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  • 1.
    Vamstad, Johan
    Ersta Sköndal högskola, Institutionen för socialvetenskap, Avdelningen för forskning om det civila samhället.
    Exit, Voice and Indifference: Older people as consumers of Swedish home care services2015Ingår i: Ageing & Society, ISSN 0144-686X, E-ISSN 1469-1779Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Sweden has in the last 20 years undergone an extensive process of marketisation of its home care sector. Where the public sector once was the only provider of home care services, there is now a wide array of different, private alternatives for older people to choose from, using their publicly funded voucher. The publicly funded home care services in Sweden are, in other words, to a large extent organised according to the principles of a quasi-market. Older people with care needs are therefore now considered to be consumers of home care since they are expected to make an informed choice of home care provider according to their own preferences. This paper studies the extent to which older people with care needs assume this role and how they do it, using Hirschman's well-known theory on ‘exit, voice and loyalty’ and theory on the difference between care and market logic. The study is based on results from a research project using telephone interviews to ask a large number of older people in three Swedish cities about their experience of making this choice. The results show that they had difficulty understanding how to choose and what the purpose of the choice was. The conclusion of this study suggests some possible reasons why policy makers in Sweden continue to favour the freedom-of-choice model in spite of these poor results.

  • 2.
    Westius, Anders
    et al.
    Örebro universitet.
    Kallenberg, Kjell
    Örebro universitet.
    Norberg, Astrid
    Ersta Sköndal högskola, Palliativt forskningscentrum, PFC. Umeå universitet.
    Views of life and sense of identity in people with Alzheimer's disease2010Ingår i: Ageing & Society, ISSN 0144-686X, E-ISSN 1469-1779, Vol. 30, nr 7, s. 1257-1278Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Making it possible for people with Alzheimer's disease to retain a sense of identity during the process of the disease poses a great challenge to care-givers, professionals and family carers. The aim of this study is to elucidate the role of the view of life of people with Alzheimer's in framing their sense of identity. Is their view of life a vital aspect of their sense of identity? ‘View of life’ was interpreted as a vital aspect of sense of identity, understood as the individual's beliefs about their life history and about the attributes that characterised them. Twenty-one people with mild to moderate stages of Alzheimer's disease were interviewed about their life story. The narratives were interpreted using a phenomenological hermeneutic method. By telling their life story, the participants also narrated their view of life, i.e. their conception of reality, their central system of values and their basic emotional attitudes. By their own accounts, the origins of the narrators' central values and basic emotional attitudes were established in early life. They also expressed a sense of meaningfulness and continuity when looking back on their lives. The findings suggest that for a care-giver or confidant, having knowledge of a person with dementia's view of life is valuable when seeking to confirm that person's sense of identity.

  • 3.
    Österlind, Jane
    et al.
    Ersta Sköndal högskola, Enheten för forskning i palliativ vård.
    Hansebo, Görel
    Ersta Sköndal högskola, Institutionen för vårdvetenskap.
    Andersson, Janicke
    Institutionen för samhälls- och välfärdsstudier, LInköpings universitet.
    Ternestedt, Britt-Marie
    Ersta Sköndal högskola, Enheten för forskning i palliativ vård. Ersta Sköndal högskola, Institutionen för vårdvetenskap.
    Hellström, Ingrid
    Institutionen för samhälls- och välfärdsstudier, Linköpings universitet.
    A discourse of silence: professional carers resoning of death and dying in nursing homes2011Ingår i: Ageing & Society, ISSN 0144-686X, E-ISSN 1469-1779, Vol. 31, nr 4, s. 529-544Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    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.

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