In Sweden, increased care in ordinary housing has contributed to a reduction of rooms in sheltered accommodation. The allocation of rooms has become stricter. Only those whose care needs cannot be met in any other ways are allocated such accommodation. The aim was to explore the waiting time between the transfer decision and the accomplishment of the move from the initial form of care to sheltered accommodation as well as whether there were differences in waiting time in relation to certain demographic data. METHOD: 445 decision documents were analysed. Mean and 95% confidence intervals (CI) for waiting time and date of the move to sheltered accommodation were calculated. Differences between mean age and waiting time were analysed using Student's T-test. Effects of age, gender and cohabitation on waiting time were estimated by means of multifactor linear regression. RESULTS: The main finding was that the difference in mean waiting time was shortest when moving from hospital, irrespective of destination. There were no significant differences in waiting time in relation to gender, age or cohabitation. CONCLUSION: The reason for a move was often described by means of abstract standard formulations. There is a need for standardised models and assessment instruments in order to ensure older people's safety and to compare different forms of accommodation.

Seven care managers employed by a large municipality in Sweden were interviewed concerning their reasoning regarding end-of-life care for older people. Data were analyzed using a hermeneutic approach. The results showed that end-of-life care was considered to constitute a small part of the care managers' work and was something they did not focus on in general when assessing care needs. Two different pathways to death--the natural and the medical--were identified. In the natural pathway, death was invisible and the care was more routine-oriented. In the medical pathway, death was visualised and the care more individualised. Neither of the pathways paid attention to communication or existential needs. Thus, there is a need for a palliative pathway to death based on the philosophy of palliative care, which could provide guidance for care managers and promote opportunities for older people to achieve a dignified dying and death.

Aim: The aim of the study was to deepen the understanding of how older persons living in a nursing home experience life close to death.

Background: A move to and a life in a nursing home while being close to death is a reality for many older people in Sweden. Being able to express thoughts and feelings about death has been described as both crucial for sustaining personhood as well as for establishing a meaningful existence at the end of life. Important are the experiences of older people living in nursing homes who are approaching death.

Method: Six older people were interviewed on one to four occasions. A total of 16 interviews were conducted with the participants. An interpretative approach was chosen.

Findings: The main interpretation, Feeling lonely in an unfamiliar place, is based on three themes (i) Waiting for death, with the subthemes death as a release and thinking of oneself as dead; (ii) Subordinate oneself to values and norms of the staff, with the subthemes feeling offended and feeling trapped; and (iii) Keep the courage up. The older people's lives were characterised by feelings of aloneness in an unfamiliar place which contributed to a sense of existential loneliness. They experienced few opportunities to discuss their thoughts of life and death, including preparations for passing away.

Conclusion and implication for practice: It is of importance for professionals to be able to meet older people as they are and respect them as human beings in their transitions, before, during and after the move to a nursing home. It is important to find ways to support older people's wellbeing and identity near death.

Nursing homes are a setting in which death and dying is common. How death and dying is articulated and the actions that take place in a nursing home constitute adiscourse that guides the staff in their work. The aim of this studywas to explore thediscourse of death and dying in nursing homes from the perspective and understandingof the staff. The study draws on Foucault’s discourse analysis. Data arefrom fivefocus-group discussions held with 28 staff of four different nursing homes in Sweden. The findings show that the discourse had three characteristics :(a) dying was silent and silenced, (b) emotions were pushed into the background,and (c) attentiveness to death arose after the moment of the elderly person’s death. The structure of the discourse was characterised by a movement between twopositions, avoiding and confronting death, themain focus being on avoidance. Thearticulation and practices of silence highlight a need to regard dying as a processthat requires attention. One way to ensure appropriate attention could be to instil the philosophy of palliative care in nursing homes, including training and supportfor the staff in their work. The study demonstrates that nursing-home staff needmore knowledge and support to enable them to feel that they do a good job.