Many older couples face the dilemma of one of them developing an illness that results in their ability to cope with everyday living activities. The well spouse may struggle for many years with an increasing workload, both physical and mental. Ultimately, there may come a time, when nursing home placement becomes necessary. The aim of this research was to find out what the experience was like for the wife, with a husband who is ill and faces placement in a nursing home, and to determine whether nurses could do more to help them to cope with this difficult situation. Following ethics approval, nine wives were interviewed over a period of two years. Each of the experience was unique, but there were some common problems that many of the wives mentioned. Loneliness was considered by most of the wives as being extremely upsetting, even when they were living with other people, for example their children. The absence of their partner and long term confident was noticed particularly in the evening when, in the past, they had sat down together and watched television. Other reactions included guilt, grief, depression and a change in the husband/wife relationship. Many of the wives seemed to accept the situation, realising that they could no longer cope with their husband at home, they were also healthier than they had been when their husband was at home. This research has highlighted some important points when a wife finds herself in the situation of having to place her husband in a nursing home, although nurses are unable to assist with many of the effects on the wife of the placement, it is helpful to know that the friendliness of the staff, the care of the patient and the cleanliness and homeliness of the nursing home are helpful at this time / Master of Nursing (Hons)

In gerontology and care research, care is often studied in ways in which older people and people with disabilities are portrayed as dependent on the care of younger or non-disabled people. This thesis, in contrast, studies care provided by people that are both old and have physical disabilities. The thesis explores how care is actualized and experienced by older couples who both have long-term or lifelong disabilities, and investigates the implications of this caring in the couples’ lives. Nine couples between 60 and 84 years old, of whom most had had disabilities for over 20 years, were interviewed as dyads; a process also conjoint interviewing. These interviews were analysed using grounded theory methods of coding and constant comparison. The results of the thesis confirm that it can make sense to be a carer even if one also needs care in everyday life. The analysis considers how conjoint interviewing resulted in relational and performative data about mutual care. The study helps explain the significance helping a partner despite having other sources of formal support and the difficulties of providing this help oneself. Finally, in a study whose participants are growing old together with disabilities, the results also show that the couples could regard themselves as ageing advantageously compared to other groups. Through its focus on caring for and by older people with disabilities, this thesis is at the intersection of social gerontology, care research and disability studies. However, from its interdisciplinary perspective, it can also challenge established discourses in these fields. Specifically, the study problematizes the absence of a care discourse in disability studies and the mostly age- and function-coded ways in which care is discussed in care research. The thesis problematizes dichotomies used in understanding care, such as roles of carers/care receiver and caring/servicing. It also challenges established ways of thinking about successful ageing. Lastly, the thesis contributes to the still growing literature on ageing with a disability. / Gerontologin och omsorgsforskningen beskriver oftast äldre och personer med funktionshinder som mottagare av omsorg från yngre personer eller personer utan funktionshinder. Denna avhandling studerar däremot det omsorgsarbete som utförs av äldre personer med fysiska funktionshinder. Avhandlingen behandlar hur omsorg kan se ut och hur den kan förstås hos par där båda har levt långa liv med fysiska funktionshinder. Den studerar också vad den ömsesidiga omsorgen kan ha för innebörder i parens liv. Nio par mellan 60 och 84 års ålder, där många har haft funktionshinder i 20 år eller mer, intervjuades tillsammans som ett par, i s.k. conjoint interviews (parintervjuer). Analysen gjordes med hjälp av analytiska verktyg från grundad teori. Avhandlingens resultat visar att det går att vara omsorgsgivare trots att man själv har omfattande omsorgsbehov. Analysen beaktar emellertid också hur parintervjuerna kan ha bidragit till dessa berättelser av ömsesidig omsorg. Betydelsen av att kunna fortsätta att ge hjälp till en partner trots tillgång till den formella hjälpapparaten och egna svårigheter att ge hjälp diskuteras. Och till sist, trots att informanterna åldras med sina funktionshinder, visar resultaten på att paren anser sig själva att ha ett gott åldrande, och till och med bättre åldrande än andra grupper. Avhandingen befinner sig i gränslandet mellan socialgerontologi, omsorgs-forskning och funktionshinderforskning. Men genom den interdisciplinära ansatsen har några av de etablerade diskurserna inom dessa fält kunnat utmanas. En omsorgsdiskurs har länge saknats i  funktionshindersammanhang. Där har istället autonomi och oberoende stått i fokus. Avhandlingens resultat bidrar till en problematisering av de underliggande dikotomier som omsorgsbegreppet bygger på, såsom omsorgsgivare/omsorgstagare och omsorg/personlig service. Resultaten problematiserar också etablerade begrepp inom socialgerontologin som successful ageing (framgångsrikt åldrande eller det goda åldrandet). Till sist bidrar avhandlingen till den nu växande forskningen om att åldras med funktionshinder.

The focus of this qualitative phenomenological research study was the lived experience of married couples between the ages of 60 and 70, one of whom has type 2 diabetes. The author sought to discover additional meanings concerning the experience of diabetic education, adherence to medications plans, modifications in lifestyle, and the role of the non-diabetic spouse in the experience. Participants were six married couples between the ages of 60 and 70. Three wives and three husbands had been diagnosed with type 2 diabetes. Two one hour interviews were conducted with each couple, both spouses present. Each couple was asked the question "Tell me what it is like living with diabetes." Interviews were audio taped and transcribed by the researcher. Informant volunteers were identified using the snowball method of sampling. The author identified the two domains of experience with the health care system and experience with the spouse..Themes of the first domain were identified as relationship with health care provider and education of patient and spouse at time of diagnosis. Themes in the second domain were spousal support, perceived compliance, and perceived risk of complications. Implications for adult education and advanced nursing practice include the importance of including the non-diabetic spouse in the education and treatment plan at time of diagnosis and offering a clear explanation of the relationship between adherence and long term complications of the disease. Suggestions for further research include investigation of the self reporting of behavior modification and outcomes of adherence, the effectiveness of provider interventions in monitoring behavioral changes, and to study women with diabetes married to men without diabetes. / Department of Educational Studies

In gerontology and care research, care is often studied in ways in which older people and people with disabilities are portrayed as dependent on the care of younger or non-disabled people. This thesis, in contrast, studies care provided by people that are both old and have physical disabilities. The thesis explores how care is actualized and experienced by older couples who both have long-term or lifelong disabilities, and investigates the implications of this caring in the couples’ lives. Nine couples between 60 and 84 years old, of whom most had had disabilities for over 20 years, were interviewed as dyads; a process also conjoint interviewing. These interviews were analysed using grounded theory methods of coding and constant comparison. The results of the thesis confirm that it can make sense to be a carer even if one also needs care in everyday life. The analysis considers how conjoint interviewing resulted in relational and performative data about mutual care. The study helps explain the significance helping a partner despite having other sources of formal support and the difficulties of providing this help oneself. Finally, in a study whose participants are growing old together with disabilities, the results also show that the couples could regard themselves as ageing advantageously compared to other groups. Through its focus on caring for and by older people with disabilities, this thesis is at the intersection of social gerontology, care research and disability studies. However, from its interdisciplinary perspective, it can also challenge established discourses in these fields. Specifically, the study problematizes the absence of a care discourse in disability studies and the mostly age- and function-coded ways in which care is discussed in care research. The thesis problematizes dichotomies used in understanding care, such as roles of carers/care receiver and caring/servicing. It also challenges established ways of thinking about successful ageing. Lastly, the thesis contributes to the still growing literature on ageing with a disability. / Gerontologin och omsorgsforskningen beskriver oftast äldre och personer med funktionshinder som mottagare av omsorg från yngre personer eller personer utan funktionshinder. Denna avhandling studerar däremot det omsorgsarbete som utförs av äldre personer med fysiska funktionshinder. Avhandlingen behandlar hur omsorg kan se ut och hur den kan förstås hos par där båda har levt långa liv med fysiska funktionshinder. Den studerar också vad den ömsesidiga omsorgen kan ha för innebörder i parens liv. Nio par mellan 60 och 84 års ålder, där många har haft funktionshinder i 20 år eller mer, intervjuades tillsammans som ett par, i s.k. conjoint interviews (parintervjuer). Analysen gjordes med hjälp av analytiska verktyg från grundad teori. Avhandlingens resultat visar att det går att vara omsorgsgivare trots att man själv har omfattande omsorgsbehov. Analysen beaktar emellertid också hur parintervjuerna kan ha bidragit till dessa berättelser av ömsesidig omsorg. Betydelsen av att kunna fortsätta att ge hjälp till en partner trots tillgång till den formella hjälpapparaten och egna svårigheter att ge hjälp diskuteras. Och till sist, trots att informanterna åldras med sina funktionshinder, visar resultaten på att paren anser sig själva att ha ett gott åldrande, och till och med bättre åldrande än andra grupper. Avhandingen befinner sig i gränslandet mellan socialgerontologi, omsorgs-forskning och funktionshinderforskning. Men genom den interdisciplinära ansatsen har några av de etablerade diskurserna inom dessa fält kunnat utmanas. En omsorgsdiskurs har länge saknats i  funktionshindersammanhang. Där har istället autonomi och oberoende stått i fokus. Avhandlingens resultat bidrar till en problematisering av de underliggande dikotomier som omsorgsbegreppet bygger på, såsom omsorgsgivare/omsorgstagare och omsorg/personlig service. Resultaten problematiserar också etablerade begrepp inom socialgerontologin som successful ageing (framgångsrikt åldrande eller det goda åldrandet). Till sist bidrar avhandlingen till den nu växande forskningen om att åldras med funktionshinder.

The purpose of this study was to examine how sexual satisfaction in older marriages (marriages with at least one spouse between the ages of 55 and 75) was affected by family-of-origin distress (recent measure of recollection of childhood experiences) and marital distress (measure of current marital relationship) for husbands and wives. The hypotheses of this study were that both family-of-origin distress and marital distress would have negative effects on sexual satisfaction for older couples, with marital distress having a direct, negative effect on sexual satisfaction and with family-of-origin distress having an indirect, negative effect on sexual satisfaction through its influence on marital distress. The sample consisted of 614 older couples (approximate average age of 65 for husbands and 62 for wives) who participated in the Project Couple Retire research project which provided the data for this study. Each participant completed the Project Couple Retire questionnaire which included the Marital Satisfaction Inventory-Revised (MSI-R) (1997), the Personal Assessment of Intimacy in Relationships (PAIR) (1981), and other instruments measuring various factors relating to older marriages. A conceptual model was created consisting of three latent variables: sexual satisfaction, family-of-origin distress, and marital distress. The latent dependent variable, sexual satisfaction, was measured by the MSI-R sexual dissatisfaction (SEX) scale and the sexual intimacy scale of the PAIR inventory. One of the latent independent variables, family-of-origin distress, was originally measured by both the MSI-R family history of distress (FAM) scale and an additional instrument from the Project Couple Retire questionnaire measuring history of abuse. However, the history of abuse measure was eventually dropped from the study due to poor measurement fit. The other latent independent variable, marital distress, was measured by the affective communication (AFC) and time together (TTO) scales of the MSI-R. The data in this study was dyadic, with each variable including data from both husbands and wives. Therefore, both actor and partner effects were examined. Structural equation modeling (SEM) was used to analyze the conceptual model. Findings indicated that both family-of-origin distress and marital distress negatively affected sexual satisfaction in older marriages for both husbands and wives when considering both indirect and direct effects.