The purpose of this study is to examine the management of Karlskrona municipality's elderly care. The aim is to examine how the management is related to the theory of New Public Management. In addition, the study will investigate how the administration's employees, in this case the caregiver, respond to the management. In order to investigate this, the steering characteristics that are described by Lennart Lundquist in his theory of implementation, can, wants and understand will play a central part in the study. The essay is a case study based on a qualitative method and semi-structured interviews were made with employees in Karlskrona municipality's home care. The analysis reveals that there were several ideas in the management of the municipality's elderly care that can be seen in relation to the theory of New public management. In addition, the analysis reveals that the caregivers to a certain extent can and wants to comply with the current management, but lacks regarding their understanding of the steering can be identified, which can be seen as a negative effect to the steering overall.

The iam with this study was to obtain an understanding of how middle managers in private elderly care experience their leadership and its inclusive requirements. The study has also investigate how middle managers in the private elderly care take into account the company’s profit interest in relation to nursing ethics and quality requirements. Our study was conducted by qualitative research through semi-structured interviews in four middle-sized municipality in the southern part of Sweden. A total of seven middle managers were interviewed. The results showed that the middle managers in private elderly care has a complex leadership with many important responsibilities. The conclusion highlights that middle managers in the private sector have many possibilities like shorter decision paths and freedom of action. The struggle for the middle managers is to implement the management's decisions that they don't agree with. The conclusion also include that the middle managers perceives the financial goals of their organization as something positive regardless of whether they perceive the profit interest as noticeable or not. The middle managers have plenty of ways to quality assure care for their care recipient. Lastly the middle managers show that their leadership is furtherance to prevent the emergence of ethical dilemmas.

The aim of this quantitative study was to statistically test empirical knowledge that supports the idea of the existence of restrictive rationing and inequality in the distribution of resources for social support by variables of age, gender, marital status and number of nursing hours in the home care system. The material was obtained from internal records from the municipality of Karlskrona which constituted a population study, with which we performed regression analyzes to test the effect of the variables age and nursing hours on the variables escorting hours and  hours for social activation. An independent samples t-test were made to reveal any differences in mean values between the sexes, and a One way Anova analysis was made to check for differences of variance between each marital status. We found that men was rationed less hours of social support than women, that age had a positive effect on hours for social activation but a negative effect on escorting hours, that nursing hours had a positive effect on hours of social support and that there was a difference in mean hours of social activation between the married and the widowed, in the laters favour. We conclude that there is a restrictive practice in the home care system and that there is a difference in distribution between social categories, though it is not an unjust distribution of social support but rather an outcome of husbanding resources that points towards fairness, but we can recognize elderly of good health to be categories of attention as our analysis shows that they are are at risk to be overlooked.

Syftet med denna studie är att belysa hur arbetet mot ensamhet bland äldre ser ut och hur undersköterskor arbetar för att kartlägga äldres psykosociala behov med frågeställningar som handlar om hur ensamheten bland äldre synliggörs, hur undersköterskor arbetar för att kartlägga arbetet mot ensamhet utifrån värdegrunden och hur undersköterskorna bemöter äldre personer som upplever ensamhet. För att besvara dessa frågeställningar har sju semistrukturerade intervjuer genomförts och sedan analyserats ur ett hermeneutiskt perspektiv. Resultatet av denna studie visar på att åldrande och ensamhet kan förstås utifrån fysiska begränsningar och ett minskat socialt kontaktnät. Arbetet med äldre och ensamhet utifrån socialstyrelsens värdegrund har visat sig vara en kombination av aktivitetsteorin och disengagemangsteorin i och med den personcentrerade vården utifrån mina intervjupersoners subjektiva uppfattningar. Värdegrundens tre mål som handlar om att skapa en personcentrerad vård, att respektera de äldre och att vårdpersonal ska ha en adekvat utbildning är behandlade utifrån mina intervjupersoners svar. Den personcentrerade vården och respekten för de äldre behandlas genom kontaktmannaskap, samtal med den äldre och anpassning av vårdinsatserna efter situation och individ. Det verkar dock vara en svårighet att kartlägga de äldres psykosociala omsorgsbehov utifrån värdegrundens riktlinjer i och med att undersköterskor har svårigheter att kommunicera med omsorgstagarna. / The aim with this study was to illuminate the work with loneliness among older people and how assistant nurses work to chart older peoples psychosocial needs with following framing of questions: How does loneliness appear among older people? How does assistant nurses work to chart the work with loneliness among older people according to socialstyrelsens values? How does assistant nurses work with loneliness among older people? To answer those questions, I used seven qualitative semi-structures interviews and then analyzed it from a hermeneutical perspective. With that background, I temathisized the interviews to the concepts aging and loneliness, work with charting of the work with loneliness among older people from Socialstyrelsens values, the teory of activity and the theory of disengagement. The results showed that loneliness among older people was understood through physical disabilities and a lack of social network according to the persons who was interviewed. The work with older people according to Socialstyrelsens values (SFS 2001:453) has shown to be a combination with the theory of activity and the theory of disengagement because of the individually oriented care. According to the three themes and goals of Socialstyrelsens values (SFS 2001:453) to create an individually oriented care, to respect older people and that the staff should have an adequate competence was partly processed according to my respondents answers. The individually oriented care and the respect for the older people were connected when the assistant nurses work with liaisonship, social interactions with the individual and adaptation of the care depending on the individual and situation. It also seems that there are some issues with the charting of older peoples psychosocial needs according to Socialstyrelsens values because of an communication problem between the caretakers and the assistant nurses according to the persons who were interviewed, which means that the goal about adequate education partly is processed.

This project explored the values considered by elderly people, their younger relatives, and health professionals in decisions about residential long - term care, aiming to contribute to the literature on prospectively held values. The mixed methods design utilised a medical record review of 60 frail elderly hospital patients, a stratified survey of 3,015 adults in the South Australian community, and interviews with 36 stakeholders ( 10 elderly people, 10 younger relatives, and 18 health professionals ). The medical record review confirmed that the hospital patients and their outcomes resembled those described internationally. It was used to develop a hypothetical vignette, used in the later studies. Survey responses suggested that when considering a hypothetical long - term care decision, community members put the elderly person ' s physical health and safety first. Situational variables ( the elderly person ' s autonomy, environmental adaptation, and caregiver burden ) appeared secondary, albeit less so with increasing age of the respondent. Thematic analysis of the interviews demonstrated that elderly stakeholders considering a hypothetical decision were more likely to mention autonomy values, and less likely to mention safety values, than were relatives or health professionals. However, elderly stakeholders were also more likely to suggest restrictive solutions, such as residential placement and proxy decision - making. This finding raised methodological issues concerning ' third person ' vignettes, in that respondents might be responding as proxy decision - makers, rather than as if the hypothetical decision applied to themselves. The project confirmed that, in this context, prospectively held values resembled the retrospectively described values identified by McCullough, Wilson, Teasdale, Kolpakchi and Shelly ( 1993 ). Hence, the retrospective literature could be applied. The project supported the importance and complexity of psychosocial predisposing factors when applying the Andersen Behavioral Model ( Andersen, 1995 ) to long - term care decisions. Additionally, the Ecological Theory of Aging ( Nahemow, 2000 ) and the MacArthur Model of Successful Aging ( Andrews, Clark, & Luszcz, 2002 ) were found to be relevant to long - term care decisions for individuals and populations. It was concluded that both clinically, and at a policy level, discussions of long - term care could be more effective if they focussed on maintenance of elderly people ' s autonomy and control, rather than on their physical health and safety. / Thesis (Ph.D.) -- University of Adelaide, School of Psychology, 2006.

<p>Denna uppsats Sociala omsorgsprogrammets yrkesrelevans har syftet att undersöka hur utexaminerade studenter vid Örebro universitets Sociala omsorgsprogram med inriktning mot äldre och funktionshindrade, beskriver att utbildningen förbereder dem för yrket som enhetschef i kommunal äldreomsorg. Genomgående i studien är tre centrala begrepp; yrkesrelevans, kunskap och ledarskap. Studiens empiriska material baseras på intervjuer med enhetschefer. Det övergripande resultatet visar att frågan om yrkesrelevans är mångfacetterad. Möjligheterna till att utöva ett bra chefskap beror inte enbart på kunskaper från utbildningen, utan också på personliga erfarenheter och kunskaper, samt förutsättningar i stöd och personalantal. Sociala omsorgsprogrammet som grundutbildning kanske inte enbart bör ses som tillräcklig för ett kvalificerat ledarskap. Utbildningen bör kanske i annat fall ändras så att den motsvarar de krav arbetsgivarna ställer på nyexaminerade enhetschefer. I denna uppsats framträder dock att arbetsgivarnas krav ibland kan uppfattas som orimliga. Att utöva ett bra ledarskap beror inte enbart på utbildning, utan förutsättningarna i verksamheten är minst lika viktigt.</p> / <p>This thesis The vocational relevance of the programme in Social Care has the intention to study how students with an examination from the programme in Social Care oriented towards Elderly and Disabled at Örebro University, describes the education concerning its ability to prepare them for a profession as manager in government organized elderly care. Throughout the study three conceptions are essential; vocational relevance, knowledge and leadership. The study’s empirical material is based on interviews with managers in elderly care. The main result in this essay is that the question on the vocational relevance of the programme in Social Care is ambiguous. The prospects of performing a good quality in the leadership among management in elderly care also depends on individual skills, earlier work experience and the organization according to number of employees and support. The programme in Social Care is a compulsory education and may not be viewed as sufficient enough in an advanced leadership. Otherwise the education perhaps should change according to these demands of the employer. However this study shows that this demands sometimes is incongruous. To perform a good leadership does not only depend on the education, the conditions in the organization is also as essential.</p>

<p>Insufficient competence among nursing staff is a major concern in elderly care worldwide as the healthcare needs of the elderly become increasingly complex. In previous research, insufficient competence has been associated with work dissatisfaction and stress among elderly care nurses, and with lower quality of care. This thesis describes the development, implementation and evaluation of an educational intervention for nursing staff in elderly care. In a prospective, controlled study, evaluation of the educational toolbox was based on nursing staff ratings of their competence and psychosocial work environment, as well as on care recipients’ and family relatives’ ratings of the quality of elderly care.</p><p>Paper I validated a questionnaire measuring care recipient relatives’ perceptions of quality of care. Paper II compared self-rated competence, work strain, stress, and work satisfaction between staff working in home-based care and nursing homes. Papers III and IV evaluated the impact of the educational intervention on staff perceptions of their competence and psychosocial work environment (Paper III) and on care recipients’ and relatives’ perceptions of the quality of care (Paper IV).</p><p>The results showed that staff ratings of their competence and psychosocial work environment, including work satisfaction and work stress, improved significantly over time in the intervention municipality, compared to the reference group. Neither care recipients’ nor relatives’ ratings of the quality of care changed significantly over time in the intervention organization. Furthermore, there were no significant interaction effects over time between the intervention and reference groups for quality ratings. These results indicate that an educational toolbox that can be used according to local workplace needs may be an effective and sustainable intervention for improving staff competence and the psychosocial work environment. However, further studies are needed to investigate whether, and under what conditions, improved staff competence and work environment have an impact on quality of care.</p>

No description available.

Insufficient competence among nursing staff is a major concern in elderly care worldwide as the healthcare needs of the elderly become increasingly complex. In previous research, insufficient competence has been associated with work dissatisfaction and stress among elderly care nurses, and with lower quality of care. This thesis describes the development, implementation and evaluation of an educational intervention for nursing staff in elderly care. In a prospective, controlled study, evaluation of the educational toolbox was based on nursing staff ratings of their competence and psychosocial work environment, as well as on care recipients’ and family relatives’ ratings of the quality of elderly care. Paper I validated a questionnaire measuring care recipient relatives’ perceptions of quality of care. Paper II compared self-rated competence, work strain, stress, and work satisfaction between staff working in home-based care and nursing homes. Papers III and IV evaluated the impact of the educational intervention on staff perceptions of their competence and psychosocial work environment (Paper III) and on care recipients’ and relatives’ perceptions of the quality of care (Paper IV). The results showed that staff ratings of their competence and psychosocial work environment, including work satisfaction and work stress, improved significantly over time in the intervention municipality, compared to the reference group. Neither care recipients’ nor relatives’ ratings of the quality of care changed significantly over time in the intervention organization. Furthermore, there were no significant interaction effects over time between the intervention and reference groups for quality ratings. These results indicate that an educational toolbox that can be used according to local workplace needs may be an effective and sustainable intervention for improving staff competence and the psychosocial work environment. However, further studies are needed to investigate whether, and under what conditions, improved staff competence and work environment have an impact on quality of care.

This thesis deals with what happens linguistically and interactionally in naturally occurring bilingual talk-in-interaction between Danes and Swedes. In the data – collected within the elderly care in a Danish municipality – three Swedish caregivers interact with Danish pensioners and colleagues. Previous research on inter-Scandinavian interaction has mostly been concerned with talk-in-interaction in arranged situations and/or situations where the participants do not interact regularly with other Scandinavians. The talk-in-interaction in the present data, however, has a clear activity context, and the participants are used to talking to people speaking the neighbour language. The aim of this study was to examine how comprehension, understanding and social affiliation were achieved and demonstrated across differences in language, age, nationality and institutional roles. The theoretical and methodological framework includes accommodation theory and conversation analysis. The linguistic aspects of the Swedish speakers’ accommodation to Danish were studied both in a detailed analysis of accommodation on five linguistic levels, and quantitatively in a study of five linguistic variables. One result was that the Swedish caregivers had individual ways of accommodating their language to Danish. The linguistic analyses also indicated that one reason for this accommodation was to make communication flow more efficiently. A CA-study of other-initiated repair showed that four factors in the interactional situation influenced understanding: context, physical distance and orientation, clearness of speech, and neighbour language and accommodation. It could, however, not be shown that the speakers’ use of different linguistic varieties caused a significant number of problems in understanding, or that the participants frequently oriented to such linguistic differences as part of the problem. Compliment sequences and their role in creating social affiliation were studied in another CA-study. They often played the role of introducing a new topic and leading the talk away from the practical chores at hand, thereby reducing the institutional aspect of the situation. The interactional ways of creating comprehension, understanding and social affiliation are likely to be at least as important as linguistic convergence in achieving these goals.