The restructuring of Canadian health care for more than twenty years has ushered in opportunities for growth in private home care services. Within this socio-economic reality, some seniors and families feeling the impacts of the cutbacks to health and social services have turned to other alternatives of care to fill care gaps. A new type of caregiver, the paid companion, has surfaced in this respect. Operating either independently or through private health care agencies, paid companions resemble surrogate family members or friends who perform a variety of services for the elderly who can afford to pay for private home care and support. My research objective has been to explore and develop an understanding of the experiences and relationships of paid companions and their clients within the context of the political-economic climate of neoliberalism that has supported the development of paid companions. This thesis presents research conducted between 2009 and 2010 in the Greater Victoria area with 30 participants: 15 companions, 8 clients, and 7 key informants. The two qualitative methods of qualitative (semi-structured open-ended) in-person interviews and autodriven photo elicitation were utilized in order to examine the subjective experiences of paid companions and their clients. The research revealed the ambiguity and divergence of opinion around the terms ‘companion’ and ‘paid companion,’ which are inherent in the nature of the work itself. The majority of participants emphasized that friendship and fictive kinship often form the core of a relationship that has been built on caregiving and trust. While paid companions derive fulfillment by providing care for clients, the relationships they develop with them are intrinsically linked to the companionship and care they give. Although clients’ care needs most often stem from general health and mobility issues, the relationships that are gradually formed with their companions often become as important as the task-based assistance their companions provide to them. / Graduate

Title: Aesthetics as a norm of life Author: PhDr. Helena Jarošová Department of Aesthetics Supervisor: Prof. PhDr. Vlastimil Zuska, CSc. The thesis focuses on body (corporeality), things and private (home) interior as the exemplary areas of a contemporary aesthetics of life. In the thesis, I do consider this relatively autonomous domain of general aesthetics (a field of aesthetic function outside art, according to Mukařovský), or more precisely a sphere of growing influence of all-embracing aestheticization of the world (G. Lipovetsky) not only as a phenomenon, with which we have to deal today, but as a much older process, the roots of which can be traced back at least two centuries to the past. In this subject matter I especially emphasize primary and derived relations of this kind of aestheticization to a public space, i.e. an aesthetic function that originally only supports the main function of a given thing or event can eventually become dominant and independent and finally influence the very domain from which it originated (e.g. female decorative make-up used to be, historically, an accompanying effect of male dominance in the society, later it became a mean of female emancipation or of an individually designed style of life). I also pay attention to a phenomenology of an aesthetic experience;...

Bakgrund: Vårdmiljöer sägs kunna bidra till att lindra såväl lidande som möjliggöra välbefinnande för patienter vid livets slut, och det privata hemmet kan möjliggöra livskvalitet och är föredragen vårdplats för döende och död i samhället. Arbetet som sjuksköterska i hemmet vid livets slut involverar att möta patienter och familjemedlemmar i deras egen miljö, vilket beskrivs som utmanande men också som positiva erfarenheter beroende på klinisk organisation och sjuksköterskans ansvarsområde. Ytterligare erfarenhetsbaserad omvårdnadsforskning om denna vårdmiljö är eftersträvansvärd. Syfte: Syftet med studien var att undersöka sjuksköterskors, som arbetar i specialiserad palliativ hemsjukvård, erfarenheter av det privata hemmet som vårdmiljö vid livets slut. Metod: Den här studien har kvalitativ design, guidad av forskningsapproachen tolkande beskrivning. Deltagarproducerade fotografier användes som utgångspunkt vid tio individuella intervjuer med sjuksköterskor inom specialiserad palliativ hemsjukvård. Resultat: Datanalysen resulterade i fyra teman; Komma till ett unikt privat hem förberedd på att anpassa interaktioner och handlingar beroende på miljön; Stödja patienter och familjemedlemmar att balansera egenvård, oberoende och säkerhet; Guida patienter och familjemedlemmar inför och igenom förändringar i hemmiljön för att stödja vård vid livets slut; Använda bilfärden mellan hemmen till reflektion, återhämtning och förberedelse. Diskussion och slutsats: Resultatet i denna svenskspråkiga uppsats diskuterades utifrån Liaschenkos teorier; som framhåller att omvårdnadsansvaret i hemmet innebär att bevara och skydda patientens möjlighet till autonomi och självbestämmande i deras naturligt subjektiva miljö, som påverkas av sjukdom och sjukvård. Resultatet genomsyras av sjuksköterskornas strävan att uppnå detta, något som beskrivs kräva specifik kompetens, men också innebär en rad utmaningar och ibland risker för det egna välbefinnandet. Då resultatet samtidigt antyder hemmet som plats med dubbla syften, dels som en privat plats vid livet slut och en arbetsplats. Omvårdnadsarbetet involverar en rad anpassningar i interaktion med vårdmiljön och personerna som bor där, och ett tillitsfullt samarbete mellan sjuksköterska, patient och/eller familjemedlem beskrivs möjliggöra en optimal och delad vårdmiljö vid livets slut. / Background: Care environments are shown to be a contributing factor for alleviate suffering and enhance wellbeing for dying patients, and private homes is found to benefit life quality and is a preferred place death and dying in society. Working in home care at end-of life involves meeting patients and family members in their own environment, entailing challenges and feasibilities depending on clinical organization and nursing role. Further experiential nursing research about this care environment at end-of-life is desirable. Aim: Exploring palliative care nurse’s experiences of the private home as an end-of-life-care environment. Method: The design of this study was qualitative, guided by the interpretive description approach. We used participant-produced photographs with follow-up interviews with ten nurses working in specialised palliative home care. Findings: Four themes were constructed; Entering the unique private home prepared to adjust interactions and actions depending on the environment, Supporting patients and family members to balance between self-care, independency and security, Guiding patients and family members towards and through environmental changes to support end of life care at home and Using the time driving between homes to reflect, recover and prepare. Discussion and conclusions: The findings in this Swedish written essay was discussed by using Liaschenkos theories; displaying that the nursing role in this care settings involves keeping and protecting the patients autonomy and self-determination in their own natural subjective home, which is affected by disease and health care. This findings clearly demonstrate the nurses strive for this, requiring specific competence, but also impair several challenges and sometimes risks for their own wellbeing. Thus, the private home is suggested being a space with dual purposes; an exclusive place for death and dying and a working environment. This involves a variety of adjustments in interactions with the environment and the persons living there, facilitated by a confident cooperation between the nurse, patient and/or family members for an optimal and shared care environment in end-of-life. / Plats och rum för vård i livets slutskede