Background: This article examines the intersection of two global trends, super-diversity and globalized aging, in the context of urban communities. Super-diversity refers to the impact of changing immigration patterns on social, health, and economic systems. Interdisciplinary by definition, gerontological social work practice bridges macro, mezzo, and micro modalities, as well as professional and disciplinary false divides.

Objective: The authors aim to highlight how urban gerontology practice can benefit from reaching across borders and boundaries. Goals include identifying best practices of care that can serve as models in a range of environments.

Methods: The authors used a qualitative case study approach. Data collection consisted of individual interviews and focus groups.

Findings: Findings suggest the ongoing relevance of ecological theory in the context of identifying best practices in social work gerontology.

Discussion: Through the lens of super-diversity and globalized aging, the authors examine processes and impacts at the intersection of migration, advanced age, and care systems in the urban context. Findings indicate the need to further de-colonize aging care.

Föreliggande rapport är en delredovisning av projektet "Kommunal hemsjukvård: arbetsmiljö bortom sjukhuset". Det övergripande syftet är att analysera och kritiskt granska den kommunala sjuksköterskans arbetsförhållanden och yrkesutövning inom hemsjukvård. Projektet baseras på insamlat empiriskt datamaterial bestående av anteckningar och foton från kommunal hemsjukvård som beskriver sjuksköterskornas yrkesutövning. Datainsamlingen har genomförts med en mobil kvalitativ metod där sjuksköterskor följdes av en forskare under en arbetsdag. Sjuksköterskorna skuggades i två mellanstora kommuner, både i tätort och på landsbygd, samt inom olika typer av områden med skilda socioekonomiska karaktärer. De övergripande fynden visar att sjuksköterskor inom kommunal hälso- och sjukvård möter många olika medarbetare under en arbetsdag, aktörer som är mer eller mindre synliga i det dagliga arbetet. Kommunikationen mellan olika aktörer sker ofta genom olika elektroniska system, vilka styr arbetsdagen på olika sätt. Sjuksköterskan befinner sig sällan på en plats utan är ständigt i rörelse, på cykel, i bil eller på kontoret där hen letar efter eller plockar i ordning utrustning eller material. Hen möter också olika typer av hem och behöver vara flexibel för att lösa de planerade och ibland oplanerade insatserna. På dessa platser möts olika personalkategorier och hemmen kan tidvis snarare karakteriseras som sjukhussalar. Analysen visar komplexa arbetsförhållanden där sjuksköterskornas specifika kompetens inte alltid verkar tillvaratas. Själva insatserna står i centrum, inte vilken kompetensnivå som utför dem, då delegering är mer regel än undantag. Sjuksköterskans yrkesutövning kan beskrivas som osynlig, men hela tiden underförstådd, då hen ibland behöver gå in när insatser skjuts över vid hög belastning eller kompetensbrist hos andra.

This paper aims to contribute to the knowledge about open, co-produced meeting centres for people with dementia, from their own perspective. Services that support people who are newly diagnosed with dementia are often insufficient. Co-produced services have the potential to address the need of people with dementia to be useful and productive, while reducing the stigma. In this study, we applied a qualitative design. Data were collected at a meeting centre for people with newly diagnosed dementia, and consisted of fieldwork (13 days for about two hours at a time), written materials, and semi-structured interviews (mean length 30 minutes) with five attendees with dementia and two staff persons. The analysis was inspired by situational analysis. The findings showed that the meeting centre provided a place for human encounters, a break from everyday life, and a place to share knowledge and develop new skills. Further, challenges were described. Co-production consisted of the attendees being encouraged to take part in the planning of activities, learning from each other and providing mutual support. The study adds to previous knowledge about co-produced services for people with dementia. Future studies can clarify how co-production can be developed in services for people with newly diagnosed dementia in countries and regions where there is a dearth of this kind of support.

Marie Cederschiöld högskola (MCHS) och Sophiahemmet Högskola (SHH) samarbetar kring en gemensam seminarieserie i publiceringsetik. Seminarierna vänder sig till högskolornas doktorander, forskare och bibliotekarier. Med liten arbetsinsats från en grupp med forskare och bibliotekarier har vi en bra samverkan både mellan våra högskolor och mellan olika professioner på högskolorna.

Most adverse events in health care are related to medication management and they are almost always preventable. Increased knowledge of patient safety related to medication management in home health care is an urgent issue to provide safe care for all patients regardless of where the health care takes place. This study explored patient safety within medication management in municipal home health care. Vignettes were used as stimulus during qualitative interviews with registered nurses. Three main themes with related subthemes were identified as challenges to patient safety within medication management in home health care: (1) challenges to information transfer, (2) challenges related to delegation, and (3) challenges of advanced medical treatments in the home. The issue of transfer of information permeated our findings. Coordinating medications, delegating tasks, along with more advanced care require clear communication between care providers to be compatible with patient safety within medication management in home health care.

BACKGROUND: Promoting the health and well-being of couples where one partner has dementia is an overlooked area of care practice. Most postdiagnostic services currently lack a couple-centered approach and have a limited focus on the couple relationship. To help address this situation, we developed a tablet-based self-management guide (DemPower) focused on helping couples enhance their well-being and relationship quality.

OBJECTIVE: The aim of this study is to investigate the feasibility and acceptability of the DemPower app.

METHODS: A nonrandomized feasibility design was used to evaluate the DemPower intervention over 3 months among couples where a partner had a diagnosis of dementia. The study recruited 25 couples in the United Kingdom and 19 couples in Sweden. Outcome measures were obtained at baseline and postintervention. The study process and interventions were evaluated at various stages.

RESULTS: The study was completed by 48% (21/44) of couples where one partner had dementia, of whom 86% (18/21) of couples accessed all parts of the DemPower app. Each couple spent an average of 8 hours (SD 3.35 hours) using the app during the study period. In total, 90% (19/21) of couples reported that all sections of DemPower were useful in addressing various aspects of daily life and helped to focus on how they interacted in their relationship. Of the 4 core subjects on which the DemPower app was structured, home and neighborhood received the highest number of visits. Couples used activity sections more often than the core subject pages. The perception of DemPower's utility varied with each couple's lived experience of dementia, geographic location, relationship dynamics, and opportunities for social interaction. A 5.2-point increase in the dementia quality of life score for people with dementia and a marginal increase in the Mutuality scale (+1.23 points) for caregiver spouses were found. Design and navigational challenges were reported in the DemPower app.

CONCLUSIONS: The findings suggest that the DemPower app is a useful resource for couples where one partner has dementia and that the implementation of the app requires the support of memory clinics to reach couples at early diagnosis.

TRIAL REGISTRATION: ISRCTN Registry ISRCTN10122979; http://www.isrctn.com/ISRCTN10122979.

AIMS AND OBJECTIVES: To investigate patients' experiences of being involved in their care in the emergency department (ED).

BACKGROUND: Previous research shows that when patients experience involvement during care visits, this increased their trust in the care, gave a sense of control and promoted their autonomy.

DESIGN: A qualitative descriptive design with semi-structured interviews, using the "Consolidated criteria for reporting qualitative research" (COREQ) checklist.

METHODS: Using convenience sampling, semi-structured interviews were conducted with 16 patients in the ED.

RESULTS: The study identified four categories: attention and inattention; communication and understanding; varying levels of participation; and inefficient and inaccessible care. The results show that patients expected to be treated with respect and to be involved in an open dialogue about their care. Patients' experiences of participation were related to their sense of control.

CONCLUSIONS: Based on the results of the study, the authors found that factors such as dialogue, information, attention and participation affected the patients' involvement during the ED visit. Experiences of involvement and control were linked to patients' experiences of care and of patients as individuals.

RELEVANCE TO CLINICAL PRACTICE: Healthcare providers' awareness of the importance of paying attention to the patient as an individual, and of the need for simple, continuous communication could facilitate patient involvement in own care.

BACKGROUND: The proportion of older people in the population has increased globally and has thus become a challenge in health and social care. There is good evidence that care based on comprehensive geriatric assessment (CGA) is superior to the usual care found in acute hospital settings; however, the evidence is scarcer in community-dwelling older people. This study is a secondary outcome of a randomized controlled trial of community-dwelling older people in which the intervention group (IG) received CGA-based care by a geriatric mobile geriatric team (GerMoT). The aim of this study is to obtain a better understanding, from the patients' perspective, the experience of being a part of the IG for both the participants and their relatives.

METHODS: Qualitative semistructured interviews of twenty-two community dwelling participants and eleven of their relatives were conducted using content analysis for interpretation.

RESULTS: The main finding expressed by the participants and their relatives was in the form of feelings related to safety and security and being recognized. The participants found the care easily accessible, and that contacts could be taken according to needs by health care professionals who knew them. This is in accordance with person-centred care as recommended by the World Health Organisation (WHO) for older people in need of integrated care. Other positive aspects were recurrent health examinations and being given the time needed when seeking health care. Not all participants were positive as some found the information about the intervention to be unclear especially regarding whom to contact when in different situations.

CONCLUSIONS: CGA-based care of community-dwelling older people shows promising results as the participants in GerMoT found the care was giving a feeling of security and safety. They found the care easily accessible and that it was provided by health care professionals who knew them as a person and knew their health care problems. They found this to be in contrast to the usual care provided, but GerMoT care did not fulfill some people's expectations.