| 1. |
- Johansson, Linda, 1978-, et al.
(author)
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Using aggregated data from Swedish national quality registries as tools to describe health conditions of older adults with complex needs
- 2021
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In: Aging Clinical and Experimental Research. - : Springer. - 1594-0667 .- 1720-8319. ; 33:5, s. 1297-1306
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Journal article (peer-reviewed)abstract
- Background: Combining National Quality Registries (NQRs) with existing National Health Registries (NHRs) might make it possible to get a wider picture of older adults health situation. The aim was to examine the feasibility of aggregating data across different NQRs and existing NHRs to explore the possibility to investigate trajectories and patterns of disease and care, specifically for the most ill older adults. Method: A Swedish twin population (N = 44,816) was linked to nine NQRs and four NHRs. A descriptive mixed-method study was performed. A manifest content analysis identified which health parameters were collected from each NQR. Factor analysis identified patterns in representation across NQRs. Two case studies illustrated individual trajectories of care by using NQRs and NHRs. Results: About 36% of the population was registered in one or more NQRs. NQRs included 1849 variables that were sorted into 13 categories with extensive overlap across the NQRs. Health and function variables were identified, but few social or cognitive variables. Even though most individuals demonstrated unique patterns of multi-morbidities, factor analysis identified three clusters of representation in the NQRs with sufficient sample sizes for future investigations. The two cases illustrated the possibility of following patterns of disease and trajectories of care. Conclusions: NQRs seem to be a significant source for collecting data about a population that may be underrepresented in most research on aging because of their age and poor health. However, NQRs are primarily disease related, and further development of the registries to maximize coverage and utility is needed.
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| 2. |
- Finkel, Deborah, et al.
(author)
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Age and site differences in planned and performed actions in response to identified risks in older adults
- 2022
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In: Innovation in Aging. - : Oxford University Press. - 2399-5300. ; 6:Supplement_1, s. 840-840
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Journal article (other academic/artistic)abstract
- The Swedish health care system focuses on allowing older adults to “age in place”; however, that approach assumes that home health services are adequate to support health and prevent unnecessary decline. Data from the Senior Alert national quality register in Sweden were examined to compare the quality of care across care locations. First registration in Senior Alert was available for 2914 adults aged 57–109 (median age = 81): 3.6% dementia unit, 7.8% home health care, 4.4% rehabilitation unit, 62.8% hospital, 21.4% care home. There were significant differences across units in the number of identified risks in 4 categories: falls, malnutrition, oral health, and pressure ulcer. Individuals in rehabilitation units averaged 2.4 risks, individuals in dementia and care homes averaged 2.0 risks, and individuals in home health care and hospitals averaged 1.4 risks. For individuals with identified risks, the differences between planned and performed actions for each risk independently were greatest for those in home health care. Moreover, the correlation between total planned and performed actions in home health care was .79 for adults aged 65–80 years and .39 for adults aged 81 and over. The correlation did not differ across age for the other care units. Results suggest that individuals most in need of actions to address health risks (older adults in home health care) are least likely to have the actions performed. Training and support of workers responsible for home health care need to be improved if the “age in place” policy is to continue.
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| 3. |
- Ernsth Bravell, Marie, 1973-, et al.
(author)
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How to assess frailty and the need for care? Report from the Study of Health and Drugs in the Elderly (SHADES) in community dwellings in Sweden
- 2011
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In: Archives of Gerontology and Geriatrics. - : Elsevier BV. - 1872-6976 .- 0167-4943. ; 53:1, s. 40-45
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Journal article (peer-reviewed)abstract
- Knowledge about the need for care of elderly individuals in community dwellings and the factors affecting their needs and support is limited. The aim of this study was to characterize the frailty of a population of elderly individuals living in community dwellings in Sweden in relation to co-morbidity, use of drugs, and risk of severe conditions such as malnutrition, pressure ulcers, and falls. In 2008, 315 elderly individuals living in community dwellings were interviewed and examined as part of the SHADES-study. The elderly demonstrated co-morbidity (a mean of three diseases) and polypharmacy (an average of seven drugs). More than half the sample was at risk for malnutrition, one third was at risk for developing pressure ulcers, and nearly all (93%) had an increased risk of falling and a great majority had cognitive problems. Age, pulse pressure, body mass index, and specific items from the modified Norton scale (MNS), the Downton fall risk index (DFRI), and the mini nutritional assessment (MNA-SF) were related to different outcomes, defining the need for care and frailty. Based on the results of this study, we suggest a single set of items useful for understanding the need for care and to improve individual based care in community dwellings. (C) 2010 Elsevier Ireland Ltd. All rights reserved.
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| 4. |
- Finkel, Deborah, et al.
(author)
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Does the length of institutionalization matter? Longitudinal follow-up of persons with severe mental illness 65 year and older : shorter-stay versus longer-stay
- 2021
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In: International Journal of Geriatric Psychiatry. - : Wiley. - 0885-6230 .- 1099-1166. ; 36:8, s. 1223-1230
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Journal article (peer-reviewed)abstract
- OBJECTIVES: As part of the process of de-institutionalization in the Swedish mental healthcare system, a reform was implemented in 1995, moving the responsibility for services and social support for people with severe mental illness (SMI) from the regional level to the municipalities. In many ways, older people with SMI were neglected in this changing landscape of psychiatric care. The aim of this study is to investigate functional levels, living conditions, need of support in daily life, and how these aspects changed over time for older people with SMI.METHODS: In this study we used data from surveys collected in 1996, 2001, 2006, and 2011 and data from national registers. A group of older adults with severe persistent mental illness (SMI-O:P) was identified and divided into those who experienced shorter stays (less than 3 years) in a mental hospital (N = 118) and longer stays (N = 117).RESULTS: After correcting for longitudinal changes with age, the longer-stay group was more likely than the shorter-stay group to experience functional difficulties and as a result, were more likely to have experienced "re-institutionalization" to another care setting, as opposed to living independently.CONCLUSIONS: The length of mental illness hospitalization has significant effects on the living conditions of older people with SMI and their ability to participate in social life. This article is protected by copyright. All rights reserved.
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| 5. |
- Jegermalm, Magnus, 1962-, et al.
(author)
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Filling the gaps? : The role of voluntary organizations in supporting older people with severe mental illnesses
- 2020
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In: Nordic Social Work Research. - : Taylor & Francis. - 2156-857X .- 2156-8588. ; 10:3, s. 219-229
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Journal article (peer-reviewed)abstract
- Older people ageing with severe mental illness (SMI) usually fall in between mental health care and old age care services. The role of informal care in filling this gap is recognized. The role of other welfare providers, such as voluntary organizations, is unclear. The aim of this article is to analyze and discuss local voluntary organizations' ability to recognize and respond to the needs of older people with SMI in the community.11 local organizations focusing on mental illness, social care or old age were identified in a mid-sized Swedish city. Seven voluntary organizations participated in the study.Our analysis revealed three overarching themes: 'Age as a non-issue?', 'Public and voluntary sector (non)links' and 'organizational vulnerabilities'. Our results show that older people with SMI are to some extent also invisible in the voluntary sector. We were also able to discern differences in the 'we-for-us' organizations that provide support for their own members with SMI, and 'we-for-them' organizations that provide help to a broader group.Overall, older people with SMI remain a relatively invisible as a group for the voluntary organizations. We discuss these findings in relation to the specificity of the group and welfare contexts of voluntary work in communities.
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| 6. |
- Lindmark, Ulrika, 1965-, et al.
(author)
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Oral health is essential for quality of life in older adults : A Swedish National Quality Register Study
- 2021
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In: Gerodontology. - : Wiley-Blackwell. - 0734-0664 .- 1741-2358. ; 38:2, s. 191-198
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Journal article (peer-reviewed)abstract
- ObjectiveTo examine the relationship between QoL and oral health from two Swedish national quality registries (NQRs). Background: Oral health plays an important part in general health, which might also affect QoL. No studies have examined the relationships between QoL and oral health in late adulthood based on aggregated data from Swedish NQRs.Material and methodsFour NQRs incorporated the EQ‐5D, which assesses 5 aspects of QoL: mobility, self‐care, usual activities, pain/discomfort and anxiety/depression. Items from the Revised Oral Assessment Guide, obtained from the NQR Senior Alert, were used to identify older adults at risk for oral health issues.ResultsA total of 510 individuals had data on all relevant variables. Analyses indicated significantly higher QoL for individuals without risk of oral health problems (M = −0.15 (SD = 1.01)), compared to those with risk (M = −0.75 (SD = 1.52)). Logistic regression analysis showed that lower QoL (OR = 0.69 (0.49, 0.97)), mental status (OR = 0.37 (0.19, 0.71)), lower self‐rated health (OR = 0.59 (0.42, 0.85)) and higher age (OR = 1.07 (1.01, 1.13)) were significantly related to risk of oral health problems. Higher BMI (OR = 1.13 (0.99, 1.30)), living alone (OR = 2.37 (0.93, 6.06)) and more years of education (OR = 1.15 (1.01, 1.31)) were associated with higher risk of oral health problems.ConclusionsOral health is a significant component of quality of life in late adulthood. NQRs are of value for healthy ageing research in populations that may be underrepresented in research studies.
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| 7. |
- Ernsth-Bravell, Marie, 1973-, et al.
(author)
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"In August, I Counted 24 Different Names" : Swedish Older Adults' Experiences of Home Care
- 2021
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In: Journal of Applied Gerontology. - : Sage Publications. - 0733-4648 .- 1552-4523. ; 40:9, s. 1020-1028
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Journal article (peer-reviewed)abstract
- In Sweden, many older adults receive care in their own homes. However, their perceptions of the experience of receiving home care has not been sufficiently examined. This study aimed to explore older adults' experiences of receiving care and services in their homes and their perceptions of the care that they had received. In-depth interviews were conducted with 29 older adults. There were individual differences in their level of participation, but they mostly perceived their participation in the planning and provision of home care to be limited. Furthermore, their needs (and wishes), especially those that pertained to different aspects of time, were not always gratified. Organizational factors and care providers' lack of competence and high levels of time pressure influenced their perceptions of care. It is important to consider the perspectives of older care recipients when developing home care.
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| 8. |
- Hallgren, Jenny, et al.
(author)
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Health- and social care in the last year of life among older adults in Sweden
- 2020
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In: BMC Palliative Care. - : BioMed Central. - 1472-684X. ; 19:1
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Journal article (peer-reviewed)abstract
- BACKGROUND: In the last years of life, burden of disease and disability and need of health- and social care often increase. Social, functional and psychological factors may be important in regard to social- and health care utilization. This study aims to describe use of health- and social care during the last year of life among persons living in ordinary housing or in assisted living facilities. METHODS: A retrospective study examining health- and social care utilization during their last year of life, using a subsample from the Swedish twin registries individually linked to several Swedish national quality registries (NQR). Persons that died during 2008-2009 and 2011-2012 (n = 1518) were selected. RESULTS: Mean age at death was 85.9 ± 7.3 (range 65.1-109.0). Among the 1518 participants (women n = 888, 58.5%), of which 741 (49%) were living in assisted living facilities and 1061 (69.9%) had at least one hospitalization during last year of life. The most common causes of death were cardiovascular disease (43.8%) and tumors (15.3%). A multivariable logistic regression revealed that living in ordinary housing, younger age and higher numbers of NQR's increased the likelihood of hospitalization. CONCLUSIONS: Persons in their last year of life consumed high amount of health- and social care although 12% did not receive any home care. Married persons received less home care than never married. Persons living in ordinary housing had higher numbers of hospitalizations compared to participants in assisted living facilities. Older persons and persons registered in fewer NQR's were less hospitalized.
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| 9. |
- Lundgren, Dan, et al.
(author)
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The Association Between Psychosocial Work Environment and Satisfaction With Old Age Care Among Care Recipients
- 2020
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In: Journal of Applied Gerontology. - : SAGE Publications. - 0733-4648 .- 1552-4523. ; 39:7, s. 785-794
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Journal article (peer-reviewed)abstract
- This study examines the association between nursing assistants' perceptions of their psychosocial work environment and satisfaction among older people receiving care in nursing homes and home care. Cross-sectional surveys were conducted among people receiving care (N= 1,535) and nursing assistants (N= 1,132) in 45 nursing homes and 21 home care units within municipal old-age care. Better psychosocial work environment was related to higher satisfaction in old-age care among the recipients. Significant and stronger associations were more common in nursing homes than in home care. Perception of mastery and positive challenges at work were associated with higher recipient satisfaction both in home care and in nursing homes: social climate, perception of group work, perception of mastery, and positive challenges at work only in nursing homes. Findings suggest that recipient satisfaction may be increased by improving the psychosocial work environment for nursing assistants, both in nursing homes and in home care.
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| 10. |
- Lundgren, Dan, et al.
(author)
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The Impact of Leadership and Psychosocial Work Environment on Recipient Satisfaction in Nursing Homes and Home Care
- 2019
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In: Gerontology and geriatric medicine. - : SAGE Publications. - 2333-7214. ; 5, s. 1-9
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Journal article (peer-reviewed)abstract
- This study examines the association between nursing assistants' assessment of leadership, their psychosocial work environment, and satisfaction among older people receiving care in nursing homes and home care. Cross-sectional surveys were conducted with nursing assistants (n = 1,132) and people receiving care (n = 1,535) in 45 nursing homes and 21 home care units. Direct leadership was associated with the psychosocial work environment in nursing homes and home care. Furthermore, better leadership was related to higher satisfaction among nursing assistants and older people in nursing homes. Thus, indirect leadership had no effect on recipients' satisfaction in either nursing homes or home care. The path analysis showed an indirect effect between leadership factors and recipient satisfaction. The findings suggest that the psychosocial work environment of nursing assistants and recipient satisfaction in nursing homes can be increased by improving leadership.
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