Total evaluation of the outcomes of this diploma work is alarming. The gained outcomes have showed an increase incidence of psychiatric pathology. Although nurses cannot substitute doctors in diagnostics, they need to be educated in etiology. Considering that nurses are in close contact with diseased, their greatest goal is to prevent the mood and behavioral defects. Out of searching for endangered and diseased, nurses must permanently function on the health education and to participate on psychiatric rehabilitation. Their goal is to motivate the diseased to treatment, explain the doctor{\crq}s recommendations and actively and initiatively gain the patients for exercitation of healthy life. Seniors need to hear affable words, they need understanding and help to solve their behavior and mood changes. Nurses can be a big help when solving these changes, because seniors trust nurses, open their hearts to nurses and tell them what bothers them and what they cannot handle anymore. Nurses must heal the body and the soul as well. I think that this way we can lower the risk of complications and conflicts and to make the life for the affected seniors better and easier. The gained results could be possibly used to increase the quality of service in other social sectors and healthcare associations.

Nursing has come a long way to become a subject of university study. Clinical placement is a vital part of the study in preparing students for future nursing roles as providers of care to patients. The placement within nursing homes is a compulsory part of the clinical studies. Major actors in the clinical placement are supervisors. Their actions and support are determinant for the nursing student’s experiences, in learning and development of their clinical skills.

Abstract In dementia care, it has been widely recognized that not only providing medical treatment, but also building an appropriate care relationship between medical professionals and the persons with dementia is one of the keys for understanding the person’s needs and for developing their residual physical and mental abilities. However, there has been little discussion about the meanings and contexts of the care relationship and the role of the therapeutic tools used and the therapist’s expertise in establishing it. To examine these points, the following research questions were addressed: 1) as a mediating tool in the care relationship, what kinds of narratives were created through everyday interaction between therapists and dementia sufferers? 2) how and why were narratives constructed? 3) what is the teaching-learning process of the therapist through narrative joint formation?, and consequently, 4) what is the relationship in dementia care? The data was collected from interviews with one experienced occupational therapist and observations of his care sessions with two Alzheimer’s disease (AD) sufferers in a Japanese nursing home for two years. Their interactions and narratives were transcribed and qualitatively analysed based on Vygotsky's cultural-historical approaches and Bakhtin’s theory of dialogue in education as a theoretical framework. The results have shown that the therapist jointly created narratives and a triadic relationship between the AD sufferers, the narratives, and himself. Using the narratives, he arranged a dialogical environment where the AD sufferers could express their own voices and encounter the voices of others. This enabled them to learn the meaning of their therapeutic activity in connection to their own life experience. As cognitive/psychological tools, the narratives worked towards a teaching-learning process and helped to establish the care relationship. Through the co-construction of narratives and the triadic relationship, the therapist listened to the AD sufferers’ voices carefully, participated in an open ended and unfinalisable dialogue himself with them, and confronted them as equal respondents. In this sense, the therapist is seen as a dialogic teacher who actively learns knowledge and ideas from the dementia sufferers and unceasingly explores unknown questions in narratives with them. / Tiivistelmä Dementian hoidossa on laajalti tiedostettu, että lääkehoidon ohella hyvän hoitosuhteen muodostaminen hoitohenkilöstön ja potilaan välille on avainkysymys potilaan tarpeiden ymmärtämiseksi ja käytettävissä olevien fyysisten ja henkisten kykyjen hyödyntämiseksi. Tästä huolimatta on ollut hyvin vähän keskustelua hoitosuhteen merkityksistä ja konteksteista, kuten myös erilaisten työvälineiden roolista ja terapeutin asiantuntijuudesta luoda niitä. Näiden seikkojen tarkastelemiseksi asetettiin seuraavat tutkimuskysymykset: 1) millaisia narratiiveja hoitosuhteen välittävänä työkaluna luotiin terapeutin ja dementiapotilaiden päivittäisessä vuovaikutuksessa, 2) miten ja miksi narratiiveja konstruoitiin, 3) millainen on terapeutin opettamis- ja oppimisprosessi yhteisessä narratiivin muodostamisessa ja näin ollen, 4) millainen on dementian hoitosuhde? Aineisto koottiin haastattelemalla kokenutta toimintaterapeuttia ja havainnoimalla hänen terapiaistuntojaan kahden Alzheimer-potilaan kanssa japanilaisessa hoivakodissa kahden vuoden ajan. Heidän vuorovaikutuksensa ja narratiivinsa transkriptoitiin ja analysoitiin laadullisesti teoreettisena viitekehyksenä Vygotskin kulttuuri-historiallinen lähestymistapa ja Bahtinin dialogin teoria. Tulokset osoittivat, että terapeutti loi yhdessä potilaiden kanssa narratiiveja sekä kolmenvälisen suhteen potilaiden, tarinoiden ja itsensä kesken. Narratiiveja käyttäen hän loi dialogisen ympäristön, jossa potilaat ilmaisivat omat äänensä ja kohtasivat toiset. Tämä auttoi heitä ymmärtämään terapian merkityksen suhteessa heidän omaan elämänkokemukseensa. Narratiivit kognitiivisina/psykologisina välineinä auttoivat opetus- ja oppimisprosessissa ja edistivät hoitosuhteen muodostumista. Narratiivien yhteiskehittely ja kolmenvälinen suhde auttoivat terapeuttia kuuntelemaan huolella potilaiden ääniä, osallisti hänet heidän avoimena jatkuvaan dialogiinsa ja asetti heidät yhdenvertaisiksi osapuoliksi. Tässä mielessä terapeutti nähdään dialogisena opettajana, joka aktiivisesti oppii dementiapotilailta ja joka jatkuvasti tutkii heidän kanssaan narratiivien tuntemattomia kysymyksiä.

No description available.

This thesis analyses thirteen key literary texts taken from the last century of Canadian English-language publishing to assess how each text reveals, reinforces, and /or resists narratives of natural-aging, decline, progress and positive-aging. When considered together, these texts illustrate overall patterns in the evolution of age-related beliefs and behaviours. Stories have a potential emotional impact that scholarly readings do not, and thus the reading and study of these texts can serve to promote conscious intellectual consideration of the issues surrounding age and aging. My analysis focuses on how our Canadian literature envisages aging into old age, primarily addressing stories set in late-life-care facilities and comprising what I am naming our ‘nursing-home-narrative genre.’ Although my chapters follow a chronological progression, beginning with Catharine Parr Traill’s 1894 Pearls and Pebbles and concluding with Janet Hepburn’s 2013 Flee, Fly, Flown, I am not arguing that each age-related belief is replaced by a succeeding one. I would assert instead that over time Canadians have accumulated an assortment of age ideologies, some of which mesh and some of which duplicate or even contradict others. For example, although many people have embraced new positive-aging ideologies, aging-as-decline narratives still circulate strongly. Using social and literary theory as support, I argue that the selected literary texts of my analysis (Traill, Wilson, Laurence, Shields, Wright, Barfoot, Munro, Tostevin, Gruen, Hepburn, King) reveal a genre that is evolving quickly in both form and content. The nursing-home-narrative genre begins with gothic stories of fear of the nursing home, of aging and of death, expands to include darkly humorous stories featuring increasingly empowered residents successfully living within care homes, and is introducing, during the twenty-first century, fantastical stories of escape from the home and of return to youthful behaviours and preferable habitats. This most recent narrative joins the earlier ones to create a new master narrative in which aging people can overcome fear with agency and thus ultimately reject the nursing home and old age itself. However, in the most compelling of the new agency and escape narratives, authors lay a thin icing of entertainment over a dark undercurrent of reality.

Bakgrund: Antalet ålderspensionärer kommer att öka i vilket medför ökade krav på framtidens hälso- och sjukvård. Äldres sexualitet är ett ämne som är stigmatiserat i samhället och inom vården, men är av betydelse då det är naturligt oavsett ålder. På ett vård- och omsorgsboende är den äldre beroende av vårdpersonal och vårdpersonalens attityder kan vara avgörande för den äldres sexuella hälsa. Syfte: Att undersöka vårdpersonalens attityder gentemot sexualitet hos personer över 65 år på vård och omsorgsboenden och vilka faktorer som påverkar attityderna. Metod: En litteraturöversikt enligt Friberg där resultatet bygger på elva utvalda originalartiklar som söktes fram via databaserna Cinahl och Ageline. Huvudsöktermerna som användes var: sexualitet, äldre, vård- och omsorgsboende och attityder. Resultat: Vårdpersonalens aktuella syn på äldres sexualitet påverkade hur de agerade när situationer uppstod. Negativa attityder karaktäriserades av låg ålder, mindre generell arbetserfarenhet, lägre utbildning och kunskap och ifall vårdpersonal identifierade sig som religiösa. Högre ålder, mer arbetserfarenhet, högre utbildning och mer kunskap medförde positivare attityder. Diskussion: Konsensusbegreppet hälsa och begreppet värdighet låg till grund för diskussionen. Huvudfokus låg på huruvida faktorer påverkar vårdpersonalens attityder samt vem den ansvarige är gällande äldres sexualitet. / Background: The number of pensioners will increase which leads to more demands on health care in the future. Elderly’s sexuality is a topic that is stigmatized in the society and within health care, but is meaningful because it’s a natural part of life regardless of age. In a nursing home, the elderly are dependent on health care workers for care and their attitudes may be crucial for the elderly’s freedom to express sexual behavior. Aim: To examine health care workers’ attitudes toward elderly’s sexuality in nursing homes and the factors that influence the attitudes. Method: A literature overview according to Fribergs method was conducted where the results are based on eleven original scientific articles sought out through the databases Cinahl and Ageline. The main keywords used were: sexuality, elderly, nursing home and attitudes Results: Health care workers current views of older peoples’ sexuality influenced how they acted when situations arose. Negative attitudes were characterized by a young age, less general work experience, less education and knowledge and self-identification as religious. A higher age, more work experience, higher education and more knowledge led to more positive attitudes. Discussion: The concept of health and the term dignity helped support the discussion. The main focus lied on factors that affected health care workers’ attitudes as well as the question regarding responsibility when it comes to elderly’s sexuality.

Bakgrund: Cirka en femtedel av befolkningen i Sverige består av personer över 65 år. Ökande livslängd leder till både fysiska och psykiska funktionsförsämringar. För att hantera effekter av tidig utveckling av delvis åldersrelaterade funktionsnedsättningar kan kommunen erbjuda hemtjänst i äldres privata boenden. När hemtjänsten inte kan täcka behovet av omvårdnad, tillräckligt för att den äldre ska kunna bo kvar i sitt egna boende, kan den äldre ansöka om att få flytta till ett vård- och omvårdnadsboende. Där kan de få heldygnsomsorg för att bibehålla en bra livskvalitet. Syfte: Att beskriva äldre personers upplevelse av att bo på ett vård- och omsorgsboende. Metod: Systematisk litteraturstudie med beskrivande syntes. Resultat: Tre huvudteman identifierades: vardagen styrs av verksamhetens rutiner, sociala interaktioner är av betydelse, existentiella funderingar. Dessa teman byggs upp av sju subteman: att vara mer beroende, trygghet med den praktiska hjälpen, behov av social samvaro, behov av tillit i vårdmöte, rädslan för ett försämrat hälsotillstånd, att döden är nära, acceptans för livet som det är. Slutsats: Omvårdnadspersonalens förståelse och bemötande i vårdsituationen är viktig för att ge de äldre personerna en större möjlighet till att anpassa sig till de förändringar i livssituationen i vård- och omsorgsboende innebär. / Background: In Sweden, a fifth of the population is aged over 65. Increasing lifespan leads to both physical and mental impairments. To deal with the effects of early development of partially age-related disabilities, the municipality can offer home care service in the elderly's private home. When home care service is not long sufficient for the elderly person to continue staying in their own home, the elderly can apply to be moved to nursing home. There, they can receive 24-hour care to maintain a good quality of life. Aim: To describe the experiences of elderly living in a nursing home. Method: Systematic qualitative literature study with descriptive synthesis. Result: Three main theme were identified:  everyday is governed by the institutes routines, importance of social interactions, and existential reflections. Seven subthemes immerged: to be more dependent, security with the practical help, need for social interaction, need for trust in a health care meeting, the fear of a deteriorating health condition, that death is near, acceptance for life as it is. Conclusion: Treatment and understanding from care staff during the caring situation consider to be important for elderly in order to enable abilities to adapt their new situation.

No description available.

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.

Background: The elderly population is a vulnerable group, it is the nurse's responsibility to promote health and meet the nursing needs that arise. Health-related benefits for animal owners have been known since the ninth century and today animal-assisted interventions (AAI) are an accepted concept in health care. Aim: The aim is to describe the effect AAI hason the elderly in elderly care. Method: This is a general literature review. A thematic analysis has been used to compile the results from previous research. 14 articles from the databases CINAHL, Pubmed and Medline were selected for the result. 3 themes and 8 subthemes were identified: Quality of life with subthemes "Quality of life according to QUALID", "Socialinteraction", "Well-being" and "Sense of coherence", Symptom relief with subthemes "Mentalillness" and "Cognitive ability" and Physical health with subthemes "Physical activity” and “Appetite”. Results: AAI results in increased social interactions, reduction of depression, increased appetite and physical activity, improved cognition, increased well-being, sense of coherence and an improved quality of life (QoL). Conclusions: AAI can improve the health and QoL of the elderly in elderly care, especially for those with dementia. AAI can potentially reduce the use of drugs among the elderly. Further research in the field is needed to strengthen results found in several of the articles and to map the duration of the effects.