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  • 1.
    Björkman Randström, Kerstin
    et al.
    Mittuniversitetet.
    Wengler, Yvonne
    Mittuniversitetet.
    Asplund, Kenneth
    Mittuniversitetet.
    Svedlund, Marianne
    Mittuniversitetet.
    Working with 'hands-off' support: a qualitative study of multidisciplinary teams' experiences of home rehabilitation for older people2014Ingår i: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 9, nr 1, s. 25-33Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: There is a move towards the provision of rehabilitation for older people in their homes. It is essential to ensure that rehabilitation services promote independence of older people.

    Aim: The aim of the study was to explore multidisciplinary teams' experiences of home rehabilitation for older people.

    Methods: Five focus groups were conducted with multidisciplinary teams based in a municipality in Sweden, covering seven different professions. In total, 28 participants volunteered to participate in these interviews. Interviews were transcribed verbatim and analysed according to content analysis.

    Results: Two main categories, as well as four subcategories, emerged. The first main category, having a rehabilitative approach in everyday life, consisted of the subcategories: ‘giving ‘hands-off’ support’ and ‘being in a home environment’. The second main category, working across professional boundaries, consisted of the subcategories: ‘coordinating resources’ and ‘learning from each other’.

    Conclusion: Common goals, communication skills and role understanding contributed to facilitating the teams' performances of rehabilitation. A potential benefit of home rehabilitation, because the older person is in a familiar environment, is to work a rehabilitative approach into each individual's activity in their everyday life in order to meet their specific needs. At an organisational level, there is a need for developing services to further support older people's psychosocial needs during rehabilitation.

    Implications for practice: Team performance towards an individual's rehabilitation should come from an emerged whole and not only from the performance of a specific professional approach depending on the traditional role of each profession. A rehabilitative approach is based on ‘hands-off’ support in order to incorporate an individual's everyday activities as a part of their rehabilitation.

  • 2.
    Dwyer, Lise-Lotte
    et al.
    Ersta Sköndal högskola, Enheten för forskning om vård i livets slutskede. Örebro universitet.
    Andershed, Birgitta
    Ersta Sköndal högskola, Enheten för forskning om vård i livets slutskede.
    Nordenfelt, Lennart
    Ersta Sköndal högskola, Enheten för forskning om vård i livets slutskede.
    Ternestedt, Britt-Marie
    Ersta Sköndal högskola, Enheten för forskning om vård i livets slutskede.
    Dignity as experienced by nursing home staff2009Ingår i: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 4, nr 3, s. 185-193Artikel i tidskrift (Refereegranskat)
  • 3.
    Dwyer, Lise-Lotte
    et al.
    Ersta Sköndal högskola, Institutionen för vårdvetenskap. Ersta Sköndal högskola, Enheten för forskning i palliativ vård.
    Hansebo, Görel
    Ersta Sköndal högskola, Institutionen för vårdvetenskap.
    Andershed, Birgitta
    Ersta Sköndal högskola, Enheten för forskning i palliativ vård.
    Ternestedt, Britt-Marie
    Ersta Sköndal högskola, Institutionen för vårdvetenskap. Ersta Sköndal högskola, Enheten för forskning i palliativ vård.
    Nursing home residents’ views on dying and death: nursing home employee’s perspective2010Ingår i: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 6, nr 4, s. 251-260Artikel i tidskrift (Refereegranskat)
  • 4. Eriksson, Henrik
    et al.
    Sandberg, Jonas
    Ersta Sköndal högskola, Institutionen för vårdvetenskap.
    Transitions in men's caring identities: experiences from home-based care to nursing home placement.2008Ingår i: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 3, nr 2, s. 131-7Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives.  The aim of this study is to describe, from a gender identity perspective, the experiences of older men involved in the process of caring for a partner at home and the placement into a nursing home. Background.  Few studies have paid attention to the importance of gender when considering the social experiences of older men providing care for an ill spouse and finally placing a partner in a nursing home. Further understanding is much needed of how older men experience the process of caring for a spouse from a gender identity perspective. Design.  A qualitative constructivist approach was adopted for this study. Participants.  Data consists of interviews with seven men that have been informal carers and experienced the placement of their wife in a nursing home. Methods.  Interviews were analysed with a constructivist approach. Results.  The results indicate that men go through two transitions in their gender identity during the caregiving process and placement. From the mutual loving relationship of being a loving husband, the social responsibility of daily care of their wives changes the situation into that of being a caring husband, and finally with the move to a nursing home there is a transition from intimate care to a relationship based on friendship. Conclusions.  The results show that older caregiving men undergo a process involving a reconstruction of gender identity. To formally recognize men's caring activities and to make them sustainable, we believe that men in an informal caring relationship need support. Relevance to clinical practice.  Nurses need to recognize the identity struggles resulting in sadness and suffering that are related to changes in men's lives during the caregiving process. Understanding the dynamics and changes that occur when men take on a caring task is important for the development of their role as carers.

  • 5.
    Fläckman, Birgitta
    et al.
    Högskolan i Gävle.
    Sørlie, Venke
    Kihlgren, Mona
    Unmet expectations: why nursing home staff leave care work2008Ingår i: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 3, nr 1, s. 55-62Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background. The shortages of healthcare professionals have been a common topic in care of older people.

    Aim and objectives. The aim of the present study was to illuminate what caused the nursing home caregivers to decide to leave their employment.

    Design. A two-year intervention study was performed in three nursing homes in Sweden.

    Method. This qualitative interview study was conducted with 18 caregivers who decided to leave their employment during the first year. Content analysis was the method used to analyse the interviews.

    Result. The caregivers’ decisions to leave their work in care of older people could be encompassed in one main category: ‘Unmet Expectations’. Their experiences were of lack of encouragement and trust and professional development. Feelings of insecurity, different opinions on the care delivered, being disregarded and betrayed followed as did thoughts of leaving work and pursuing other opportunities.

    Conclusions. The main findings indicated that organizational work pressure with information about pending financial cutbacks caused the caregivers to leave the nursing homes.

    Relevance to clinical practice. The study’s results show the value of meeting the needs of caregivers, as caregivers consider that they meet the needs of the older people. Optimal use of caregivers’ skills, experiences, competence and respect for their aspirations is also likely to result in cost-efficient care.

  • 6.
    Melander, Catharina
    et al.
    Luleå tekniska universitet.
    Sävenstedt, Stefan
    Luleå tekniska universitet.
    Välivaara, Britt-Marie
    Luleå tekniska universitet.
    Olsson, Malin
    Luleå tekniska universitet.
    Human capabilities in advanced dementia: Nussbaum's approach2018Ingår i: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 13, nr 2, artikel-id 12178Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims and objectives

    To explore how Martha Nussbaum's approach to human capabilities can apply to dignity in the lives of people with advanced dementia living in nursing homes.

    Background

    Challenges experienced when supporting people with advanced dementia who express problematic behaviours include understanding their needs and ensuring a dignified life for them.

    Design and methods

    Data were gathered using an ethnographic approach based on participatory observation. Nussbaum's capability approach was then used as a framework for the analysis. Four women diagnosed with advanced dementia who also expressed problematic behaviours were recruited from a nursing home in Northern Sweden. The data collection was performed during 2015.

    Findings

    Individuals with advanced dementia had difficulties in participating in the planning of their lives and achieving the human capability of practical reasoning. They were also at risk of being placed outside the social group, thus hindering them from attaining the human capability of affiliation. A dignified life for individuals with advanced dementia requires nursing staff to be present and to provide adapted support to ensure that the individual can actually pursue human capabilities.

    Conclusion

    Creating opportunities for the human capabilities of practical reasoning and affiliation is essential as they permeate all other human capabilities. For these individuals, it was crucial not only to create opportunities for human capabilities but also to attend to their expressions and needs and to guide and steer them towards a dignified life.

    Implications for Practice

    The normative structure of the capability approach described by Nussbaum can ensure that nursing staffs move beyond fulfilling patients’ basic needs to consider other capabilities vital for a dignified life.

  • 7.
    Saarnio, Lotta
    et al.
    Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap. Karolinska institutet.
    Boström, Anne-Marie
    Karolinska institutet, Danderyds sjukhus.
    Gustavsson, Petter
    Karolinska institutet.
    Hedman, Ragnhild
    Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap.
    Öhlén, Joakim
    Göteborgs universitet.
    Temporally and spatially shaped meanings of at-homeness among people 85 years and over with severe illness.2018Ingår i: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 13, nr 1Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS AND OBJECTIVES: The aim of the study was to illuminate how meanings of at-homeness are temporally and spatially shaped by older people with severe illness.

    BACKGROUND: At-homeness can be understood as a feeling of being metaphorically at-home while experiencing well-being. The research field of at-homeness among older people with severe illness is under researched and knowledge about how at-homeness is shaped by time and place is limited.

    METHOD: Narrative interviews were conducted in Sweden with a total of twenty men and women who were aged 85 years or over and affected by severe illness. The narrative interviews were analysed based on a phenomenological hermeneutical method.

    RESULTS: Meanings of at-homeness that were shaped temporally and spatially were interpreted, where time and place were shaped individually by other aspects and also interwoven. Two main inter-related themes were constructed: shaping at-homeness through relying on a familiar place and shaping at-homeness through continuous balancing between the past, present and future.

    CONCLUSION AND IMPLICATIONS: At-homeness is temporally and spatially shaped in two ways: through a process over time, or momentarily, where older people's earlier experiences and expectations are interwoven with their experiences of place and the people around them. The results of this study would be applicable to similar societal contexts. For future research, it is important to continue to study how at-homeness can be promoted for severely ill older people, in specific situations and over time.

  • 8. Stenwall, Ewa
    et al.
    Sandberg, Jonas
    Ersta Sköndal högskola, Institutionen för vårdvetenskap.
    Jönhagen, Eriksdotter
    Fagerberg, Ingegerd
    Mälardalens högskola.
    Relatives' experiences of encountering the older person with acute confusional state: experiencing unfamiliarity in a familiar person2008Ingår i: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 3, nr 4, s. 243-251Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims and objectives. The aim was to understand the lived experience of close relatives encountering older persons with acute confusional state.

    Background. Little is known about relatives of patients with acute confusional state and their experiences while encountering a family member exhibiting acute confusional state.

    Design. A descriptive phenomenological research approach was used.

    Methods. Data were collected by interviewing 10 close relatives of older people with acute confusional state at two hospital wards.

    Results. Relatives experience the encounter as encountering a familiar person who has suddenly become unfamiliar, struggling to separate the familiar from the unfamiliar and trying to understand the causes of acute confusional state and the behaviour of the person. Six constituents illuminate the phenomenon: 'change in the other person', 'rapid and unexpected changes', 'experiencing insecurity in the encounter', 'trusting or mistrusting the other person', 'experiencing loss' and 'experiencing exposure'.

    Relevance to clinical practice. It is important for professional carers to support relatives on how to encounter the person with acute confusional state, and to co-operate with relatives to gain knowledge about the unique person behind the acute confusional state.

    Conclusion. Relatives' difficulties in dealing with strong emotions evoked within the encounter, experiencing limitation and lack of trust is essential knowledge for professional carers in all care settings.

  • 9.
    Swall, Anna
    et al.
    Karolinska Institutet.
    Ebbeskog, Britt
    Karolinska Institutet.
    Lundh Hagelin, Carina
    Sophiahemmet högskola.
    Fagerberg, Ingegerd
    Ersta Sköndal högskola, Institutionen för vårdvetenskap.
    Can therapy dogs evoke awareness of one's past and present life in persons with Alzheimer's disease?2014Ingår i: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743Artikel i tidskrift (Refereegranskat)
  • 10.
    Söderlund, Mona
    et al.
    Ersta Sköndal högskola, Institutionen för vårdvetenskap. Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Norberg, Astrid
    Ersta Sköndal högskola, Institutionen för vårdvetenskap. Department of Nursing, Umeå University, Umeå, Sweden.
    Hansebo, Görel
    Ersta Sköndal högskola, Institutionen för vårdvetenskap. Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Validation method training: nurses' experiences and ratings of work climate2014Ingår i: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 9, nr 1, s. 79-89Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Training nursing staff in communication skills can impact on the quality of care for residents with dementia and contributes to nurses' job satisfaction. Changing attitudes and practices takes time and energy and can affect the entire nursing staff, not just the nurses directly involved in a training programme. Therefore, it seems important to study nurses' experiences of a training programme and any influence of the programme on work climate among the entire nursing staff.

    Aims and objectives: To explore nurses' experiences of a 1-year validation method training programme conducted in a nursing home for residents with dementia and to describe ratings of work climate before and after the programme.

    Design: A mixed-methods approach.

    Methods: Twelve nurses participated in the training and were interviewed afterwards. These individual interviews were tape-recorded and transcribed, then analysed using qualitative content analysis. The Creative Climate Questionnaire was administered before (n = 53) and after (n = 56) the programme to the entire nursing staff in the participating nursing home wards and analysed with descriptive statistics.

    Results: Analysis of the interviews resulted in four categories: being under extra strain, sharing experiences, improving confidence in care situations and feeling uncertain about continuing the validation method. The results of the questionnaire on work climate showed higher mean values in the assessment after the programme had ended.

    Conclusion: The training strengthened the participating nurses in caring for residents with dementia, but posed an extra strain on them. These nurses also described an extra strain on the entire nursing staff that was not reflected in the results from the questionnaire. The work climate at the nursing home wards might have made it easier to conduct this extensive training programme.

    Implications for practice: Training in the validation method could develop nurses' communication skills and improve their handling of complex care situations.

  • 11.
    Österlind, Jane
    et al.
    Ersta Sköndal högskola, Enheten för forskning om vård i livets slutskede. Ersta Sköndal högskola, Institutionen för vårdvetenskap.
    Ternestedt, Britt-Marie
    Ersta Sköndal högskola, Institutionen för vårdvetenskap. Ersta Sköndal högskola, Enheten för forskning i palliativ vård. Karolinska institutet.
    Hansebo, Görel
    Ersta Sköndal högskola, Institutionen för vårdvetenskap. Karolinska institutet.
    Hellström, Ingrid
    Ersta Sköndal högskola, Enheten för forskning om vård i livets slutskede. Ersta Sköndal högskola, Institutionen för vårdvetenskap. Linköpings universitet.
    Feeling lonely in an unfamiliar place: older peoples experiences of life close to death in a nursing home2017Ingår i: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 12, nr 1, s. 1-8, artikel-id e12129Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    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.

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