| 1. |
- Westius, Anders, et al.
(författare)
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View of life in persons with dementia
- 2009
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Ingår i: Dementia. - London : Sage. - 1471-3012 .- 1741-2684. ; 8:4, s. 481-499
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To study the view of life in dementia. The view of life of an individual is defined as a conception of reality, a central system of values and a basic emotional attitude.Method: Interviews with persons (N = 21) with mild to moderate dementia of the Alzheimer’s type. The interview data were interpreted with a phenomenological hermeneutical method.Results: Despite their cognitive deterioration it was possible to understand the view of life of the participants in the frame of their life story. Their view of life seemed to guide them towards selecting mainly emotionally powerful and value-oriented memories. No exceptional characteristics that could be traced to their dementia disease were found in the participants’ views of life. Conclusions: The view of life of the participants with mild to moderate dementia was vital for their life story and was not erased by dementia.Implications: In order to respect people with dementia as persons, caregivers should strive for gaining some knowledge of their view of life.
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| 2. |
- Westius, Anders, et al.
(författare)
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Views of life and sense of identity in people with Alzheimer's disease
- 2010
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Ingår i: Ageing & Society. - Cambridge, United Kingdom : Cambridge university press. - 0144-686X .- 1469-1779. ; 30:7, s. 1257-1278
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Tidskriftsartikel (refereegranskat)abstract
- 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.
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| 3. |
- Morin, Lucas, et al.
(författare)
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Estimating the need for palliative care at the population level : A cross-national study in 12 countries
- 2017
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Ingår i: Palliative Medicine. - : SAGE Publications. - 0269-2163 .- 1477-030X. ; 31:6, s. 526-536
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Tidskriftsartikel (refereegranskat)abstract
- Background: To implement the appropriate services and develop adequate interventions, detailed estimates of the needs for palliative care in the population are needed.Aim: To estimate the proportion of decedents potentially in need of palliative care across 12 European and non-European countries.Design: This is a cross-sectional study using death certificate data.Setting/participants: All adults (18years) who died in 2008 in Belgium, Czech Republic, France, Hungary, Italy, Spain (Andalusia, 2010), Sweden, Canada, the United States (2007), Korea, Mexico, and New Zealand (N=4,908,114). Underlying causes of death were used to apply three estimation methods developed by Rosenwax et al., the French National Observatory on End-of-Life Care, and Murtagh et al., respectively.Results: The proportion of individuals who died from diseases that indicate palliative care needs at the end of life ranged from 38% to 74%. We found important cross-country variation: the population potentially in need of palliative care was lower in Mexico (24%-58%) than in the United States (41%-76%) and varied from 31%-83% in Hungary to 42%-79% in Spain. Irrespective of the estimation methods, female sex and higher age were independently associated with the likelihood of being in need of palliative care near the end of life. Home and nursing home were the two places of deaths with the highest prevalence of palliative care needs.Conclusion: These estimations of the size of the population potentially in need of palliative care provide robust indications of the challenge countries are facing if they want to seriously address palliative care needs at the population level.
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| 4. |
- Breitholtz, Agneta, et al.
(författare)
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Carers’ ambivalence in conflict situations with older persons
- 2013
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Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 20:2, s. 226-237
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this study was to illuminate the meaning of professional carers’ experiences in caring situations when a conflict of interest arises with the older person receiving care. The findings reveal the complexity of the carers’ ambivalence when facing a conflict of interest, weighing between the older persons’ right to self-determination and external demands. The carers are alone in their ambivalence and the conclusion is that they need help and support to be more present in the encounter. The implication for this study is a person-centred practice, and to focus on people as interdependent on support carers to maintain older people’s right to self-determination in the relationship.
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| 5. |
- Lagerin, Annica, et al.
(författare)
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Extent and quality of drug use in community-dwelling people aged >= 75 years : A Swedish nationwide register-based study
- 2020
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 48:3, s. 308-315
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Tidskriftsartikel (refereegranskat)abstract
- Aims: It is important for district nurses and other health professionals in primary care to gain more insight into the patterns and quality of drug use in community-dwelling older people, particularly in 75-year-olds, who have been the target of preventive home visits. This study aimed to examine the extent and quality of drug use in community-dwelling older people and to compare drug use in 75-year-olds with that of older age groups. Methods: Data from 2013 on people aged >= 75 years were obtained from the Swedish Prescribed Drug Register. Those living in the community (671,940/739,734 people aged >= 75 years) were included in the study. Quality of drug use was assessed by using a selection of indicators issued by the Swedish National Board of Health and Welfare. Results: The prevalence of polypharmacy and of many drug groups increased with age, as did several indicators of inappropriate drug use. However some drug groups, as well as inappropriate drugs, were prevalent in 75-year-olds and declined with age, for example diabetes drugs, drugs with major anticholinergic effects and nonsteroidal anti-inflammatory drugs. Conclusions: The substantial use of some drugs as early as 75 years of age confirms the value of including drug use as a topic in preventive home visits to 75-year-olds. The finding that polypharmacy and many measures of inappropriate drug use increased with age in community-dwelling older people also underscores the importance of district nurses' role in continuing to promote safe medication management at higher ages.
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| 6. |
- Ahlström, Gerd, et al.
(författare)
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Ageing people with intellectual disabilities and the association between frailty factors and social care : A Swedish national register study
- 2022
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Ingår i: Journal of Intellectual Disabilities. - Thousand Oaks, CA : Sage Publications. - 1744-6295 .- 1744-6309. ; 26:4, s. 900-918
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe the social care provided for different age groups of people with intellectual disability, 55 years or above, and to investigate the association between such care and frailty factors for those with diagnosed level of intellectual disabilities. Descriptive and logistic regression analyses were used. Commonest forms of social care among the 7936 people were Residential care, Daily activities and Contact person. Home help and Security alarm increased with age. The frailty factors significantly associated with increased social care were age, polypharmacy and severe levels of intellectual disabilities. Persons most likely to be in residential care were in the age group 65–79 with polypharmacy and severe disability. The results indicate a need for further research of how frailty factors are considered in social care and longstanding medication, especially then severe intellectual disability hinders communication. A national strategic plan for preventive interventions should be developed to ensure the best possible healthy ageing. © The Author(s) 2021.
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| 7. |
- Ericsson, Iréne, 1956-, et al.
(författare)
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"To be seen" : older adults and their relatives' care experiences given by a geriatric mobile team (GerMoT)
- 2021
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Ingår i: BMC Geriatrics. - : Springer Science and Business Media LLC. - 1471-2318 .- 1471-2318. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- 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.
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| 8. |
- Mamhidir, Anna-Greta, 1952-, et al.
(författare)
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Systematic pain assessment in nursing homes: a cluster-randomized trial using mixed-methods approach
- 2017
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Ingår i: BMC Geriatrics. - : Springer Science and Business Media LLC. - 1471-2318 .- 1471-2318. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundChronic pain affects nursing home residents’ daily life. Pain assessment is central to adequate pain management. The overall aim was to investigate effects of a pain management intervention on nursing homes residents and to describe staffs’ experiences of the intervention.MethodsA cluster-randomized trial and a mixed-methods approach. Randomized nursing home assignment to intervention or comparison group. The intervention group after theoretical and practical training sessions, performed systematic pain assessments using predominately observational scales with external and internal facilitators supporting the implementation. No measures were taken in the comparison group; pain management continued as before, but after the study corresponding training was provided. Resident data were collected baseline and at two follow-ups using validated scales and record reviews. Nurse group interviews were carried out twice. Primary outcome measures were wellbeing and proxy-measured pain. Secondary outcome measures were ADL-dependency and pain documentation.ResultsUsing both non-parametric statistics on residential level and generalized estimating equation (GEE) models to take clustering effects into account, the results revealed non-significant interaction effects for the primary outcome measures, while for ADL-dependency using Katz-ADL there was a significant interaction effect. Comparison group (n = 66 residents) Katz-ADL values showed increased dependency over time, while the intervention group demonstrated no significant change over time (n = 98). In the intervention group, 13/44 residents showed decreased pain scores over the period, 14/44 had no pain score changes ≥ 30% in either direction measured with Doloplus-2. Furthermore, 17/44 residents showed increased pain scores ≥ 30% over time, indicating pain/risk for pain; 8 identified at the first assessment and 9 were new, i.e. developed pain over time. No significant changes in the use of drugs was found in any of the groups. Nursing pain related documentation was sparse. In general, nurses from the outset were positive regarding pain assessments. Persisting positive attitudes seemed strengthened by continued assessment experiences and perceptions of improved pain management.ConclusionThe implementation of a systematic work approach to pain issues in nursing homes indicates that an increased awareness, collaboration across and shared understanding among the team members of the pain assessment results can improve pain management and lead to decreased physical deterioration or the maintenance of physical and functional abilities among NH residents. However, pain (proxy-measured) and wellbeing level did not reveal any interaction effects between the groups over time.Trial registrationThe study was registered in ISRCTN71142240 in September 2012, retrospectively registered.
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| 9. |
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Värdighet i vården av äldre personer
- 2010. - 1
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Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
- I flera årtionden har livskvalitet varit ett vedertaget begrepp i den etiska diskussionen om hälso- och sjukvården och vården av äldre. På senare tid har dock begreppet värdighet kommit att ta en större plats i denna diskussion. Värdighet i vården av äldre personer belyser begreppet värdighet inom äldreomsorgen och fokuserar på vikten av teoretiska begrepp. Boken baseras till största delen på forskningsprojektet Dignity and older Europeans och den beskriver ingående begreppet värdighet samt relaterade begrepp som livskvalitet och autonomi. Begreppsundersökningen resulterar i en värdighetsmodell med fyra varianter av värdighet: meritvärdighet, den moraliska resningens värdighet, identitetsvärdighet och människovärdet (Menschenwürde, det specifikt mänskliga värdet). Av detta följer en diskussion om hur dessa varianter av värdighet kan tillämpas för att karaktärisera vården av äldre. Begreppen värdighet och värdig vård diskuteras, särskilt i samband med personer med demens och döende personer. Boken innehåller också ett kapitel om den döda personens värdighet. Genom dess internationella perspektiv ger Värdighet i vården av äldre personer ett högst aktuellt bidrag till den pågående diskussionen om vården av äldre. Boken vänder sig till blivande och redan yrkesverksamma sjuksköterskor samt personer inom den sociala omsorgen som arbetar med äldre.
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| 10. |
- Lagerin, Annica, et al.
(författare)
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District nurses' preventive home visits to 75-year-olds : An opportunity to identify factors related to unsafe medication management
- 2014
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 42:8, s. 786-794
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To investigate factors related to unsafe medication management among 75-year-olds during preventive home visits, and to describe the interventions district nurses used. Methods: An explorative study. During a 9- to 12-month period, 36 DNs used the Safe Medication Assessment (SMA) tool during preventive home visits to 75-year-olds who used at least one drug (n=113). Results: One or more factors related to unsafe medication management were identified in 84% of the 75-year-olds. More than 40% used five or more drugs, and 34.5% reported symptoms potentially indicative of adverse effects of their drugs. Nearly 30% had prescribers from more than two medical units, and 7.1% of the older persons were appraised as having reduced cognitive ability. DNs intervened in more than two-thirds of the cases and used a variety of nursing care interventions to improve the safety of medication management. Conclusions: Preventive home visits seem to provide a unique opportunity to promote safe medication management. Several factors related to unsafe medication management were identified, and several different nursing care interventions were carried out to ensure safe medication management. Use of the SMA tool in preventive home visits seems to be advantageous in improving the safety of medication management among older persons.
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