Bakgrund: Depression betraktas som den mest förekommande psykiska sjukdomen globalt och påverkar både mental och fysisk hälsa negativt. Äldre individer löper högre risk av att drabbas av depression, och övergången till pension kan ha negativ inverkan på den psykiska hälsan. Individer som lider av depression i äldre ålder är ofta i behov av kommunal vård i form av äldreboende eller stöd med medicinutdelning. Det är avgörande med tillräckligt kvalificerad omvårdnadspersonal för att säkerställa de äldres trygghet och främja högsta möjliga fysiska och mentala välmående. Syfte: Syftet var att kartlägga och utvärdera effekter av omvårdnadsåtgärder vid depression hos äldre på äldreboende. Metod: En litteraturöversikt med 12 vetenskapliga artiklar med kvantitativ design. Artikelsökningar genomfördes i databaserna Cinahl, Pubmed samt genom manuell sökning. Kvalitetsgranskning genomfördes med hjälp av Jönköping Universitys granskningsprotokoll för kvantitativa artiklar. Data analyserades med stöd av Fribergs (2017b) trestegsanalys. Resultat: Resultaten visar att olika omvårdnadsåtgärder har en positiv inverkan för att minska depressiva symtom hos äldre. Förbättring av Sömn: Ljusterapibehandling och sjuksköterskeledda sömnprogram. Terapeutisk Underhållning: Humorprogram, hundbesök, gruppmusikprogram, skrattterapi och individuellt valda aktiviteter. Välbefinnande i Vardagen: Fysisk aktivitet, muskelcensoriska stimuleringsmetoder, grönt te, akupunktur och reminiscens. Slutsats: Implementering av olika omvårdnadsåtgärder spelar en betydelsefull roll i att hantera och minska depressiva symtom hos äldre. Inkludering av sömnfrämjande strategier, terapeutisk underhållning som skrattterapi, och omvårdnadsåtgärder för välbefinnande visade positiva effekter. Resultaten understryker behovet av att skräddarsy vården för att inkludera aktiviteter som främjar positiva upplevelser och välbefinnande. Dessa insikter bör integreras i klinisk praxis för att optimera äldres psykiska och fysiska hälsa. / Background: Depression is considered the most prevalent mental illness globally, adversely affecting both mental and physical health. Older individuals are at a higher risk of experiencing depression, and the transition to retirement can have a negative impact on mental health. Those suffering from depression in later years often require community care in the form of elderly housing or assistance with medication distribution. It is crucial to have adequately qualified nursing staff to ensure the safety of the elderly and promote their highest possible physical and mental well-being. Aim: This study aimed to describe and evaluate the effects of nursing interventions for depression in older individuals in nursing homes. Method: A literature review with 12 scientific articles with a quantitative design. Article searches were conducted in Cinahl and Pubmed, as well as through manual searches. Quality assessment was carried out using the Jönköping University of Healthreview protocol for quantitative articles. Data were analyzed with the support of Friberg´s (2017b) three-step analysis. Results: The results show that various nursing interventions have a positive impact on reducing depressive symptoms in the elderly. Improvement of Sleep: Light therapy and nurse-led sleep programs. Therapeutic Entertainment: Humor programs, dog visits, group music programs, laughter therapy, and individually chosen activities. Well-being in Daily Life: Physical activity, sensory-motor stimulation methods, green tea, acupuncture, and reminiscence. Conclusion: The implementation of various nursing interventions plays a significant role in managing and reducing depressive symptoms in the elderly. Inclusion of sleep-promoting strategies, therapeutic entertainment such as laughter therapy, and well-being nursing measures demonstrated positive effects. The results emphasize the need to tailor care to include activities that promote positive experiences and well-being. These insights should be integrated into clinical practice to optimize the mental and physical health of the elderly.

This dissertation aims to examine racial and ethnic inequities in nursing home (NH) palliative care services and potentially avoidable hospitalizations at the end of life. Health disparities are pervasive in NHs, but disparities in NH end-of-life care (i.e. palliative care services, hospital transfers) have not been comprehensively examined. Chapter One provides an overview of this dissertation, which explores inequities in nursing home end-of-life care. Chapter Two is a systematic review that synthesized the current state of the science in racial and ethnic disparities in NH end-of-life care. Chapter Three was designed to describe palliative care services in U.S. NHs and associations with differences in the concentrations of Black and Hispanic residents, respectively, and the impact by region. Chapter Four is an analysis of racial and ethnic differences in NH potentially avoidable hospitalization incidence rates. Finally, Chapter Five is a synthesis of this body of work. It contains a summary of findings of this dissertation, a discussion of the results, practice and policy implications, and directions for future research.

INTRODUKTION/BAKGRUND Sexualiteten är en grundläggande rättighet och central del genom livet som påverkar individens välbefinnande. Det är därav av värde att hälso- och sjukvårdspersonal inom äldrevården innehar kunskap i boendes upplevelser av sexualitet för att främja ett gott välbefinnande.  SYFTE Att studera boendes upplevelser av sexualitet inom äldrevården. METOD Litteraturöversikt med beskrivande design, baserad på tio originalartiklar med kvalitativa studier. Litteratursökning genomfördes i databaserna PubMed och CINAHL. Artiklarna kvalitetsgranskades genom SBU:s mall för Bedömning av studier med kvalitativ metodik och resultatanalyserades enligt Fribergs analysmodell. Kari Martinsens omvårdnadsteori utgjorde arbetets teoretiska referensram. RESULTAT Många boende inom äldrevården ser sin sexualitet som en viktigt del i livet, medan andra har lämnat det sexuella livet bakom sig. Äldrevårdens utformning, brister i kommunikation gällande sexualitet och negativa attityder hör till faktorer som begränsar det sexuella uttrycket. Fyra kategorier identifierades - Skilda upplevelser av sexualitet, Sexuell autonomi och integritet, Bristande kommunikation och kunskap samt Upplevelser av attityder från personal och andra boende - med totalt åtta subkategorier.  SLUTSATS Äldrevårdens sociala och fysiska miljö samt vårdpersonalens kunskapsbrist gällande sexualitet begränsar den boendes möjlighet till sexuella uttryck. En bredare förståelse och kunskap bör finnas hos hälso- och sjukvårdspersonal för att kunna identifiera och bemöta boendes sexuella behov. / INTRODUCTION/BACKGROUND Sexuality is a fundamental right and central part throughout life that affects the individual's well-being. It is therefore of value that healthcare professionals within geriatric nursing homes have knowledge of residents' experiences of sexuality in nursing homes, in order to promote good well-being. AIM To examine residents’ experiences of sexuality in geriatric nursing homes.  METHOD Literature overview with descriptive design, based on ten original articles with qualitative studies. Literature search was performed in the databases PubMed and CINAHL. The articles were quality audited through SBU’s quality assessment template for qualitative methodology and analyzed according to Friberg’s analysis model. The theoretical frame of reference for the work was Kari Martinsen’s nursing theory. RESULTS Many residents in geriatric care sees their sexuality as an important part of life, while others have left their sexual life behind. The design of the nursing home, deficiencies in communication regarding sexuality and negative attitudes are among the factors that limit the sexual expression. Four categories were identified - Different experiences of sexuality, Sexual autonomy and integrity, Lack of communication and knowledge and Experience of attitudes from staff and other residents - with a total of eight subcategories. CONCLUSION The nursing home's social and physical environment as well as the care staff's lack of knowledge regarding sexuality limits the resident's opportunity for sexual expression. A broader understanding and knowledge should be available among healthcare professionals in order to be able to identify and respond to the residents sexual needs.

Syfte: Var att sammanställa och beskriva hur meningsfulla aktiviteter kan möjliggöras för äldre på särskilt boende. Metod: En litteratursammanställning gjordes av kvalitativa studier eftersökning i databaserna Pubmed, Cinahl och Scopus. Datan analyserades och sammanfattades i fyra kategorier: När aktiviteter utgår från den unika personen blir de meningsfulla, Utbilda och samarbeta med omvårdnadspersonal, Meningsfulla aktiviteter som främjar gemenskap och samhörighet och Uppmuntra engagemang i aktivitet genom tillgängliga och varierande miljöer. Resultat: Studiens resultat visar att det finns flera viktiga aspekter att beakta för att möjliggöra meningsfulla aktiviteter för äldre personer på särskilt boende. För att skapa aktiviteter som är meningsfulla behöver de boendes intressen, livshistoria och behov beaktas. Arbetsterapeuten kan arbeta med att utbilda och samarbeta med omvårdnadspersonal för att skapa meningsfulla aktiviteter. Att göra aktiviteter i grupp ökar motivation och livstillfredsställelse. Det är även viktigt att beakta miljön då den på olika sätt kan skapa förutsättningar för aktivitet. Slutsats: Meningsfulla aktiviteter är en viktig del i vardagen för äldre personer på särskilt boende. Genom att beakta person, miljö och aktivitet samt stödja omvårdnadspersonalen kan arbetsterapeuten möjliggöra meningsfulla aktiviteter. / Aim: The aim was to summarize and describe how meaningful activities can be enabled for elderly at nursing homes. Method: A literature review was made of qualitative studies after searching for scientific articles that were selected from the databases Pubmed, Cinahl and Scopus. The data were analyzed and summarized in four categories: When activities are based on the unique person they become meaningful, Educate and collaborate with nursing staff, Meaningful activities that promote community and belonging and Encourage engagement inactivity through accessible and varied environments. Results: The result of the study suggests there are several important aspects to consider in order to enable meaningful activities for older people in nursing homes. In order to create activities that are meaningful, the residents'interests, life histories and needs need to be taken into account. The occupational therapist can work to educate and collaborate with the nursing staff to create meaningful activities. Doing activities in groups increases motivation and life satisfaction. It is also essential to consider the environment as it can create conditions for activity in different ways. Conclusion: Meaningful activities are an important part of everyday life for elderly people in nursing homes. By considering the person, environment and activity and also supporting the nursing staff the occupational therapist can enable meaningful activities.

A variety of individual and geographic factors influence the mix of formal and informal services utilized by older adults and their families along the continuum of care. This study focuses on a specific rural population in the United States - Central and South Central Appalachia, which experiences the triple jeopardy of vulnerable people (older adults) in vulnerable places (rural Appalachia), with cultural views and beliefs that may negatively impact the care they receive. Using Andersen’s behavioral model of service utilization, Soldo’s supplementation model of care, and Bronfenbrenner’s ecological theory as the theoretical frameworks, data from the Older Families in Rural Communities: Personal and Social Influences on Service Use project and the United States 2000 Census were used to examine the utilization of informal and formal care services and nursing home placement risk in a rural Appalachian population. The main goals of this research were to (a) examine the relationships among individual and geographic characteristics and determine how those relationships affect the utilization of informal-formal care-mix, and (b) determine how the informal-formal care-mix is associated with nursing home placement risk in older adults living in rural southwest Virginia. Two separate analyses were completed in order to address the research objectives. First, a multinomial regression model, including both individual and geographic data, was used to predict care-mix. Second, after calculating the outcome variable “nursing home placement risk” via a derived logistic regression equation, a log-linear analysis with a 3×4 contingency table was computed in order to understand the association between care-mix and nursing home placement risk. Results indicate that disparities in sex and poverty level in an area that already suffers from healthcare disparities significantly affect the type of care an older adult receives. When formal care was utilized, it was more often added to existing informal care systems, supplementing them, rather than replacing them. The type of care-mix individuals received was also associated with nursing home placement risk. Specifically, when informal support was the only source of care, nursing home placement risk was significantly higher than when informal-formal care-mix was received. Research and policy implications for disparity-ridden areas are discussed. / Ph. D.

Getting old involves a lot of changes in life. Family and social relations change and mobility can decrease. These variations require new settings, and of course special care. A nursing home is a place dedicated to help with this situation. Sometimes nursing homes can be perceived as mere institutions by society, and even by future residents. Inside, senior citizens are suppose to spend the rest of their lives doing the same activities day after day. How can we improve these days? Architecture can help. This project deals with architectural design of a nursing home located in an open green area in Blacksburg, Virginia. The project's focus is in creating a home that is related to its surroundings and the proximity to nature. Also deals with all the complexity of this kind of program, but tries to create a homely feeling, and an architectural environment that can adapt to the resident's physical and mental condition over time. / Master of Architecture

The focus of this study was to determine what types of information and support families wanted at the time they admitted a relative to a long-term care facility. Twenty families were interviewed by telephone, including both the primary caregiver and, where appropriate caregiving family members. It was found that half of the families felt they wanted no additional information or support than they had received, and that they were basically satisfied with the facility's admission process. The majority of the families felt that the institution also encouraged their continued involvement with their relatives after admission. The results suggest that researchers and practitioners need to be aware, however, that the admission process if often a stressful time, and that family members may be so involved in making long-term care arrangements that they do not focus on their own needs, but only on those of the elderly patient. Support services and information should be provided on an individual basis, considering such factors as whether the caregiver is employed full-time and the distance the caregiver lives from the facility. / Master of Science

This study investigated, responses, of older married persons to questions concerning anticipated availability of help and anticipated sources of help for seven in-home service areas: personal care, nursing care, physical therapy, continuous supervision, household chores, and meal preparation. Variables such as age, gender, level of impairment, proximity of nearest family member, and social resources served as independent variables for this study. Anticipated availability of, help and anticipated sources of help, specifically spouse, other family member, friend-neighbor, agency, or other, served as dependent variables. The investigator's interest was to determine what variables influenced the choice of spouse versus other choices in, anticipated sources of help, and to examine gender differences in anticipated assistance. Use of chi square analysis determined the independence of variables characterizing older married respondents and their anticipated sources of help. Respondents most frequently chose spouse as the anticipated source of help for all in-home services except physical therapy, where agency was the most frequently chosen source of help. Men anticipated help from spouse significantly more than did women. Women anticipated help from sources other than spouse more frequently than men. / Master of Science

No / This paper reports on the evaluation of the Enriched Opportunities Programme in improving well-being, diversity of activity, health, and staff practice in for people with dementia. Participants were 127 residents with a diagnosis of dementia or enduring mental health problems in three specialist nursing homes in the UK. A repeated measures within-subjects design was employed, collecting quantitative and qualitative data at three points over a twelve-month period in each facility with follow-up 7 to 14 months later. Two-way ANOVAs revealed a statistically significant increase in levels of observed well-being and in diversity of activity following the intervention. There was a statistically significant increase in the number of positive staff interventions but no change in the number of negative staff interventions overall. There was a significant reduction in levels of depression. No significant changes in anxiety, health status, hospitalisations, or psychotropic medication usage were observed. The Enriched Opportunities Programme demonstrated a positive impact on the lives of people with dementia in nursing homes already offering a relatively good standard of care, in a short period of time. The refined programme requires further evaluation to establish its portability.

Yes / This article aims to explore family perspectives on their involvement in the timely detection of changes in their relatives' health in UK nursing homes. Increasingly, policy attention is being paid to the need to reduce hospitalisations for conditions that, if detected and treated in time, could be managed in the community. We know that family continue to be involved in the care of their family members once they have moved into a nursing home. Little is known, however, about family involvement in the timely detection of changes in health in nursing home residents. This was a qualitative exploratory study with thematic analysis. A purposive sampling strategy was applied. 14 semi-structured one-to-one telephone interviews with family members of people living in 13 different UK nursing homes. Data were collected from November 2015 to March 2016. Families were involved in the timely detection of changes in health in three key ways: noticing signs of changes in health, informing care staff about what they noticed, and educating care staff about their family members' changes in health. Families suggested they could be supported to detect timely changes in health by developing effective working practices with care staff. Families can provide a special contribution to the process of timely detection in nursing homes. Their involvement needs to be negotiated, better supported, as well as given more legitimacy and structure within the nursing home. Families could provide much needed support to nursing home nurses, care assistants, and managers in timely detection of changes in health. This may be achieved through communication about their preferred involvement on a case-by-case basis as well as providing appropriate support or services. / NIH Research Programme Grant for Applied Research (RP-PG-0612-20010)