The aim of this study is to examine how assisting nurses reflects and talks about physical restraint in dementia care in Sweden. This study is based on three focus group interviews with a total of 13 people working in the eldercare in Sweden. The theoretical framework is a conflict, created by Rosmari Eliasson, between seeing the older persons as a subject and an object and that the conflict doesn’t have a solution. My results show that there is a difficult area to work in which attempts to protect persons with impaired decision-making capacity from harming themselves or be harmed in any other way and at the same time respect the individual and his autonomy.  There is a thin line between on one had to harm someone and on the other hand to protect the elderly person. The staff that are working with the elderly people feel forced to use physical restraint as a way of harm reduction, but at the same time they are violating the elderly people’s autonomy. In many cases the physical restraint is justified as a protective measure and the staff doesn’t see the physical restraint as a way of restrict and constrain the elder person.

Traditional familial care has been challenged due to the reduction of family size and increased mobility of the Chinese population. Institutional elder care is increasingly becoming an alternative to familial care. This study explores the relationship between ownership of elder care home and care quality, using data collected in 2010 from 157 homes in Tianjin. Two hypotheses were proposed for the study: 1) There is a difference between government and non government-owned facilities in facility characteristics; 2) Government-owned facilities have better care quality outcomes. The t-test results showed that government-owned elder care homes had advantages in economic resources, staffing and the availability of services. Government-owned facilities reported lower mortality rate compared to non government-owned facilities. Multi-variant regression analysis showed that economic resources—whether funding from the government or high payments from care-recipients in private facilities--are important factors predicting higher levels of care quality. These results indicate that the Chinese government continues to play an important role in institutional long term care; in the meantime, private market is increasing its prominence in the long term care market.

Det äldrepedagogiska arbetet kan se olika ut, beroende på var äldrepedagogen arbetar någonstans och vad äldrepedagogen har för resurser. Genom att studera det äldrepedagogiska arbetet vill vi ta reda på hur det kan se ut i kommunerna. För att få grepp om äldrepedagogiken och det äldrepedagogiska förhållningssättet har vi intervjuat chefer som har äldrepedagoger anställda i sin verksamhet. Vi vill ta reda på vad de chefer som har anställt äldrepedagoger har för tankar om äldrepedagogik och äldrepedagoger både innan och efter att de anställt äldrepedagoger. Vi har också intervjuat personer som arbetar som äldrepedagoger och undersköterskor för att se skillnader i synsätt. För oss är det viktigt att det äldrepedagogiska förhållningssättet synliggörs. En äldrepedagog kan arbeta på många olika sätt och därför tycker vi att det är intressant att titta närmare på äldrepedagogiken. Ett äldrepedagogiskt arbete kan t ex vara att leda personal men det kan också vara att leda äldre på olika sätt. Arbetssätten kan därför vara vitt skilda från varandra. Vår uppfattning är att det finns en positiv inställning till äldrepedagogiskt arbete och att den anses vara en viktig del i arbetet med äldre. Dock upplever vi att etableringen inte har fått den genomslagskraft som skulle vara önskvärd. / The elderpedagogy work can vary, depending on where the elderpedagogue is working and what resources the elderpedagogue has at his or her disposal. By studying the elderpedagoguywork, we want to find out how the work might appear in the municipalities. In order to get a grip on the elderpedagogy and the pedagogical approach of the elderly we conducted interviews with managers who have had elderpedagogues employed within their staff. We want to find out what managers, who have hired elderpedagogues, think about elderpedagogy and elderpedagogues both before and after they hired elderpedagogues. We have also interviewed people working as elderpedagogues and nurses to see the differences in approach. For us, it is important that the elderpedagogy approach is made visible. An elderpedagogue can work in many different ways and therefore we think it is interesting to look more closely at the elderpedagogy. The elderpedagogywork can, for instance, consist in supervision of personnel but can also mean the direct guiding of elderly people in different ways. The various approaches can because of this vary greatly. Our view is that there is a positive attitude towards elderpedagogoues’ work effort and that elderpedagogy is considered to be an important part in the work with elderly people. However, we feel that the implementation in the community have not had the impact that would be the desired.

Elderly sexuality in residential care is a subject ignored in both society and in research. This qualitative study investigates staff’s beliefs and experiences of sexuality in residential care. The research was conducted in Sweden, using semi-structured in-depth interviews with staff in residential care. Thirteen caregivers participated in this study. The study embraces the concept of constructionism as its analytical framework. The following are the key findings: (1) The participants noted the presence of sexuality among elderly people; (2) Staff’s interpretation of sexual expressions varied; depending on where, to whom and how the sexual expressions were articulated; (3) The institutional barriers were: lack of privacy, overall institutional limitationsin knowledge and guidelines, and caregivers understanding about sexuality among elderly; (4) The participants also identified sexual harassment at their workplace by the elderly; (5) Caregivers emphasized Dementia as a key factor disrupting sexual boundaries. In conclusion this study shows that residential care institutions do not recognize the need of sexuality among elderly people. As a consequence of elderly´s sexual needs being unrecognized their sexual needs is not taken account for. This also legitimize lack of guidelines and the staff being put in situations that they are not properly equipped to handle.

The thesis aimed to investigate the relationship between influence over scheduling and schedule satisfaction with three central factors within the psychosocial work environment within the elder care sector: quality of work, work-life conflict and intention to quit. The JD-R model was used as theoretical approach as it provides a framework of the relationship between different work factors, characteristics, health and wellbeing, as well as a context to the different factors in the scope of the thesis. A survey was distributed among workers within the elder care sector in collaboration with a union (n=1202) and statistical analyses were made, establishing correlations between the different variables with the use of Pearson Correlation Coefficient as well as multiple linear regression analyses. The results revealed that higher degrees of influence over scheduling were associated with higher degrees of schedule satisfaction, and both variables were positively related with quality of work and negatively related with work-life conflict and intention to quit. To conclude, relatively strong relationships were found between the factors indicating that influence on scheduling and specifically schedule satisfaction are important factors associated with quality of work, work-life conflict and intention to quit within Swedish elder care.

Det svenska välfärdssamhället har sedan länge värnat om alla likas rätt att få sina levnadsbehov tillgodosedda. I de fall där äldre blivit inkapabla att själva ta hand om sina behov kan plats till särskilt boende sökas där den äldre får assistans i sin livsföring. Biståndsansökningar till dessa boenden hanteras av kommunala tjänstemän och ska enligt lag hanteras lika för alla, oavsett kommunal utförare.Studien undersöker och analyserar huruvida det råder skillnader mellan större kommuner i Sverige vad gäller planering av- och placering till särskilt boende.Slutsatsen är att skillnader föreligger då vissa kommunerna utformat en reaktiv strategi där en uppbyggnad av ej verkställda beslut rättas till i efterhand och som inte tar hänsyn till behov utan endast ålder. De kommuner som lyckats väga in hälsa och behov i sin planering och i förväg försökt skatta den framtida efterfrågan på särskilt boende har lyckats bättre. Studiens resultat är att det råder kommunala skillnader kopplade till planering och placering till särskilda boende / The swedish welfare state has a history of equal rights for living needs. In cases whereolder people become incapable to take care of their needs, there are specialaccommodations where the elderly can receive all forms of assistance. Theapplication to these special accommodations are managed by the municipal officialsand must be handled equal by law, regardless of local performers.This study examines and analyzes whether there are differences between the largermunicipalities in Sweden in terms of planning and placement to specialaccommodations.The conclusion is that differences exist because some municipalities have designed areactive strategy in which a buildup of unexecuted decisions has to be correctedretrospectively and does not take needs but age into to account. The municipalitiesthat managed to weigh health and needs in their planning and tried to estimate thefuture in advance regarding demand for special accommodations has been moresuccessful. The result of this study is that there are municipal differences in planningand placement for special accommodations

This study will examine if caregivers, working with people with dementia problems, is in need of support and in what way they see how the support should be designed. Previous research shows that there are many factors in elderly care that affect all of the caregivers. Working with people in this sort if dependence, requires a lot of the caregivers, both mentally and physically. To study if the caregivers consider themselves to be in need of support, and in what way they see how the support should be designed, the study employs a qualitative approach using to types of interviews, one focus group with four assistant nurses, and two individual in-depth interviews with the administrative personnel and one nurse.   The results show that the need for support for the caregivers exists. Caregivers working with people with dementia problems, daily face difficulties, some more difficult to handle than others. The more difficulties to handle, the more the caregivers have the need for support.  The support should be designed in both internal and external forms, such as support from colleagues and tutoring. It is also indicated, by the caregivers that the need of support in their work exists despite of several years of experience. The need for continuous professional development is, according to caregivers, based in that each person with dementia problems has different needs. It can be seen as a similar need, but it's never quite the same. / Denna studie skall undersöka om vårdpersonalen, som arbetar med vårdtagare med demensproblematik, är i behov av stöd och på vilket sätt de då ser att detta i så fall ska utformas. Tidigare forskningsresultat visar att det finns väldigt många faktorer inom äldreomsorgen, som påverkar vårdpersonalen. Att arbeta med människor i denna beroendeställning kräver väldigt mycket av vårdpersonalen, både psykiskt och fysiskt. För att undersöka om vårdpersonalen anser sig ha ett behov, och i så fall på vilket sätt de ser att detta ska utformas, gjordes en kvalitativ studie. Studien delades upp i olika former av intervjuer. Det genomfördes två enskilda intervjuer och en fokusgruppintervju. Intervjuerna gjordes med sjuksköterska och chefen för demensboendet. Fokusgruppen genomfördes med fyra av demensboendets undersköterskor.   Resultatet påvisar att det finns ett behov av stöd för vårdpersonalen. Ett arbete på ett äldreboende, med inriktning för vårdtagare med demensproblematik innebär dagligen svårigheter, vissa mer svårhanterliga än andra. De mer svårhanterliga utmaningarna, som sker på demensboendet, behöver vårdpersonalen hjälp att hantera. Stödet får gärna vara utformat i både interna och externa former, som till exempel stöd mellan kollegor och handledning. Det framkommer även av vårdpersonalen att de behöver ett stöd i sitt arbete trots flera års erfarenhet. Behovet av kontinuerlig kompetensutveckling ligger, enligt vårdpersonalen, i att varje vårdtagare har olika behov. Det kan ses som liknande behov, men det är aldrig helt lika.

People born 1940-1949 will be more demanding regarding help from the elder care than previous generations. The explanation often proposed is that people born in the 1940’s grew up after the Second World War when cultural changes took place in society. The aim of this qualitative study was to describe the social needs of people born in the 1940’s today, in order to make cautious assumptions about what type of social needs elder care is likely to face in the future, when the older people becomes in need of elder care. A hermeneutic interpretation was made of the interviews with four older people born in the 1940’s who are not in need of elder care at the moment, and one social care assistant. The results showed that people born in the 1940’s want to maintain their current interests and activities in the future. Demands from the 1940’s generation concerning request for help from elder care, will according to this study and previous research, increase, especially concerning social needs and relationships. The conclusion is that the 1940’s generation will have bigger demands on getting various social needs satisfied, but how those needs will be met by the elder care, is still an open question for the future. / Fyrtiotalisterna kommer att ställa mer krav angående hjälp från äldreomsorgen än vad tidigare generationer gjort och förklaringen sägs vara att fyrtiotalisterna växte upp efter kriget då ett kulturellt skifte förändrade samhället. Syftet med denna studie var att redogöra för vilka sociala behov fyrtiotalister har i dagsläget för att göra försiktiga antaganden om vilka sociala behov som äldreomsorgen kan tänkas möta i framtiden, när fyrtiotalisterna blir i behov av äldreomsorg. Intervjuer med fyra fyrtiotalister som idag inte har något behov av äldreomsorg och en biståndshandläggare låg till grund för studien och analysen genomfördes utifrån ett hermeneutiskt perspektiv. Resultatet visade att fyrtiotalisterna vill bevara sina nuvarande intressen och aktiviteter i framtiden. Kraven från fyrtiotalisterna kommer enligt denna studie och tidigare forskning att öka jämfört med tidigare generationer, speciellt när det rör sociala behov och relationer. Slutsatsen är att fyrtiotalisterna kommer ställa mer krav på att få olika sociala behov tillgodosedda, men hur dessa behov senare kommer att tillgodoses av äldreomsorgen är en öppen fråga för framtiden.

Thesis advisor: Ruth McRoy / Unmet long term care needs are increasingly filled by immigrant home health workers who are primarily female (88%), racial minorities (85%), and from developing countries including Mexico, Caribbean, Philippines, and Africa. The growing numbers of immigrant home health workers are a result of global factors including economic policies, colonial histories with developing countries, and immigration legislation. In addition to macro factors, personal motivations lead migrant home health workers to immigrate and find jobs in the U.S. Once in the U.S., little is known about migrant home health workers' caregiving experiences and work conditions. This study was designed to address this need and explored the personal experiences and viewpoints of the workers. Additionally information on migration histories and work setting was gathered to contextualize caregiving experiences. The study was guided conceptually by caregiving theory on the commodification and devaluation of "care" which can ultimately result in outsourcing care to immigrant women. Qualitative description methods were used to guide the research design, data collection, and analysis of twenty-three semi-structured interviews of female immigrant home health workers in Massachusetts. Interviews focused on three topics: caregiving experiences, reasons for migrating to the U.S., and work conditions. Findings will add to the knowledge base about immigrant home health workers paying particular attention to how workers themselves describe their experience which will in turn inform future policy and program initiatives on inclusion of a multicultural workforce into the long term care system. / Thesis (PhD) — Boston College, 2014. / Submitted to: Boston College. Graduate School of Social Work. / Discipline: Social Work.

<p>The purpose of this study is to examine the influence of leadership on co-workers during a re-organization. Our framing of the problem is based on a book written by Lee G. Bolman and Terrence E. Deal (2007) <em>“Reframing organizations – artistry, choice and leadership” </em>and their four perspectives on leadership. The questions that our study is based on are:</p><ul type="disc"><li>What leadership perspective was characteristic for the chief of staff during the re-organization? </li><li>How did the employees experience the leadership of the chiefs during the re-organization?</li><li>In what way do the chiefs of staff feel that their leadership affected the employees during the re-organization?</li></ul><p> </p><p>To get a deeper understanding in this subject we conducted interviews with the two chiefs of staff and their employees in a small suburb to Stockholm, Sweden. In our background we described the history of the suburb and why this re-organization is taking place. Thereafter we account for research in this area of expertise. In chapter five we account for the four perspectives and organization culture. We analyzed our interviewed material from these four perspectives and organization culture. Thereafter we conducted a conclusion based on the analyzed material. We concluded that both chiefs of staff were influenced by all four perspectives and this influence had different impacts on their employees. One chief were influenced by a Human Resource-perspective and a perspective focusing on structure. The second chief was also influenced by a perspective focusing on structure but also the perspective that focuses on politics.</p>