The position of middle-management is a role where the manager is at risk of being caught between its management and its employees. Elderly care is an industry that has been discussed a lot, to a large extent on how businesses should be managed and by whom it should be conducted. Middle-management in the business of elderly care thereby possess a vulnerable position in a controversial industry. In this study the aim is to investigate the managers' roles and tasks in both the public sector and the private sector in elderly care. It also aims to examine whether there are differences between the roles and how they in such cases is manifested. Previous researchers treats middle-managements role in elderly care as uniform for both sectors and focuses on the conditions and challenges. The theoretical background of the thesis is partly Ritzers McDonaldization to explain efficiency work in elderly care and Goffman's theories of social roles between the managerial role. The study was conducted through qualitative semi-structured interviews with nine interviews conducted, divided of five respondents in the public sector and four in the private sector. The result shows that the conditions for middle-management in elderly care for both sectors are similar in most cases, for example responsibilities and economic impact and that middle-management in both sectors experience a lack of time. However, there are certain areas that differ slightly, for example it is described by the private players that they have a better financial situation than their rivals in the public sector. It is also clear from the thesis that there may be other influential factors, for instance whether a home for the elderly run by public sector is exposed for competeition, or if a privately elderly care-unit is owned and fully run in-house. / Mellanchefsrollen är en utsatt roll där chefen riskerar hamna i kläm mellan sin ledning och sina medarbetare. Det är ett stressfyllt arbete. Äldreomsorgen är en bransch som diskuterats mycket, till stor del kring hur verksamheter ska skötas och i vilken regi den ska bedrivas. Mellanchefen inom äldreomsorgen besitter därmed en utsatt roll i en omdiskuterad bransch. I den här studien syftas att undersöka mellanchefers roller och arbetsuppgifter i den offentliga sektorn och privata sektorn inom äldreomsorgen. Syftet är även att undersöka om det finns skillnader mellan rollerna och hur de i sådana fall tar sig uttryck. Tidigare forskning behandlar genomgående mellanchefsrollen inom äldreomsorgen som enhetligt för båda sektorerna och redogör för förutsättningar och utmaningar. Den teoretiska bakgrunden i uppsatsen är dels Ritzers McDonaldization för effektiviseringsarbetet inom äldreomsorgen och Goffmans teorier om sociala roller för mellanchefsrollen. Studien är genomförd genom kvalitativa semistrukturerade intervjuer där 9 intervjuer har genomförts fördelat på 5 respondenter i offentlig sektor och 4 i privat sektor. Resultatet visar att förutsättningarna för mellanchefer inom äldreomsorgen inom båda sektorerna är likartade i de flesta fall, bland annat gällande ansvarsområden och ekonomisk påverkan samt att de i båda sektorerna känner stor tidspress. Vidare finns det vissa områden där det skiljer sig åt en aning, exempelvis redogör de privata aktörerna för att de har en bättre ekonomisk situation. Det framgår även av uppsatsen att det kan finnas andra påverksansfaktorer, bland annat om en verksamhet är konkurrensutsatt eller om verksamheten privat drivs i egen regi.

Diss. Lund : Lunds universitet, 2005.

Sjukvårdsorganisationer står inför stora utmaningar när andelen äldre i befolkningen ökar. Undersköterskor inom äldreomsorgen är en yrkeskategori som det ställs höga krav på eftersom de står för huvuddelen av den praktiska patientvården. Sjukskrivningarna ökar och ur ett nationellt perspektiv sticker Västsverige ut med särskilt höga sjukskrivningstal. Syftet med föreliggande studie var att få en djupare förståelse för undersköterskors subjektiva upplevelser av arbetslivet inom kommunal äldreomsorg. En kvalitativ fenomenologisk metod med tematisk analys tillämpades med semistrukturerade intervjuer som datainsamlingsmetod. Tio undersköterskor från en kommun i regionen deltog. Intervjuerna transkriberades och kodades. I resultatet utkristalliserades tre teman och åtta underteman/kategorier: Arbetsuppgifter (praktiska arbetsuppgifter, sociala arbetsuppgifter, osynliga arbetsuppgifter), Organisering (formell organisation, informell organisation, omorganisation), och Välbefinnande (ökar välbefinnandet samt minskar välbefinnandet). De socialpsykologiska teoretiska utgångspunkter som ligger till grund för analysen är social utbytesteori samt gruppsykologi. Resultaten visade att upplevelser av arbetslivet till stor del präglas av sociala relationer, både inom arbetsgruppen och mellan vårdtagare - undersköterska. Själva arbetsuppgifterna var mindre framträdande när det kom till meningsskapandet kring vad som upplevs påverka välbefinnandet i yrkeslivet. / Healthcare organizations face great demands as the proportion of the elderly is increasing. Assistant nurses account for the majority of practical patient care and as a result, they are experiencing negative working conditions. As a consequence, the Western region in Sweden especially, is dealing with high levels of sick-leaves. The aim of the present study was therefore to gain a deeper understanding of assistant nurses’ experiences of working conditions. Qualitative phenomenological method together with semi-structured interviews was adopted. Ten assistant nurses in one municipality participated. The interviews were transcribed and coded based on qualitative thematic analysis. Three themes and eight thematic categories emerged: Working tasks (practical working tasks, social working tasks, invisible tasks), Organization (formal organization, informal organization, re-organisation), and Well-being (increasing well-being, decreasing wellbeing). The social psychological theories underlying the theoretical part of the analysis were Social Exchange Theory and Group Psychology. The result showed that experiences of working conditions to a large extent were connected to social relations, both within the working group and between healthcare providers and care-recipients. Working tasks were less prominent as far as the creation of meaning about what affects well-being within the profession.

The diploma thesis Perception of a Retirement Home before and after Client's Admission deals with elderly people's decision to go to a retirement home and their subsequent life in a retirement home. The diploma thesis is divided into two parts theoretical and empirical. The theoretical part focuses on aging and old age, quality of life, autonomy, modern families and elderly care at home as well as in institutions. The chapter Aging, Old Age and the Elderly explains the terms "aging" and "old age". Next, it also describes the changes that occur during old age, how the elderly manage to adapt to these changes and what is their attitude toward old age. From the nursing perspective, the senior citizens can be divided into following categories: able, fragile, dependent, completely dependent and dying. According to this division, the level of care for the elderly can be determined. However, it is vital to maintain acceptable life quality among the elderly as well as respect their real needs. Not only basic physiological needs have to be satisfied, but also higher-level needs cannot be overlooked, such as safety, security, love, acceptance, belonging, respect, recognition and personal fulfillment. One of the next main aspects that also should be taken into account is personal autonomy. Personal autonomy includes independence and freedom. It is self-sufficiency of an individual related to his or her possibilities, abilities and willingness to seize the choices and opportunities that life offers. People have the right to make independent decisions and establish or carry out them in their social environment. In general, people are considered to be autonomous individuals when they manage and organize their own activities without help of anyone else, are able to satisfy their physiological needs, stand up for their opinions and do not enforce approval, closeness and emotional support. They should not excessively fear other people or even feel guilty. If elderly people are no longer self-sufficient due to any reason, it is necessary to provide them with comprehensive care. Elderly people should be entitled to choose their preferred form of care. Elderly care can be provided in clients' private environment, by their family or by field social work. If the elderly do not have a family or it is not possible to take care of them in their home, a housing facility called a retirement home can be used. A retirement home helps its clients with following: accommodation, meals, assistance with daily self-care tasks, personal hygiene or arrangement for personal hygiene, maintaining contacts with social environment, activating tasks and enforcing rights and interests (for instance assistance in dealing with authorities, communicating with various companies, etc.). The aim of the empirical part of the thesis was to determine how the elderly perceive the retirement home before their admission and after adaptation. A secondary aim was to identify the views of family members on changes in the behavior of the elderly after their placement in a retirement home. With regard to the objectives of the thesis, a qualitative research method has been chosen which allows to examine the area in depth. The research was conducted by a survey method (a semi-structured interview). The research was conducted in two retirement homes in South Bohemia. The research group consisted of 10 respondents aged from 60 to 88 years. The target group was selected by quota sampling. The respondents consisted of clients without loss of cognitive abilities placed in a retirement home who could remember their idea about the retirement home before entering it. Another target group were family members of the individual interviewed clients. The diploma thesis states questions related to the research areas.

The purpose of the study is to describe and analyze how different professions in elderly care perceive the need for change and how they respond to challenges the elderly care is facing with an increasing heterogeneous generation of elderly in need of care. Further the study wants to describe and analyze differences between the professions perception of needs for change. Through this the study can contribute to increase knowledge in the area of an increasing heterogeneous generation of elderly people and its response to the needs of care. The empirical material has been collected through five semi-structured qualitative interviews where different employee positions in elderly care have been represented. One focus group has also been conducted. The empirical material from these interviews has thereafter been analyzed through the concept of salutogenic approach, forty talists and the third age. The result and conclusions shows that there are similar opinions about the importance of the quality of healthcare in the elderly care. The different employes work with the specific needs of the elderly in different ways and have overall similar goals. The results and conclusions confirm how communication lacks differently in the cooperation with each other. The employes believe that their interaction and cooperation with each other is important for the prospective work with future elderly care.

The purpose of this study is to examine how employees in Swedish elderly care, more specific night patrols, describe their care work based on the national value base. A qualitative ap-proach has been used as a method in this study, with semi-structured interviews as a base. To gather empirical material, seven people who are assistant nurses and care assistants, working in Swedish elderly care as night patrols, were interviewed. The theoretical point of departure has been professional ethics, proximity ethics, Martin Buber´s I-and-Thou-theory. The theo-ry has been helpful whilst analysing the empirical material. The national value-based work describes how caregivers perceive when a I-Thou-relationship is achieved. In such relation-ship the caregiver and the elderly are in a subject-subject-relationship. In a opposite relation-ship the caregiver and the elderly are in a subject-object-relationship with a distance between them. In such relationship the caregivers don´t feel they have done a value based work. The results shows that a certain objectification must be done in order for the working process to function. This is also accepted by the employees, as long as there is still a certain balance be-tween the subject-subject relationship and the subject-object relationship. The results also shows that the experience of creating meaningfulness for the elderly seems to be weaker than the creation of security.

The world population is ageing, and this is also relevant to South Africa. At the same time the potential support ratio (the number of persons aged 15 to 64 years per one older person aged 65 years or older) is falling, and the dependency burden on potential workers increases. To alleviate the financial burden on the aged, and their families, it has become necessary to develop a financial plan to cover the cost of frail care. The overall purpose of this research is to determine whether any financial plans exist which are relevant. If nothing existed, a plan had to be developed. The research methodology for this study comprised the following steps: Firstly, the demographics of the world and South Africa were researched. The concept of frail (long-term) care in the United States of America and New Zealand was investigated to determine what is available. The subsidisation concept of the South African Government towards caring for the elderly was also investigated. Secondly, a questionnaire was sent to the residents of five retirement complexes in George to determine their interest in such a plan. The records of the frail care unit that these residents utilise were analysed to determine the number of residents needing frail care. A comparative study of the cost of frail care in the Southern Cape was undertaken. Thirdly, two options to partly subsidise the cost of frail care were examined, where the first option covers the running cost, and the second option, subsidising one third of the frail care cost, builds up a sustainable fund after the first five year period. The funds of the second option can then be utilised in the subsequent years to increase the subsidisation portion of frail care cost. The final step of this study entailed the formulation of recommendations to implement the frail care nursing levy as soon as possible, with special attention given to the following: a) It must be compulsory for new residents to join the fund. b) A yearly capital amount of R100 000 or more is needed to sustain the fund. c) A contract must be drafted to set out all the rules and regulations to the residents. d) An attitude change amongst some residents is required. Individuals must realise that the success of this plan depends upon themselves and with the necessary support could make a significant contribution towards their own peace of mind if and when frail care is needed.

In Sweden the need to recruit care assistants is increasing because of a growing older population together with their demands to stay in their own homes as long as possible. Swedish municipalities are responsible for organizing the social care and services for elderly with a coordination of some private provider companies. Moreover, to improve the care work a range of information and communication technologies (ICTs) e.g. safety alarm and electronic health record system are used to support care assistants’ daily activities and communication with elderly. Thus qualitative research aims to explore the care assistants’ use and experiences of existing ICTs. Furthermore, it examines the impact of the ICTs on their daily activities. The thesis pay attention also to care assistants demands, ideas and visions about future ICTs. The research found that care assistants were satisfied with the ICTs, they use today. However, the research also identified some problems related to ICT, which the care assistants are confronted with during their everyday work e.g. alarm buttons loosen and falsely triggered sensors. Care assistants expressed their ideas and visions about the ICT’s degree of involvement in their care activities and elderly’s lives. They had contradictions in their point of views related to the use of monitoring technologies for elder’s care. They also had negative feelings about these technologies. In short, the thesis explored two things; firstly, it reflected ICTs and care assistants’ demands and ideas related to the ICTs. Secondly, the daily activities of care assistants were examined. Therefore this research brings forward care assistants’ activities and makes their work more noticeable in order to be used in the development of new IT systems in the social care work.

The aim of this study was to investigate whether or not nursing staff working in a care home notice and, if they do, how they interpret signs of gerotranscendence in the residents and how they approach the residents that exhibited those signs. The study was conducted with qualitative semi-structured interviews with nursing staff active in a Swedish care home.  The theoretical approach was hermeneutic and the study was conducted due to the author’s view that the current research on gerotranscendence is sparse. The conclusion of this study is that the nursing staff were able to notice some signs connected to gerotranscendence in the residents but not all. Notification and interpretation of the signs were varied and residents were approached differently by the nursing staff due to the nursing staff’s varying theoretical and working background.

The aim of this study was to investigate how healthcare professionals perceive the importance of music as part of care in elderly care. The study has been inspired by the phenomenographic methodology aimed at detecting variations in caregivers' perceptions of music in elderly care. The data collection methods used in this study are participatory observations conducted during a music activity, as well as semi-structured interviews with caregivers. The analysis has been conducted based on a phenomenographic analysis model and has resulted in three descriptive categories:functional ability, emotions and learning together with associated subcategories. The result shows that music can improve old people´s memory, mobility and affect their mood. Music in elderly care can also increase the well-being and quality of life of elderly people, as well as contribute to the learning of staff that can increase the quality of care for the elderly. / Syftet med denna studie var att undersöka hur vård- och omsorgspersonal uppfattar betydelsen av musik som en del av vård och omsorg inom äldreomsorgen. Studien har inspirerats av den fenomenografiska metodansatsen som syftar till att upptäcka variationer i omsorgspersonalens uppfattningar om musik i äldreomsorgen. De datainsamlingsmetoder som har använts i studien är deltagande observationer som genomförts under en musikaktivitet på ett äldreboende, samt semistrukturerade intervjuer med omsorgspersonalen. Analysen har genomförts utifrån en fenomenografisk analysmodell och har resulterat i tre beskrivningskategorier:funktionsförmåga, känslor och lärande med tillhörande underkategorier. Resultatet visar att musik kan förbättra äldre personers minne, rörelseförmåga och påverka deras humör. Musikinslag i vård- och omsorg kan öka äldre personers välbefinnande och livskvalitet samt bidra till ett lärande hos personalen som kan leda till att kvaliteten i äldreomsorgen ökar.