual activity-travel behaviour of carer-employees. The purposes of all three objectives are to: contribute to closing the literature gap; visually inform decision-makers and health planners, and; efficiently develop caregiver-friendly transport policies (CFTPs). Highlighted findings show that carer-employees conducting assisted-transport have lower income and are more likely to be tired and overwhelmed than those not performing the transport task (Objective 1). In Hamilton metropolitan area, 38% of the older adult population are not within immediate reach to a vital service, and another 15% are located in potentially high assisted-transport demand areas. Suggested areas for service implementation would improve access for older adults by 18% (Objective 2). Lastly, the framework has classified and ranked three types of activity-travel behaviours (Objective 3). All of these findings have led to the discussion of a multi-pronged implementation strategy for uptake of CFTPs. / Dissertation / Doctor of Philosophy (PhD)

The purpose of this study was to understand what the care recipients considering as care quality in their long-term eldercare. Our intention has been to contribute a bit to the development of the care work. Previous studies show that user surveys are carried out regularly but there is very few studies that are based on care recipients own opinions and experiences. The main questions in the study have been to examine what is considered as good elder care from a user perspective. Even to understand the characteristics of a good meeting with the care staff and also examine how the elder care in Nybro municipality can improve. This study was based on a qualitative method in the form of seven interviews with recipient of elder care. The interviews were based on five themes which were; background, care, interaction, "special housing and social interaction" and also changes. The collected material is analyzed from a symbolic interactionism perspective. We view the symbolic interactionism as a useful perspective to gain an understanding of the interaction between care recipients and staff, and how it can develop care work The result revealed that the elder care in Nybro Municipality is generally of good quality and that it works well with home care. The care recipients appreciate when the care staffs are cheerful and friendly during visits, and they use the term "helpfulness" to describe what characterize a good treatment. What emerges as a negative aspect of the elder care is that the care staffs are extremely busy and always in a rush at each visit, which may partly affect the care a bit negative. The study shows a desire for change to improve care staff working environment. All respondents have different perceptions of the elderly and what is considered quality of care. Although there are common views on certain things, it is because of their differing views at who they interact with and in what context, the overall situation.

Thesis (DPhil (Environmental Health))--Cape Peninsula University of Technology, 2016. / Informal caregivers play an important role in the well-being of dependent members in a household. The burdens of these caregivers are multiple and pervasive and may contribute to mental health epidemiology as a result of worry, grief, anxiety and stress. The literature review revealed that studies in caregiving and its various facets began from a pragmatically applied interest rather than from theoretical and intellectual curiosity. The majority of the research on caregiver burden involves meta-analysis of qualitative studies with little quantitative research. Also, many of these studies are concentrated on caregivers of chronically ill patients, such as those suffering from dementia, Alzheimer’s disease, and heart disease, without much attention to care burden resulting from caring for those who are not necessarily ill. Similar studies by other researchers did not consider the impact of the physical health of the care recipients or the environmental factors that are critical in the study of female caregiver burden in low-income settings. In addition, existing studies did not adequately evaluate the many potential factors that may vary and influence the lives of the caregivers, especially in a single, comprehensive model. This study attempted to provide a more complete picture of these relationships in low-income and culturally diverse settings. The study population consisted of black/African and coloured populations living in subsidised or low-cost housing settlements. In each of the two different cultural communities, 100 black/African and 100 coloured female caregivers were selected through a systematic random sampling procedure. In addition, data were also collected from caregivers in Tamale, Ghana to assess differences between the socio-demographic profiles of the caregivers in Cape Town, South Africa and Tamale, Ghana. The theoretical paradigm used in this study is the Stress Process Model by Pearlin et al., (1990). The study instrument assessed caregiver burden with both objective and subjective measures through the use of a fully structured questionnaire. The information that was collected according to the constructs of the Stress Process Model included personal and role strains and incorporated the physical health of the care recipients and environmental factors such as kitchen and toilet hygiene. Inclusion criteria for the respondents in both Cape Town and Tamale were the principal female caregivers who were present, willing, and able to give informed consent. The Statistical Package for Social Sciences (SPSS Version 22) was used for the analyses. The Chi-square test was used to assess the relationships between environmental health, the socio-demographics of the female caregivers and the health status of the care recipients. The hierarchical regression analysis in the form of a General Linear Model was used to model caregiving burden. iv The results showed that the majority of the female caregivers were in the age group 40 – 49 years and in both Cape Town and Tamale, a large proportion was in the low-income group. Also, the majority of the informal caregivers in the two samples were in care tasks as a full-time job, providing more than 40 hours of care per week. Regarding the length of time in caregiving, a large proportion of the caregivers in both Cape Town and Tamale had been in the care role for more than three years preceding the survey, and almost all the caregivers in the Cape Town sample (98.4%) did not use any form of caregiving programme to ameliorate the negative effects of caregiving. Further, the results showed statistically significant relationships between the socio-demographic characteristics of female caregivers (age, education, population group and income status) and the diarrhoea status of the care recipients. Also, a significant relationship was shown between environmental health variables of the home (kitchen hygiene and toilet hygiene) and the physical health of the care recipients. The major predictors of female caregiver burden in the samples were the physical health of the care recipients and access to social grants. On the basis of the analyses, it was recommended that the government should recognise the importance of the physical health of the care recipients and increase the amounts of social grants to the caregivers since this could improve the circumstances of both the caregivers and the care recipients. In addition, this could aid in improving the standard of living of caregivers in these households. Future research in similar settings should disaggregate the data to compare the burden of caring for caregivers of physically strong care recipients with physically ill care recipients.

Allt fler blir allt äldre i Sverige och äldreomsorgen står inför en stor utmaning när resurser i form av ekonomiska medel och rätt personal blir allt svårare att konkurrera om. I eHälsans tidsålder utvecklas det på många håll smarta tekniska lösningar för att effektivisera och kvalitetshöja omsorgsinsatser, något som allt fler aktörer får upp ögonen för. Denna uppsats utreder behovsbilden för att kunna skapa en ny kontaktyta mellan omsorgstagare, närstående och utförare inom äldreomsorg. Uppsatsens resultat är en del av det Vinnova-finansierade projektet BoNUS VO som undersöker förutsättningarna för en sådan kontaktyta. IKT-stödet ska underlätta delaktighet i den egna omsorgen såväl som stödja yrkesutövare i arbetsuppgifter. Data samlades in genom en observationsstudie av hemtjänstarbete, deltagande i gruppsamtal med närstående till omsorgstagare samt kvalitativa intervjuer med 13 informanter som hade erfarenhet av äldreomsorg. Resultatet av dataanalysen visar på att det i dagsläget finns problem som skulle kunna undvikas genom att underlätta kommunikation och informationsdelning mellan användargrupperna. Resultaten visar också på att det finns många diskussionspunkter vad gäller nytta, motsättningar i behov och avvägningen mellan ett översiktligt eller komplext system. Studien konstaterar att det finns utrymme för vidare forskning inom området. / Sweden’s population is steadily growing older and while the demand for care of senior citizens is increasing, care givers are forced to cope with diminishing resources in terms of money and qualified staff. Many put hope in new eHealth technology, as a means of raising efficiency and quality in the every day working situation. This thesis aims to study needs regarding communication, information and interaction between care takers, dependants and caregivers in geriatric care, in order to create a foundation upon which an ICT system may be built to fulfill those needs. The results presented are part of a research project focusing on future ICT systems in healthcare. Data was collected through an observational study, group discussions with informants related to care takers, and qualitative interviews with 13 informants who have extensive experience of geriatric care. The results imply there are existing problems that may be avoided by facilitating information sharing between the aforementioned groups. The study also presents some important points of discussion regarding usefulness, clashing needs of different users, and the balance between simplicity of use and system size.

Inledning: Andelen äldre personer i Sverige ökar och beräkningar visar att det kommer finnas över en miljon personer i Sverige som är över 80 år 2045. Det är fler och fler äldre personer som väljer att bo i ordinärt boende vilket betyder att det kommer att behövas fler resurser för att bemöta deras behov. Att undersöka vårdtagarnas upplevda matsituation är viktigt för att förstå de hälsomässiga, sociala och samhällsekonomiska risker en bristfällig matförsörjning kan resultera i. Syfte: Syftet är att undersöka och beskriva den upplevda matsituationen bland äldre ensamstående vårdtagare som bor i ordinärt boende med hemtjänst för att få en förståelse för vilka förbättrande åtgärder som behövs. Fokus läggs på måltidsordning, känslorna kring matsituationen och måltidsmiljön. Material och metod: En kvalitativ studie gjordes i form av djupintervjuer med enskilda individer samt observationer av serverad mat och befintlig mat i hemmet. Intervjuerna spelades in samt transkriberades. Informanterna bestod av sex vårdtagare mellan 77 och 96 år från Höör och Simrishamn. Resultat: Resultatet visar att informanterna är nöjda med maten de får av hemtjänsten. Det finns dock ett underliggande missnöje med hur maten serveras, anpassning till hemtjänstens scheman samt brist på sällskap under måltiderna. Slutsats: Utifrån studien har det visats att vårdtagarna är tacksamma för den hjälp de får av hemtjänsten men det finns tecken på att det behövs förbättringar gällande hemtjänstens kunskap och planeringen av måltiderna. Det är inte möjligt att generalisera resultaten på grund av den begränsade omfattningen dock finns det möjligheter för framtida insatser och forskning kring exempelvis äldres speciella behov när det gäller matens innehåll, konsistens och måltidsordning. / Introduction: The number of elderly in Sweden is increasing and calculations show that there will be over one million people in Sweden over 80 years of age year 2045. There are more and more elderly people who choose to live in their own homes which means that more resources are required to meet their needs. Studying the experienced food situation of care recipients is important in understanding the health, social and socio-economic risks that a lack of food intake can result in. Aim: The purpose of this study was to explore and describe the experiences of elderly care recipient’s food situation, whom are living alone with home care in order to gain insight into which improvement actions are needed. The focus was on meal arrangements, the feelings about their food situation and their meal environment. Materials and methods: A qualitative study was implemented in the form of in-depth interviews with individuals as well as observations of served food and existing food in the informant's home. The interviews were recorded and transcribed. The informants consisted of six care recipients between the ages of 77 and 96 from municipalities Höör and Simrishamn. Results: The result shows that the informants are satisfied with the food they receive from the home service. There is an underlying dissatisfaction with how the food is served, adaptation to the home service schedules and company during meals. Conclusion: Based on the study, it has been shown that care recipients are grateful for the help they receive from home care services, but there are indications that improvements are needed regarding home care’s knowledge and planning of meals. It is not possible to generalize the results because of the limited extent, however, there are opportunities for future actions and research on, for example, special needs regarding food content, consistency and meal arrangements for the elderly.