Sveriges befolkning blir allt äldre och därmed kommer det att ställas höga krav på hälso- och sjukvården. Redan idag är situationen inom äldrevården oroande på grund av brist på utbildad personal, speciellt sjuksköterskor. Konsekvensen av detta resulterar ofta i bristande omvårdnad och risk för vårdskador inom äldrevården. Sjuksköterskor som omvårdnadsexperter har en viktig roll i omvårdnadsarbete och därmed ett ansvar för att äldre får den omvårdnad som de behöver och som håller en hög kvalitet. Syfte var att att belysa faktorer avseende sjuksköterskors ledarskap i omvårdnad som kan ha inflytande på omvårdnadskvalitet inom äldrevården i Sverige. En litteraturöversikt med datainsamling från två databaser som resulterade i elva artiklar, sex kvalitativa och fem kvantitativa. Det finns flera faktorer som har inflytande på sjuksköterskornas ledarskap i omvårdnadsarbete och som i sin tur påverkar omvårdnadens kvalitet inom äldrevården. Resultat består av tre huvudteman: Verksamhetsstruktur och vårdkultur, Kunskap och kompetens samt Relationer och Samarbete. I metoddiskussionen diskuterade författarna arbetets styrkor respektive svagheter samt samarbetets processer under hela arbetsgången. I resultatdiskussion resonerade författarna kring faktorer som visade sig ha påverkan på sjuksköterskors ledarskap i omvårdnadsarbete samt vårdandets viktigaste aspekter utifrån Katies Erikssons omvårdnadsteori. / The elderly population is getting older in Sweden and high requirements will affect the health care. Situation within the care of elderly is alarming due to lack of educated staff, especially nurses. This often results in insufficient care and could be a risk for the patients’ safety. Nurses as expert in nursing have an important role in the care and thus carry responsibility for the elderlies nursing is of high quality. Aim was to illuminate factors regarding nurses' leadership in nursing that may influence the quality of nursing in the care of elderly in Sweden. : A literature review of data collection from two databases that resulted in eleven articles, six qualitative and five quantitative. There are several factors that influence the nurses' leadership in nursing care, which in turn affects nursing quality in the elderly care. The results consist of three main themes: Organizational structure and care culture, Knowledge and expertise, Relationships and cooperation. There are several factors that influence the nurses' leadership in nursing care, which in turn affects nursing quality in the elderly care. The results consist of three main themes: Organizational structure and care culture, Knowledge and expertise, Relationships and cooperation. In method discussion, the authors discussed the strengths and weaknesses of the work as well as the process of cooperation throughout the work. In the result discussion, the authors reasoned factors that proved to affect nurses' leadership in nursing as well as the most important aspects of careers, based on Katie Eriksson's nursing theory.

The aim of this study was to get an increased understanding regarding how carers relate to consent while working with people who has dementia. The study asks the following questions: How does the carers understand the concept of consent associated with giving care to people with dementia? What is considered by the carers in connection to consenting to caregiving by people with dementia? And lastly, how does consent mediate between carers and people with dementia? It had a hermeneutic and qualitative scientific approach. The data was collected through three focus groups with carers and then analyzed according to Jens Rennstam and David Wästerfors (2015) method of analysis. The theoretical analysis was performed with three different theoretical aspects called: Scope for action and relationship, Being a client and relational power. The authors of the theoretical aspects were Kerstin Svensson, Eva Johnsson and Leili Laanemets (2014), Roine Johansson (2007), Katarina Jacobsson, Joakim Thelander and David Wästerfors (2010) and also Mats Franzén (2010). The main conclusion of this study was that the carers used body language and had to phrase their questions well towards the people with dementia regarding if they consented to let them help or not. The relationship between carers and the people with dementia was vital - without it consent was very hard to reach.

Ces dernières années, les réseaux de capteurs sans fil ont vu leurs champs d'applications s'élargir pour toucher plusieurs domaines dont celui de surveillance. En parallèle, le domaine à vocation médicale pour l'assistance aux personnes n’a pas manqué de s'intéresser lui aussi à cette technologie émergente face aux nombreux attraits qu'elle représente. C'est dans ce contexte que se situe notre travail de thèse. Nous nous intéressons à l'utilisation des réseaux de capteurs de type vidéo non intrusif pour la surveillance continue de personnes âgées évoluant dans leur environnement naturel. L’objectif est la proposition d’un système associant capteur vidéo et analyse intelligente locale, à un système de communication sans fil permettant la surveillance de personnes dans son habitat ou en milieu spécialisé. Nous désirons avant tout être capable d’identifier la personne surveillée et détecter son comportement, ses actions, ses mouvements afin d’agir sur son environnement via un système de communication sans fil et domotique, détecter une chute et émettre une alerte à travers le réseau. Une telle proposition, représente une solution avantageuse pour plusieurs raisons. Sur le plan économique, surveiller une personne âgée tout en la gardant dans son environnement normal permettrait de diminuer les charges d'assistance aux personnes en les traitant par un personnel spécialisé à l'hôpital ou à une maison de retraite. Un apport non négligeable est celui lié aux aspects psychiques et sociaux de la personne âgée, à qui cette surveillance discrète et imperceptible lui assure à la fois le sentiment de sécurité, de respect de la vie privée et d'autonomie. / In recent years, wireless sensor networks have seen their fields of application expand to affect several areas, including monitoring. In parallel, the field medical projects to assist people did not fail to be interested in this emerging technology thanks to the attractions it represents. It is in this context that our thesis is subscribed. We are interested in the use of a non-intrusive video sensors network to monitor elderly people continuously in their natural environment. The objective is the proposal of a video sensor system combining local and intelligent analysis, a wireless communication system for monitoring people in their habitat or specialized environment. We want above all, to be able to identify and detect the monitored person's behavior as well as his actions and his movements to act on his environment via a wireless communication system and home automation. Then we aim to detect a fall and communicate an alert through the network. This proposal represents an advantageous solution for several reasons. Economically, monitor an elderly person while keeping it in his normal environment would reduce the charges of assistance to people by treating them with specialized staff at the hospital or a nursing home. A significant contribution is the one related to the psychological and social aspects of the elderly, to whom this discreet and invisible monitoring ensures both the feeling of security, respect for privacy and autonomy.

This licentiate thesis is based on the growing interest in Swedish elderly care. The aim of this thesis is to investigate what generates satisfaction with elderly care among older persons. The dominant ideology in both privately and publically run elderly care is individualized care, also called person-centered care, which holds the older person’s satisfaction as one of the main quality indicators. The proportion of older people is increasing and to maintain high levels of satisfaction with elderly care will require more knowledge. Data from the National Board of Health and Welfare’s (2012) nationwide survey on seniors’ experiences with elderly care was collected. Statistical analyses of this sample formed the basis for the results of the thesis and were reported in two papers. Study I used Donabedian’s (1988) model of quality of care in terms of structure, process, and outcome, and all municipal units in Sweden were included (N = 324). The results showed that structural variables (i.e. budget, staff, and training level) have minimal or no relationships with older persons’ satisfaction with care, while process variables (i.e. experiences of respect, information, and influence) have strong relationships with satisfaction with care. Study II made use of the long-standing person versus situation- model in social psychology, and was analyzed on an individual level (N = 95,000). The results showed that care process factors (i.e. experiences of treatment, safeness, staff- and time-availability) had a stronger relationship, than individual factors (i.e. health, anxiety, and loneliness) with satisfaction with care. The results also showed that older persons with home care generally felt better treated than older persons in nursing homes, but also felt less safe. Mediational analyses, based on this comprehensive elderly data, suggest that the individual aging condition of loneliness can be countered by providing safeness and treatment, resulting in high satisfaction with care. In conclusion, satisfaction with elderly care in Sweden today can largely be explained from a psychological perspective by the older persons’ perception of the care process, not by the amount of structural resources or the conditions of the aging persons. These findings could help facilitate the future quality development in municipalities and care organizations.

This licentiate thesis is based on the growing interest in Swedish elderly care. The aim of this thesis is to investigate what generates satisfaction with elderly care among older persons. The dominant ideology in both privately and publically run elderly care is individualized care, also called person-centered care, which holds the older person’s satisfaction as one of the main quality indicators. The proportion of older people is increasing and to maintain high levels of satisfaction with elderly care will require more knowledge. Data from the National Board of Health and Welfare’s (2012) nationwide survey on seniors’ experiences with elderly care was collected. Statistical analyses of this sample formed the basis for the results of the thesis and were reported in two papers. Study I used Donabedian’s (1988) model of quality of care in terms of structure, process, and outcome, and all municipal units in Sweden were included (N = 324). The results showed that structural variables (i.e. budget, staff, and training level) have minimal or no relationships with older persons’ satisfaction with care, while process variables (i.e. experiences of respect, information, and influence) have strong relationships with satisfaction with care. Study II made use of the long-standing person versus situation- model in social psychology, and was analyzed on an individual level (N = 95,000). The results showed that care process factors (i.e. experiences of treatment, safeness, staff- and time-availability) had a stronger relationship, than individual factors (i.e. health, anxiety, and loneliness) with satisfaction with care. The results also showed that older persons with home care generally felt better treated than older persons in nursing homes, but also felt less safe. Mediational analyses, based on this comprehensive elderly data, suggest that the individual aging condition of loneliness can be countered by providing safeness and treatment, resulting in high satisfaction with care. In conclusion, satisfaction with elderly care in Sweden today can largely be explained from a psychological perspective by the older persons’ perception of the care process, not by the amount of structural resources or the conditions of the aging persons. These findings could help facilitate the future quality development in municipalities and care organizations.

AASS, or the Center for Applied Autonomous Sensor Systems, is a research environment at Örebro University. This report will touch the development of a robot intended for elderly care in a project called "Project Sputnik". The robot is essentially a manually controlled communication robot that is driven by a pilot from a computer. The robot’s purpose is to provide the option of virtual visits between elders and healthcare professionals or family and friends. The requirements for the robot are numerous and the project itself is far too extensive for one student to complete in a 15 credit course. Therefore, the project was limited to the physical design only. During the pilot-study a large amount of research was done to gain a better understanding of the touched subjects and to prepare for the future development of the project. The project followed the design methodology to gradually develop a conceptual sketch. The concept should form a basis that AASS can continue the development on, and is therefore deliberately crude not to limit AASS in the continued work of Project Sputnik. / AASS, eller Centrum för tillämpade autonoma sensorsystem är en forskningsmiljö på Örebro Universitet. Den här rapporten kommer röra utvecklandet av en robot ämnad åt äldreomsorgen i ett projekt vid namn "Project Sputnik". Roboten är huvudsakligen en kommunikationsrobot som styrs manuellt av en pilot från en hemdator och ska ge en upplevelse av virtuell närvaro. Kraven för roboten är många och projektet i sig är för omfattande för en student att utföra i en kurs på 15 högskolepoäng. Därför begränsades projektet till enbart den fysiska designen. Under förstudien gjordes en stor mängd research för att få en bättre förståelse för berörda områden och förbereda inför kommande processer i projektet. Projektet följde designmetodiken för att gradvis bygga fram en konceptskiss. Konceptskissen ska utgöra en grund som AASS kan utveckla, och är därför medvetet grov för att inte begränsa AASS i det fortsatta arbetet i Project Sputnik.

Background: Caring for an elderly person at the end of life means a complex care situation for healthcare professionals. There are several factors to consider in this regard; the patient's, relatives and healthcare staff as described in this work from the nurse. Aim: The purpose of the study was to describe municipality nurses' experiences of caring for older people in the final stages of life. Method: The study had a descriptive design with a qualitative approach. Data were collected through eight interviews and analyzed using a qualitative manifest content analysis, whereas five categories and ten sub-categories emerged. Results: The result is that the nurse practitioners saw this work as meaningful but also emotional stress. Feelings like insufficiency, participation, adequacy and existential issues were raised at the nurse's nurse. The palliative care complexity was visualized as the patient's self-determination, relatives, and nursing staff's needs were made visible and met. Conclusion: Palliative care is a person-centered care based on patient needs, which proved to be complex. Corresponding to these expectations and implementing the required care creates experiences, good and less good, with nurses who consciously or not, affect them regardless of patient or care opportunity and give a chance of reflection, further experience and opportunity to grow as a person and in profession. Keywords: C aring, end-of-life care, elderly care, nurses’ experience, palliative care

The care of older people today strives to focus on a person-centered care, aimed to perform individual care filled with wellbeing and respect. To do so the Swedish municipalities are using individual plans to describe how care actions should be performed in line with law descriptions on elderly individuals.This study is a qualitative study using semi-structured interviews aiming to describe and understand how staff working in close contact with elderly individuals establish and use individual plans. This also include difficulties that the staff may experience. The results found that the interviewed staff saw great importance of filling out these plans due to the formal structure linking the plans to law descriptions. The study also explain difficulties with this as they try to make the individual plans work as a living document that is person-centered for the elderly, as well as being a modell for documentation and the work that the staff are assigned. Furthermore, the results also include examples of how the informants show great interest of caring for the elderly and how they also share what could be described as a normative view on the matter.

Bakgrund: Den vanligaste kroniska sjukdomen bland äldre människor i hela världen är demens. Vård och omsorg på ett boende för människor med demens kräver kompetens och erfarenhet. Dessutom är sjuksköterskans uppdrag att vara en ledare inom omvårdnad och hälso- och sjukvård. Syfte: Arbetets syfte är att belysa sjuksköterskans ledarskap på boende för personer med demens.Metod: En kvalitativ litteraturstudie innehållande tio studier med kvalitativ ansats. Databaserna PubMed, CINAHL, SveMed+ användes för sökning av vetenskapliga artiklar. Artiklarnas kvalitet granskades med hjälp av modifierad SBU:s (2018) granskningsmall. Analysen av samtliga vetenskapliga artiklar utgick utifrån Forsbergs och Wengströms (2013) beskrivning av innehållsanalys.Resultat: Sjuksköterskans ledarskap är ett komplext mångbottnat fenomen. Tio huvudkategorier identifierades inom ämnet: handledning och styrning, kunskap, etik, undervisning, kommunikation, teamarbete, hinder, stöd, vårdkvalitet och vårdmiljö.Konklusion: Mer uppmärksamhet till sjuksköterskans ledarskap behövs. Fördjupad kunskap inom ledarskap är nödvändig för succesivt arbete och sjuksköterskans status. / Background: In the world dementia is the most common chronic disease among older people. Competence and experience are essential for providing care and ward in residential facilities for people with dementia. Nurses mission is to be a leader in nursing and healthcare.Aim: The aim of this paper is to describe nurse’s leadership in nursing home for people with dementia.Method: A qualitative literature review consisting ten research articles with qualitative approach. PubMed, CINAHL and SveMed+ databases were used for research. Articles were quality reviewed according to modified SBU’s quality template. Content analysis as described by Forsbergs and Wengströms (2013) was used for analysis. Result: Nurse’s leadership is a complex, multicomponent phenomena. Ten main categories of the subject were identified: coaching and guiding, skills, ethics, education, communication, teamwork, obstacles, support, quality of care and care environment.Conclusion: More attention is needed for nurse’s leadership. More research on nurse’s leadership, deeper knowledge in this area is needed for successful work and increasing of nurse’s status.

The purpose of this paper is to examine in which ways animal-assisted work can be used within elderly care and with people that are included in support and service for persons with certain functional impairments (in Sweden called LSS). Through qualitative, semi-structured interviews we wanted to see what kind of experiences the professionals had and if there are any advantages and disadvantages with this type of work. Our selection consisted of six people from various institutions that practice social work in the south of Sweden, equally divided between LSS and elderly care, who together with five dogs and one horse implement animal-assisted social work in their institutions. Six different themes were identified in the empirical data we gathered throughout our interviews. With the help from our themes, previous research on the subject and our theories the biophilia hypothesis, SOC and symbolic interactionism we managed to analyse our empirical data. To sum up, our result indicates that the animal-assisted work gives very positive results for the clients. We have been given examples on how the animal-assisted social work helps breaking the client’s isolation, how it can contribute to an increased well-being physically as well as mentally. We have also seen how the animals can be used to work as a motivational factor and how they can teach the clients accountability. Furthermore, we discuss our results and future research we are interested in seeing to ease the animal-assisted social work progress in the Swedish social work.