En viktig del av den svenska välfärden är kommunens äldreomsorg för personer över 65 år, där Socialtjänstlagen ger rättighet till vårdboende och andra servicetjänster när det behövs. Kommunernas kommunaltjänst ska enligt Socialtjänstlagen vara av god kvalitet. Rapportering av avvikande händelser är en av hörnpelarna i arbetet med att förbättra kvalitet och säkerhet i vården. Avvikelserapportering bidrar till att undvika att negativa händelser upprepas, samt att rutiner förbättras för att höja kvalitet. Genom att ta tillvara möjligheterna med avvikelserapporter kan kvaliteten på vårdboenden förbättras och utvecklas. Denna studie visar på behovet av ytterligare fokus på arbetet med avvikelsehantering gällande omsorg.

The aim of this observational study was to see how social interaction works in nursing homesdayroom. The focus was to study the staff and the residents during lunch, afternoon coffee,and during the eventual common activity. The observation persons were passive and they didnot communicate with either staff nor with the residents. The theoretical framework usedwas Georetrendens theory, KASAM and Communication theory. The results showedthat social interaction in the dayroom of the nursing home is rarely spontaneous, but mustinstead be planned by the staff. The results also showed differences in theinteraction regarding the treatment of the residents. The younger and older staff had differentapproaches. Staff who had a different cultural background than the Swedish had anotherway to respond to the residents. The residents were unhappy about the lack of activities. Theyexpressed that they felt lonely when the staff had several tasks outside the nursinghome. Another thing we observed was that the staff often urged the residents to go and rest intheir apartments. There was also a difference in the various nursing homes that wereobserved; the smaller nursing home had one staffgroup that some of the residents had for longknown each other because of the small community they live in.

SAMMANFATTNING Syfte: Syftet med studien var att undersöka vilka uppfattningar äldre vårdtagare på vårdboende hade om kvalitet i samband med måltider med avseende på aspekterna produkten, rummet och mötet. Metod: Studien är av deskriptiv design och bygger på kvalitativa intervjuer. Urvalet var målmedvetet och undersökningsgruppen bestod av nio äldre vårdtagare på vårdboenden. Intervjuerna analyserades med en kvalitativ analysmetod. Resultat: I resultatet framkom att det var viktigt att maten smakade som förväntat, tillagades på rätt sätt av kompetent kökspersonal samt var nylagad med ett aptitligt utseende. Viktigt var att få välja exempelvis portionsstorlek och dryck. Måltidsmiljön skulle vara trivsam, ren och stressfri. Vårdtagarna ville få möjlighet att välja matrum. Personalen påverkade måltidsupplevelsen och viktigt var en trevlig, omtänksam samt hjälpsam personal. Sällskap ansågs viktigt och att själv få välja mellan att äta med eller utan sällskap. Slutsats: Vårdtagarna i studien hade varierande uppfattningar om vad som ansågs vara kvalitet gällande måltider. Däremot uttryckte alla vårdtagarna i studien att det var viktigt att bli tillfrågad och ges möjlighet att påverka sin egen måltid. Detta visar vikten av att vårdpersonal strävar efter att möta individens egna önskemål under måltiden för att optimera upplevelsen av kvalitet vid måltiden. / ABSTRACT The purpose: The purpose of the study was to investigate what older people living in nursing homes consider to be quality at meals regarding the aspects the product, the room and the meeting. Method: The study has a descriptive design and is based on qualitative interviews. The sampling was purposive and the interviewees consisted of nine elderly nursing home residents. The interviews were analysed with a qualitative analysis. Results: The result showed that it was important that the food was fresh with an appetizing appearance, tasted as expected and was cooked in the right way by competent kitchen staff. To be able to choose for example the beverage and the size of the portion was important. The surroundings at meals should be pleasant, clean and free from stress. The nursing home residents wanted the option to choose dining room. The staff affected the experience of the meal and a pleasant, considerate and helpful staff was important. Company was of importance and also the option to choose between eating with company or alone. Conclusion: The opinions of quality regarding meals differed among the participating nursing home residents. However all the informants in the study expressed that it was important to be asked and given the possibility to influence one's meal. This shows that it is important that the nursing staff show respect for individual desires to optimize the experience of quality at meals.

The presence of human pharmaceuticals in the aquatic environment is now becoming a well-established fact. The identified problems associated with their presence include the fact that these compounds are biologically active, some of them are toxic in nature, and a number of compounds have potential to foster and maintain drug resistant microorganisms. They are discharged into the aquatic environment from a variety of sources, but mainly by the excretion of incompletely metabolized pharmaceuticals by individuals into the wastewater. This situation makes finding a source-control strategy difficult. However, healthcare facility (hospitals and long-term-care homes) effluents are suspected to have relatively higher concentrations of these compounds, as such facilities use pharmaceuticals in large amounts for diagnostic, cure and research purposes. It is expected that controlling discharges from these facilities may provide a cost-effective solution to reduce the pharmaceutical loads entering the aquatic environment.

Darbo tikslas – išanalizuoti pagyvenusių žmonių, gyvenančių stacionarioje globos įstaigoje, psichosocialinių poreikių tenkinimo optimizavimą. Tyrimo tikslas – nustatyti Veisiejų pensionato pagyvenusių žmonių poreikius ir vadybiniai sprendimai juos tenkinant. Pagyvenę ir seni žmonės susiduria su daugeliu specifinių problemų, būdingų jų amžiaus tarpsniui. Jų statusas menkėja, vaidmenų skaičius mažėja, pamažu jie stumiami iš visuomenės gyvenimo, kol tampa nereikalingais. Dėl amžiaus vis sunkiau įsitraukti į visuomeninę veiklą, todėl pagyvenę ir seni žmonės tampa lyg atskira visuomenės dalimi. Be to silpnėja kartų solidarumas, mažėja suaugusių vaikų parama senyvo amžiaus tėvams. Senas žmogus be maisto, pastogės šilumos turi ir kitus poreikius. Šiandien tapo labai svarbu padėti žmogui nugalėti vienišumą, emocinę izoliaciją, nugalėti dvasinę krizę, kad vėl taptų save gerbiančia asmenybe. Pensionato kontingentas – tai sergantys, negalės ištikti žmonės, našliai ir našlės arba gyvenime likę viengungiai. Tarp jų ir tie, kurie linkę su artimaisiais ir bendruomenės atstovais konfliktuoti, atlikti nuskriausto ar net kankinio vaidmenį. Socialinių darbuotojų ir viso personalo, tiesiogiai sąveikaujančio su pensionato kontingentu veiklos strategijos pagrindą sudaro pagalbos teikimas žmogui, pakitus jo gyvenimo sąlygoms, padėti pagyvenusiam, senam žmogui susitaikyti su savo paties senėjimu, suvokti, kad kiekvienas amžiaus tarpsnis turi savo vertybes. Atlikus tyrimą galima teigti, kad... [toliau žr. visą tekstą] / The goal of this research paper is to analyse the optimization of meeting the psychomatic needs of elderly people living in nursing homes. The aim of the research is to identify the needs of the elderly in Veisejai nursing home and to produse management solutions to meeting the needs of the residents. The elderly and old people face a lot of specific problems that are typical of their age. Their status diminishes, the role in life declines as they are driven out of social life and eventually become unnecessary. Due to the age it becomes more difficult to get involved in social activity, consequently the elderly and the aged become as a separate part of a society. Moreover, due to the unemployment the solidarity of generations diminishes and the support from grown-up children decreases. Except for food and a shelter the aged have and more needs. It has become of vital importance to help an individual to fight with loneliness, emotional isolation, physic crisis and to regain self-confidence and self-respect. The residents of the nursing home are ill or disabled, majority of whom are widows or widowers and single people. Among them there are those who tend to get into conflicts with relatives or community members and feel as disadvantaged ones or even as victims. The background strategy of social workers and the staff directly working with the residents of the nursing home is to provide help to an individual in the changed living conditions, to assist the elderly to face... [to full text]

This study is a secondary analysis of data collected from a six-year longitudinal qualitative study called Eating Together (ET), which sought to better understand the mealtime experience of community dwelling persons with dementia and their primary partners in care. Findings from the primary study highlighted the importance of mealtimes for these families, and as persons with dementia moved into long-term care homes it was noted that the meaning of the mealtime experience was challenged. Data from select dyads in the primary study was thematically analyzed, to understand the mealtime experience of persons with dementia and their primary partners in care, when persons with dementia relocated to a “new place”; a long-term care home. Findings revealed five themes related to the new mealtime experience in the long-term care home, including: systemizing the meal, adjusting to dining with others, holding on to “home”, evolving roles, and becoming “at home”. / Social Sciences and Humanities Research Council of Canada

No description available.

An exploratory, qualitative study on the experiences of Polish older adults who made a transition from independent living to an ethno-specific residential care facility in Toronto is presented. Using the framework of Continuity Theory of Aging, the impact of ethnic/cultural identity on the process of relocation and subsequent adjustment to a nursing home environment was investigated. A purposive sampling strategy was used to select 2 male and 4 female participants. The data was collected using long interviews that were tape recorded and transcribed verbatim. The findings of this study indicate that the subjects employed specific coping strategies that stem from traditional value orientation and life experiences hence suggesting that ethnic/cultural identity may have played a role in their successful adaptation to residential care setting. Although this research study is limited to one group of older adults and cannot be generalized to other ethnic groups, it has a potential to contribute to increasing the body of knowledge about the dynamics of residential care placement among ethnic minority seniors. Implications for social work policy, research and practice are discussed.

Många äldre som bor på särskilda boenden behöver ofta hjälp med sin munvård. Tidigare studier och rapporter beskriver vårdpersonalens bristande kunskap om och inställning till munhälsa och munvård. Syftet med den här studien är att beskriva sjuksköterskors uppfattningar av arbetet med äldres munhälsa på särskilt boende i en kommun. Metoden var kvalitativ med fenomenografisk ansats. Femton informanter från elva särskilda boenden intervjuades. Resultatet från informanternas olika uppfattningar av arbetet med äldres munhälsa bestod av sju kvalitativt skilda beskrivningskategorier: ansvar, skötsel av munvård, organisation och arbetsledning, tillgänglighet, autonomi och integritet, kunskap och kompetens samt information och samarbete. Ansvaret delades mellan flera yrkeskategorier, munvårdens skötsel varierade och organisation och arbetsledning fungerade bra. Tillgänglighet till tandvården underlättade arbetet med äldres munhälsa, medan autonomi och integritet kunde utgöra ett hinder. Det fanns ett behov av utbildning om demens för tandvårdens personal, om munhälsa och munvård för vårdpersonal på boende. Information och samarbete mellan sjuksköterskor och tandvården varierade. Slutsatser: Rutiner och riktlinjer behöver förbättras och tydliggöras vad gäller sjuksköterskans ansvar för och arbete med äldres munhälsa på särskilda boenden. Sjuksköterskor behöver även förbättra sina kunskaper om och bedömning av äldres munhälsa. Även vårdpersonal behöver mer kunskap om äldres munhälsa och munvård, som ofta sköts bristfälligt men som fungerar bra i välorganiserade verksamheter. Trots att tandvårdens tillgänglighet beskrivs underlätta arbetet med äldres munhälsa, tycks samarbetet mellan sjuksköterskor och tandvården inte alltid fungera, vilket behöver förbättras. / Older people living at nursing homes often need help with their oral care. Earlier studies and reports describe a lack of knowledge among the nursing staff about caring about and the attitude towards oral health and oral care. The purpose of this study is to describe nurses’ perceptions of the work with old people’s oral care in nursing homes in a municipality. A qualitative method with a phenomenographic approach was used. Fifteen informants from eleven nursing homes were interviewed. The result from the informants’ different perceptions of the work with old people’s oral health comprised seven qualitative divided description categories: responsibilities, management of oral care, organization and leadership, access, autonomy and integrity, knowledge and competence, information and cooperation. The responsibility was divided between several trade categories, the management of oral care varied and organization and work management functioned well. Accessibility to the Dental service facilitated the work, while autonomy and integrity could be an obstruction. There was a need of education about dementia for Dental service’s staff. Nursing home staff needed education about oral health and oral care. Information and collaboration between the nurses and the Dental service varied. Conclusion: Routines and guidelines need to be improved and clarified regarding nurses’ responsibilities for the work with older people’s oral care in nursing homes. Nurses also need to improve their knowledge and assessment of older people’s oral care. Nursing staff also need to improve their knowledge of older people’s oral care, which often was deemed inadequately, but was adequately done in well-organized establishments. Even though Dental service’s availability supposedly improves the work with older people’s oral care, the cooperation between nurses and Dental service occasionally did not functioned, which need to be improved.

The actual fluid intake of forty (40) residents of a nursing home was determined by an analysis of detailed three-day food and fluid intake records obtained by direct observation. Intake was compared to an established standard to determine the adequacy of fluid intake for this population. Subjects were grouped in two groups according to age (<85 years and >85 years) to determine whether age influenced fluid intake. In addition, data such as number and frequency of medications and dependency factors, such as ability to feed self, ability to communicate, ability to move and ability to make decisions, were collected and correlated.There was no significant difference between actual fluid intake and required fluid intake for the population a whole and for the two age groups. However, there were individuals who had very low fluid intakes suggesting other factors which influence fluid intake. There were positive correlations between fluid obtained from non meal feedings and frequency of medication delivery and number of medications delivered during a 24 hour period. In addition, there were positive correlations among the dependency factors. There was no correlation among any of the dependency factors and fluid intake for the group as a whole or for the two age groups.It was concluded from this study that this population of elderly nursing home residents obtained adequate fluid. Medication frequency and number appeared to influence the amount of fluid that a resident might obtain during non meal feedings. However, as a subject became more dependent, this factor did not affect the fluid intake of this population. / Department of Home Economics