1. |
- Dahlberg, Lena, 1970-, et al.
(author)
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Ensamhet bland äldre personer i Norden
- 2020
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Reports (other academic/artistic)abstract
- Rapporten presenterar översikter av tidigare forskning och analyser av känslan av ensamhet bland äldre personer. Överlag finns det kunskap om ensamhetens konsekvenser för ohälsa, men det behövs ytterligare forskning där starkare slutsatser kan dras om sambandens riktning, och ett tydligare fokus på ensamhet i gruppen äldre personer. En systematisk översikt visar att det finns god kunskap om en del faktorer som ökar risken för ensamhet, men mer forskning behövs om andra potentiella riskfaktorer. Analyserna visar en relativt låg och stabil förekomst av ensamhet bland äldre personer i Norden, samt att ohälsa och olika indikatorer för social exkludering (t.ex. bristande sociala relationer, otillräcklig inkomst, samt otrygghet i närområdet) har samband med ensamhet. Slutligen konstateras att forskningen om nordiska interventioner för att minska ensamhet bland äldre personer är begränsad.
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2. |
- Falk Johansson, Marcus, et al.
(author)
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A comparison of spouse and non-spouse carers of people with dementia : a descriptive analysis of Swedish national survey data
- 2021
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In: BMC Geriatrics. - : BioMed Central. - 1471-2318. ; 21:1
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Journal article (peer-reviewed)abstract
- BackgroundBeing an informal carer of a person with dementia (PwD) can have a negative effect on the carer's health and quality of life, and spouse carers have been found to be especially vulnerable. Yet relatively little is known about the care provided and support received by spouse carers. This study compares spouse carers to other informal carers of PwDs regarding their care provision, the support received and the psychosocial impact of care.MethodsThe study was a cross-sectional questionnaire-based survey of a stratified random sample of the Swedish population aged 18 or over. The questionnaire explored how much care the respondent provided, the support received, and the psychosocial impact of providing care. Of 30,009 people sampled, 11,168 (37.7%) responded, of whom 330 (2.95%) were informal carers of a PwD.ResultsIn comparison to non-spouse carers, spouse carers provided more care more frequently, did so with less support from family or the local authority, while more frequently experiencing negative impacts on their social life and psychological and physical health. Spouse carers also received more carer support and more frequently experienced a closeness in their relationship with the care-recipient.ConclusionsSpouse carers of PwD differed from non-spouse carers on virtually all aspects of their care situation. Policy and practice must be more sensitive to how the carer-care-recipient relationship shapes the experience of care, so that support is based on an understanding of the individual carer's actual needs and preferences rather than on preconceptions drawn from a generalised support model.
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3. |
- Falk Johansson, Marcus
(author)
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For better and for worse, till death do us part : Support needs of persons caring for a co-habitant spouse or partner with dementia
- 2024
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Doctoral thesis (other academic/artistic)abstract
- Background: Caring for a partner with dementia is typically stressful and challenging. Such carers can become overwhelmed by their responsibilities, neglecting their personal needs as well as their need for support as a carer. Receipt of support is low among spouse carers, while the support received may not be appropriate for their needs. More research is required to develop effective support for this important group of carers. Overall aim: To explore the life- and caring situation of spouses caring for a partner with dementia and to increase the understanding of their needs and experiences of support. Methods: This thesis consists of four papers (I-IV): I, Analysis of data on informal carers of persons with dementia (n=330) from a cross-sectional survey of a stratified random probability sample of adults in Sweden (N=30 009); II and III, a cross-sectional survey of a convenience sample of people aged 65 years or older caring for a partner with dementia (N=175). Hierarchal regression models explored positive and negative aspects of caring (II), and principal component analysis examined carers’ perceptions of support (III); IV, a thematic analysis of semi-structured telephone interviews with 24 spouse carers, exploring their caring experiences. Results: Compared to other carers, spouses of persons with dementia received less support from family or local authorities, while experiencing more negative impact from caring (I). Negative impact from, and positive value of, caring among spouses, were associated with different aspects of their situation (II). Support was perceived as important, yet spouses may not perceive support to themselves as more important than support to their partner (III). Spouse carers experienced a loss of self and felt confined in their situation, finding it hard to distinguish between their needs and those of their partner (IV). Conclusion: Compared to other carers, spouses are more exposed to the negative aspects of caring, while being less supported. Support to spouse carers should focus on strengthening the positive aspects of caring to mitigate the negative aspects. As a spouse’s needs are conditioned by their partner’s, support should focus on spouses’ personal needs and their partners’ care needs.
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4. |
- Falk Johansson, Marcus, et al.
(author)
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Negative Impact and Positive Value of Caregiving in Spouse Carers of Persons With Dementia in Sweden
- 2021
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In: Family Caregiving and Persons with Dementia. - : Oxford University Press (OUP). ; , s. 154-
-
Conference paper (peer-reviewed)abstract
- As welfare providers struggle to meet the care needs of persons with dementia (PwDs), most of their needs are being met by a family carers, most often a spouse. The situation for spouse carers is unique, e.g., with grief, loneliness and loss of intimacy combining with stress and poor health. Research is needed to develop adequate support for spouse carers based on evidence of what influences negative and positive outcomes of care. The present study investigated psychosocial correlates of spouse carers’ (i) negative impact and (ii) positive value of caring. Data from a cross-sectional survey of 165 spouse carers community-resident in Sweden was analysed in two hierarchical regression models to predict negative impact and positive value of caring. Results found that negative impact and positive value were explained by different variables, significant predictors for negative impact included carer stress, health, and emotional loneliness, and change in intimacy with the care-recipient, while positive value was predicted by mutuality, change in closeness to the care-recipient and quality of support. Negative impact and positive value shared variance of only 17.2%. Thus, negative impact and positive value represent different aspects of the carer situation. Consequently, support needs to target several aspects in carers’ life, aiming to; facilitate for spouses to manage PwD’s impairment, increase emotional support while also strengthening the relationship between carer and PwD to reduce negative impact while increasing positive value.
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5. |
- Falk Johansson, Marcus, et al.
(author)
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Negative Impact and Positive Value of Caregiving in Spouse Carers of Persons with Dementia in Sweden
- 2022
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In: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 19:3
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Journal article (peer-reviewed)abstract
- (1) Background: Spouse carers of persons with dementia (PwD) are particularly vulnerable to negative outcomes of care, yet research rarely focuses on their caregiving situation. This study explores factors associated with the positive value and negative impact of caregiving in spouse car-ers of PwD in Sweden. (2) Methods: The study was a cross-sectional questionnaire-based survey, with a convenience sample of spouse carers of PwD (n = 163). The questionnaire addressed: care situation, carer stress, health and social well-being, relationship quality and quality of support, and contained measures of positive value and negative impact of caregiving. (3) Results: Hierarchical regression models explained 63.4% variance in positive value and 63.2% variance in negative impact of caregiving. Three variables were significant in the model of positive value: mutuality, change in emotional closeness following dementia and quality of support. Six variables were significant in the model of negative impact: years in relationship, years as carer, behavioural stress, self-rated health, emotional loneliness and change in physical intimacy following dementia. (4) Conclusions: Support to spouse carers of PwD should address the carerâcare-recipient relationship quality, although different aspects of the relationship should be addressed if both the positive value of caregiving is to be enhanced and the negative impact reduced.
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6. |
- Falk Johansson, Marcus, et al.
(author)
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Spouse’s supported and unsupported care of persons with dementia : Home care and the informal caregiver’s perspective
- 2021
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Conference paper (peer-reviewed)abstract
- Introduction. Caring for a person with dementia (PWD) can negatively affect the quality of life of informal carers, and research suggests spouse carers, often being older, are particularly vulnerable and requiring of support. Yet the formal support offered is rarely tailored to meet the needs of spouse carers of PWDs. The aim of the present study was to compare spouse carers to other carers of PWDs on a range of factors, as a foundation for a better understanding of their support needs. Material and methods. Cross-sectional survey. In late 2018 a random stratified sample was taken of the Swedish population aged 18 and older. Of 30,009 people contacted, 11,168 completed and returned a questionnaire or completed a web-based version, a response rate of 37.3%. The questionnaire contained questions on whether the respondent was an informal carer for another person, the extent of care provided, contact with and support received from formal services, and impacts of care.Results. Of the respondents, 378 (3.38%) were carers of PWDs, of whom 107 (28.3%) were spouse carers. Spouse carers compared to other carers of PWD provide care more intenselyand are more informed on their right to support from local authorities. While more often being offered formal support in their carer role, they are less supported in providing care and report a higher negative impact (for all p<.05). Conclusions. Formal support is offered to spouse carers in their carer role, but might not be tailored to their specific needs of support.
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7. |
- Marmstål Hammar, Lena, 1979-, et al.
(author)
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Exhausted and trapped in isolation. Caring for a spouse with dementia during the Covid-19 pandemic
- 2021
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In: Family Caregiving (HS Poster). - : Oxford University Press (OUP). ; , s. 800-801
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Conference paper (peer-reviewed)abstract
- Even before the Covid-19 pandemic, spouse carers of persons with dementia (PwDs) found their care responsibilities overwhelming and had little time to focus on their own lives. To minimize the risk of being infected with Covid-19, older persons are recommended to self-isolate in their homes, while formal support such as respite care and day care centers are withdrawn. This study involved semi-structured interviews with 24 spouse carers of community-living PwDs, with the aim of describing their situation during the pandemic. The interviews were analyzed with qualitative content analysis. Results revealed that they commonly declined help because of the perceived risk of their spouse being infected with Covid-19 and thus also possibly causing their death. They described feelings of being trapped in their situation, as they experienced having no choice than take all responsibility for the care of their partner themselves, with cost of being unable to take necessary breaks. This was described as making an already strained situation almost unbearable, which led to conflicts with their partner. However, the spouses also described positive aspects due to strategic changes in health and social care provision to prevent the spread of the virus, such as greater staff continuity in home care services, and patient transportation service. These made the PwD less stressed and influenced their everyday life positively. It could be concluded that the extent burden during the Covid-19 pandemic calls for extensive development of tailored support to better tackle the rapid changes that can occur in a society.
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8. |
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9. |
- Agahi, Neda, et al.
(author)
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Social integration and alcohol consumption among older people : A four-year follow-up of a Swedish national sample
- 2019
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In: Drug And Alcohol Dependence. - : Elsevier BV. - 0376-8716 .- 1879-0046. ; 196, s. 40-45
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Journal article (peer-reviewed)abstract
- Background: Today’s older people drink more alcohol than earlier cohorts of older people. Social integration has been identified as an important factor for older people’s drinking, but the association is complex. This study investigates both high and low levels of social integration and their associations with longitudinal patterns of alcohol consumption among older women and men.Methods: Longitudinal nationally representative data of older Swedish women and men aged over 65 – the Swedish Level of Living Survey (LNU) and Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) – from 2010/2011 and 2014 (n = 1048). Associations between social contacts and social activities at baseline and longitudinal patterns of drinking frequency were examined with multinomial logistic regression analyses. Results: Men reported drinking alcohol more often than women, but the most common drinking frequency among both women and men was to drink monthly or less. Drinking habits were generally stable over time. People with high levels of social activity at baseline were more likely to have a stable daily or weekly drinking frequency or increased drinking frequency over the four-year follow-up period, particularly women. People with low levels of social contacts and/or social activities were less likely to have a stable daily or weekly drinking frequency, compared to people in the low and stable drinking frequency group.Conclusions: Alcohol consumption is embedded in a social context, older people drink in social situations and social integration predicts continued drinking patterns.
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10. |
- Burholt, Vanessa, et al.
(author)
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A critical review and development of a conceptual model of exclusion from social relations for older people
- 2020
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In: European Journal of Ageing. - : Springer Science and Business Media LLC. - 1613-9372 .- 1613-9380. ; 17:1, s. 3-19
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Journal article (peer-reviewed)abstract
- Social exclusion is complex and dynamic, and it leads to the non-realization of social, economic, political or cultural rights or participation within a society. This critical review takes stock of the literature on exclusion of social relations. Social relations are defined as comprising social resources, social connections and social networks. An evidence review group undertook a critical review which integrates, interprets and synthesizes information across studies to develop a conceptual model of exclusion from social relations. The resulting model is a subjective interpretation of the literature and is intended to be the starting point for further evaluations. The conceptual model identifies individual risks for exclusion from social relations (personal attributes, biological and neurological risk, retirement, socio-economic status, exclusion from material resources and migration). It incorporates the evaluation of social relations, and the influence of psychosocial resources and socio-emotional processes, sociocultural, social-structural, environmental and policy contextual influences on exclusion from social relations. It includes distal outcomes of exclusion from social relations, that is, individual well-being, health and functioning, social opportunities and social cohesion. The dynamic relationships between elements of the model are also reported. We conclude that the model provides a subjective interpretation of the data and an excellent starting point for further phases of conceptual development and systematic evaluation(s). Future research needs to consider the use of sophisticated analytical tools and an interdisciplinary approach in order to understand the underlying biological and ecopsychosocial associations that contribute to individual and dynamic differences in the experience of exclusion from social relations.
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11. |
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12. |
- Calderón-Larrañaga, Amaia, et al.
(author)
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Effectiveness of interventions to address the negative health outcomes of informal caregiving to older adults : protocol for an umbrella review
- 2021
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In: BMJ Open. - : BMJ. - 2044-6055. ; 11:11
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Research review (peer-reviewed)abstract
- Introduction Informal (unpaid) caregivers play an essential role in caring for older people, whose care needs are often not fully met by formal services. While providing informal care may be a positive experience, it can also exert a considerable strain on caregivers’ physical and mental health. How to best support the needs of informal caregivers remains largely debated. This umbrella review (review of systematic reviews) aims to evaluate (1) whether effective interventions can mitigate the negative health outcomes of informal caregiving, (2) whether certain types of interventions are more effective than others, (3) whether effectiveness of interventions depends on caregiver/receiver, context or implementation characteristics and (4) how these interventions are perceived in terms of acceptability, feasibility and added value.Methods and analysis We will include systematic reviews of primary studies focusing on the effectiveness of interventions (public or private, unifaceted or multifaceted, delivered by health or social care professionals or volunteers) aimed at reducing the impact of caregiving on caregivers’ physical or mental health. This will also include quantitative and qualitative syntheses of implementation studies. The literature search will include the following databases: Medline, CINAHL, PsycINFO and Web of Science. A key informant-guided search of grey literature will be performed. Quality appraisal will be conducted with the AMSTAR-2 checklist for quantitative reviews and with an ad hoc checklist for qualitative syntheses. Narrative and tabular summaries of extracted data will be produced, and framework synthesis will be employed for weaving together evidence from quantitative studies in effectiveness reviews with findings on implementation from qualitative studies.Ethics and dissemination This umbrella review will use data from secondary sources and will not involve interactions with study participants; it is thus exempt from ethical approval. Results will be presented at international conferences and will be published in a peer-reviewed journal.
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13. |
- Dahlberg, Lena, 1970-, et al.
(author)
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A social exclusion perspective on loneliness in older adults in the Nordic countries
- 2022
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In: European Journal of Ageing. - : Springer Science and Business Media LLC. - 1613-9372 .- 1613-9380. ; 19:2, s. 175-188
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Journal article (peer-reviewed)abstract
- Several factors associated with loneliness are also considered indicators of social exclusion. While loneliness has been proposed as an outcome of social exclusion, there is limited empirical evidence of a link. This study examines the associations between social exclusion indicators and loneliness in older adults (60+ years) in four Nordic countries. Data from four waves of the European Social Survey were pooled, providing a total of 7755 respondents (Denmark n = 1647; Finland n = 2501, Norway n = 1540; Sweden n = 2067). Measures of loneliness, demographic characteristics, health, and eight indicators of social exclusion were selected from the survey for analysis. Country-specific and total sample hierarchical logistic regression models of loneliness were developed. Significant model improvement occurred for all models after social exclusion indicators were added to models containing only demographic and health variables. Country models explained between 15.1 (Finland) and 21.5% (Sweden) of the variance in loneliness. Lower frequency of social contacts and living alone compared to in a two-person household was associated with a higher probability of loneliness in all countries, while other indicators were associated with loneliness in specific countries: lower neighbourhood safety (Sweden and Denmark); income concern (Sweden and Finland); and no emotional support (Denmark, Finland, and Sweden). A robust relationship was apparent between indicators of social exclusion and loneliness with the direction of associations being highly consistent across countries, even if their strength and statistical significance varied. Social exclusion has considerable potential for understanding and addressing risk factors for loneliness.
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14. |
- Dahlberg, Lena, 1970-, et al.
(author)
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A systematic review of longitudinal risk factors for loneliness in older adults
- 2021
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In: Aging & Mental Health. - : Informa UK Limited. - 1360-7863 .- 1364-6915. ; 26:2, s. 225-249
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Journal article (peer-reviewed)abstract
- OBJECTIVES: To effectively reduce loneliness in older adults, interventions should be based on firm evidence regarding risk factors for loneliness in that population. This systematic review aimed to identify, appraise and synthesise longitudinal studies of risk factors for loneliness in older adults.METHODS: Searches were performed in June 2018 in PsycINFO, Scopus, Sociology Collection and Web of Science. Inclusion criteria were: population of older adults (M = 60+ years at outcome); longitudinal design; study conducted in an OECD country; article published in English in a peer-review journal. Article relevance and quality assessments were made by at least two independent reviewers.RESULTS: The search found 967 unique articles, of which 34 met relevance and quality criteria. The Netherlands and the United States together contributed 19 articles; 17 analysed national samples while 7 studies provided the data for 19 articles. One of two validated scales was used to measure loneliness in 24 articles, although 10 used a single item. A total of 120 unique risk factors for loneliness were examined. Risk factors with relatively consistent associations with loneliness were: not being married/partnered and partner loss; a limited social network; a low level of social activity; poor self-perceived health; and depression/depressed mood and an increase in depression.CONCLUSION: Despite the range of factors examined in the reviewed articles, strong evidence for a longitudinal association with loneliness was found for relatively few, while there were surprising omissions from the factors investigated. Future research should explore longitudinal risk factors for emotional and social loneliness.
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15. |
- Dahlberg, Lena, 1970-, et al.
(author)
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Age and gender of informal carers : a population-based study in the UK
- 2007
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In: Health & Social Care in the Community. - : Hindawi Limited. - 0966-0410 .- 1365-2524. ; 15:5, s. 439-45
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Journal article (peer-reviewed)abstract
- This paper identifies variations in the age and gender characteristics of informal carers in the UK. The paper is based on the Individual Sample of Anonymous Records, a 3% random sample of the 2001 UK Census. The sample size was 1 825 595. Of this sample, 10% were reported to be carers. The analysis shows that informal caregiving is systematically linked with both age and gender. Caregiving increased with age until reaching a peak in the 45-59 age group, in which almost 20% were carers. Similarly, the amount of time spent caregiving increased with age, with the highest levels of caregiving commitment in people aged 80-89 years. Regarding gender, 11.3% of women were carers compared to 8.6% of men and overall women committed more time to caregiving than men. However, this pattern was reversed in later life (70+), where there was a higher proportion of carers and greater time commitment to caregiving amongst men. While the predominance of women as informal carers has been well reported, the importance of men as informal carers in old age is much less commented upon. This study thus suggests that informal caregiving is most prevalent in groups of the population that, according to previous research, may experience most strain from doing so: elderly people who may be frail and often are in a spousal relationship with the care-recipient, and middle-aged women with multiple roles. Therefore, it is of great importance that their particular needs and circumstances are fully taken into account both in the development of formal support and when information about available support is targeted.
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16. |
- Dahlberg, Lena, 1970-
(author)
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Ageing in a changing place : a qualitative study of neighbourhood exclusion
- 2019
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In: Ageing & Society. - 0144-686X .- 1469-1779. ; 40:10, s. 2238-2256
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Journal article (peer-reviewed)abstract
- An inclusive neighbourhood is a key facilitator enabling older adults to age in place. Neighbourhoods have been identified as a dimension of social exclusion important to older adults, and it has been argued that older adults are particularly vulnerable to neighbourhood change. The aim of this study was to explore older adults’ experiences of neighbourhood exclusion within the context of neighbourhood change. Focus groups were undertaken in the urban and rural areas of a metropolitan borough in England involving a total of 41 older adults, with data analysed via thematic analysis. Urban areas in the borough studied have transformed following the closure of the mining industry, with a high level of deprivation in many areas, while some rural areas have undergone gentrification. Within the context of structural neighbourhood change, four themes were identified: community cohesion, political agency, feelings of safety and the physical environment. The themes were interlinked, which calls for collaboration across traditional lines of professional responsibility, and for research that encompasses different aspects of neighbourhood exclusion. This study contributes with knowledge on older adults’ experiences of exclusion, including novel findings on the importance of political agency and collective memory, and identifies actions to combat exclusion. An active involvement of older adults in the development of initiatives to tackle social exclusion is recommended.
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17. |
- Dahlberg, Lena, 1970-
(author)
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Correlates and predictors of loneliness in old age : Evidence from Sweden and England
- 2013
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Conference paper (other academic/artistic)abstract
- It is important to identify factors associated with loneliness in older people if effective policies and strategies to prevent and reduce loneliness are to be developed. In this presentation two studies that identify factors associated with loneliness in old age are reported. Strengths and weaknesses of the studies, which differ in design and focus, shed light on issues of importance for future studies on loneliness.The first study was based on data from two waves of SWEOLD, a Swedish longitudinal national survey study (N=613). It aimed to examine the extent to which older people (70+) report feelings of loneliness with a focus on changes in loneliness over time, and on factors predicting loneliness in women and men, respectively. This study showed that older people moved in and out of loneliness over time, but there was a general increase in loneliness as they aged. It also identified gender differences in both incidence and risk factors.The second study was based on data from the Barnsley Social Exclusion in Old Age Study, an English cross-sectional community survey (N=1255), and aimed to identify risk factors for social and emotional loneliness in older people (65+). This study identified different, as well as shared, risk factors for social and emotional loneliness, thereby providing further empirical support for the conceptual separation of emotional and social loneliness.Taken together, these studies demonstrate the importance of: 1) longitudinal research in order to determine risk factors for loneliness; 2) considering women and men separately; and 3) looking at social and emotional loneliness separately. These approaches in combination will aid the development of effective interventions to reduce loneliness in the older population and to ensure those interventions are targeted at the appropriate groups.
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18. |
- Dahlberg, Lena, 1970-, et al.
(author)
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Correlates of social and emotional loneliness in older people : evidence from an English community study
- 2014
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In: Aging & Mental Health. - : Taylor & Francis. - 1360-7863 .- 1364-6915. ; 18:4, s. 504-514
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Journal article (peer-reviewed)abstract
- Objectives: Loneliness is an important influence on quality of life in old age, and has been conceptualised as consisting of two dimensions, social and emotional. This paper describes analyses that sought to produce models of social and emotional loneliness in older people, using demographic, psychological and health, and social variables.Method: Older people (aged 65+, N=1255) from the Barnsley metropolitan area of the United Kingdom were recruited randomly from within a stratified sampling frame, and received a questionnaire-based interview (response rate: 68.1%). The questionnaire contained items and scales on demographic, psychological and health and social characteristics, and a validated measure of loneliness that assesses both social and emotional loneliness.Results: Of the respondents, 7.7% were found to be severely or very severely lonely, while another 38.3% were moderately lonely. Social and Emotional Loneliness shared 19.36% variance. Being male, being widowed, low well-being, low self-esteem, low income comfort, low contact with family, low contact with friends, low Activity, low Perceived Community Integration, and receipt of community care were significant predictors of Social Loneliness (R=.50, R2=.25, F(18, 979)=18.17, p<.001). Being widowed, low well-being, low self-esteem, high activity restriction, low income comfort, and non-receipt of informal care were significant predictors of Emotional Loneliness (R=.55, R2=.30, F(18, 973)=23.00, p<.001).Conclusion: This study provides further empirical support for the conceptual separation of emotional and social loneliness. Consequently, policy on loneliness in older people should be directed to developing a range of divergent intervention strategies if both emotional and social loneliness are to be reduced.
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19. |
- Dahlberg, Lena, 1970-
(author)
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De äldre och ensamheten
- 2013
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In: Äldre i Centrum. - 1653-3585. ; :1, s. 46-46
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Journal article (pop. science, debate, etc.)
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20. |
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21. |
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22. |
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23. |
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24. |
- Dahlberg, Lena, 1970-, et al.
(author)
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Living on the edge : Social exclusion and the receipt of informal care in older people
- 2016
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In: Journal of Aging Research. - : Hindawi Limited. - 2090-2204 .- 2090-2212. ; , s. 1-10
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Journal article (peer-reviewed)abstract
- Older people have been identified as being at risk of social exclusion. However, despite the fact that care is commonly required in later life and the majority of that care provided by informal carers, a connection between social exclusion and informal care-receipt has rarely been considered. The aim of this study was to examine how informal care-receipt is related to social exclusion.A face-to-face questionnaire survey on social exclusion and informal care-receipt was carried out among older people (n=1255) living in Barnsley, United Kingdom. Multivariable analyses examined the association between social exclusion and categories of informal care-receipt: care receiver; assurance receiver; non-receiver with no need; non-receiver with need.Compared to being a non-receiver with no need participants were more likely to be a care receiver or assurance receiver if they had higher levels of social exclusion. The highest level of social exclusion, however, was found in non-receivers with need. Despite a lack of informal care and support, formal practical support and personal care was also low in this latter group. Findings are discussed in relation to the conceptualisation of care-receipt and how contact with medical services could be an opportunity for identification and appropriate referral of non-receivers with need.
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25. |
- Dahlberg, Lena, 1970-, et al.
(author)
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Lonelier than ever? Loneliness of older people over two decades
- 2018
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In: Archives of gerontology and geriatrics (Print). - : Elsevier BV. - 0167-4943 .- 1872-6976. ; 75, s. 96-103
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Journal article (peer-reviewed)abstract
- To live with feelings of loneliness has negative implications for quality of life, health and survival. This study aimed to examine changes in loneliness among older people, both with regard to prevalence rates, and socio-demographic, social and health-related correlates of loneliness. This study had a repeated cross-sectional design and was based on the nationally representative Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD). Analyses of trends in loneliness covered the years 1992, 2002, 2004, 2011 and 2014, and included people aged 77 years or older (n = 2 572). Analyses of correlates of loneliness covered 2004 and 2014, and included people aged 70 years or older (n = 1 962). Logistic regression analyses were conducted with findings presented as average marginal effects. Contrary to what is often assumed, there has been no increase in loneliness among older people over time (1992-2014). Regression analyses for 2004 and 2014 showed that social and health-related correlates were more strongly associated with loneliness than socio-demographic correlates. Psychological distress was most strongly associated with loneliness, followed by widowhood. Most associations between the correlates and loneliness were stable over time.
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26. |
- Dahlberg, Lena, 1970-
(author)
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Loneliness during the COVID-19 pandemic.
- 2021
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In: Aging & Mental Health. - : Informa UK Limited. - 1360-7863 .- 1364-6915. ; 25:7, s. 1161-1164
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Journal article (peer-reviewed)abstract
- Responses to the COVID-19 pandemic in terms of physical distancing risk collateral damage such as increased loneliness. Older adults have been identified as being at higher risk of poor outcomes if infected and in many countries have been subjected to greater restrictions on physical contacts with others. Most research so far points towards an increase in loneliness during the pandemic. However, there has been a lack of prospective studies based on representative samples of older adults, with the oldest old, older adults with low or no Internet usage, and those in poor health currently underrepresented. Despite the significance of cultural norms for individuals' standards for social relations and, thus, the experience of loneliness, there has been a lack of comparative research on loneliness in older adults during the pandemic. Reviews have found little evidence for what interventions and what elements of interventions are effective in reducing loneliness. There is potential for social relations to be maintained via technology-based solutions, although there is a risk of excluding older adults with limited resources who are both least likely to use technology and most vulnerable to loneliness. Furthermore, remote social contacts cannot fully compensate for the loss of physical contacts. Where stay-at-home orders are not imposed, supporting neighbourliness and the community use of accessible open spaces are other options. Finally, policy responses to the pandemic need to be more nuanced and non-ageist in order to avoid unnecessary increases in loneliness in older adults.
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27. |
- Dahlberg, Lena, 1970-
(author)
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Loneliness during the COVID-19 pandemic
- 2023
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In: Loneliness and Social Isolation in Old Age. - : Taylor and Francis. - 9781003289012 ; , s. 191-200
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Book chapter (peer-reviewed)abstract
- Responses to the COVID-19 pandemic in terms of physical distancing risk collateral damage such as increased loneliness. Older adults have been identified as being at higher risk of poor outcomes if infected and in many countries have been subjected to greater restrictions on physical contacts with others. Most research so far points towards an increase in loneliness during the pandemic. However, there has been a lack of prospective studies based on representative samples of older adults, with the oldest old, older adults with low or no Internet usage, and those in poor health currently underrepresented. Despite the significance of cultural norms for individuals’ standards for social relations and, thus, the experience of loneliness, there has been a lack of comparative research on loneliness in older adults during the pandemic. Reviews have found little evidence for what interventions and what elements of interventions are effective in reducing loneliness. There is potential for social relations to be maintained via technology-based solutions, although there is a risk of excluding older adults with limited resources who are both least likely to use technology and most vulnerable to loneliness. Furthermore, remote social contacts cannot fully compensate for the loss of physical contacts. Where stay-at-home orders are not imposed, supporting neighbourliness and the community use of accessible open spaces are other options. Finally, policy responses to the pandemic need to be more nuanced and non-ageist in order to avoid unnecessary increases in loneliness in older adults. © 2024 selection and editorial matter, André Hajek, Steffi G. Riedel-Heller and Hans-Helmut König; individual chapters, the contributors.
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28. |
- Dahlberg, Lena, 1970-
(author)
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Lonely and sad and/or sad and lonely?
- 2022
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In: International psychogeriatrics. - 1041-6102 .- 1741-203X. ; 34:7, s. 613-616
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Journal article (other academic/artistic)
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29. |
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30. |
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31. |
- Dahlberg, Lena, 1970-, et al.
(author)
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Long-term predictors of loneliness in old age : results of a 20-year national study
- 2018
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In: Aging & Mental Health. - : Taylor & Francis. - 1360-7863 .- 1364-6915. ; 22:2, s. 190-196
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Journal article (peer-reviewed)abstract
- OBJECTIVES: The understanding of social phenomena is enhanced if individuals can be studied over longer periods. Regarding loneliness in old age, there is a general lack of longitudinal research. The aim of this study was to examine whether there is an association between loneliness in old age and social engagement 20 years earlier, as stated by life course theory and the convoy model.METHOD: Data from the nationally representative Swedish Panel Study of Living Conditions of the Oldest Old (2002 and 2011 data collection waves) and the Swedish Level of Living Survey (1981 and 1991 data collection waves) were used. The sample included 823 individuals with an average age of 62.2 years at baseline and 82.4 years at follow-up.RESULTS: Each form of social engagement in old age was significantly associated with the same form of social engagement 20 years earlier. Close forms of social engagement were associated with loneliness in old age; as were more distant forms of social engagement, but only when they were considered solely in old age.CONCLUSION: Patterns of social engagement in old age were established at least 20 years earlier and close forms of social engagement are long-term predictors of loneliness, although current social engagement tended to be more influential on loneliness. The study underlines the importance of interventions targeted at close relationships that can provide social support in old age.
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32. |
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33. |
- Dahlberg, Lena, 1970-, et al.
(author)
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Planned and Unplanned Hospital Admissions and Their Relationship with Social Factors : Findings from a National, Prospective Study of People Aged 76 Years or Older
- 2018
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In: Health Services Research. - : Wiley. - 0017-9124 .- 1475-6773. ; 53:6, s. 4248-4267
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Journal article (peer-reviewed)abstract
- Objective Data Sources/Study Setting To examine the relationship between social factors and planned and unplanned hospital admissions among older people. 2011 data from the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) and data from the Swedish National Patient Register until December 31, 2012. Study Design Data Collection The study had a prospective design. Data were analyzed via Cox proportional hazard regressions with variables entered as blocks (social factors, sociodemographic and ability factors, health factors). Data were collected via interviews with people aged 76+ (n = 931). Principal Findings Conclusions Living in institutions was negatively associated with planned admissions (hazard ratio (HR): 0.29; confidence interval (CI): 0.09-0.88), while being in receipt of home help was positively associated with unplanned admissions (HR: 1.57; CI: 1.15-2.14). Low levels of social contacts and social activity predicted unplanned admissions in bivariate analyses only. Higher ability to deal with public authorities was positively associated with planned admissions (HR: 1.77; CI: 1.13-2.78) and negatively associated with unplanned admissions, although the latter association was only significant in the bivariate analysis. Hospital admissions are not only due to health problems but are also influenced by the social care situation and by the ability to deal with public authorities.
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34. |
- Dahlberg, Lena, 1970-, et al.
(author)
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Predictors of loneliness among older women and men in Sweden : A national longitudinal study
- 2014
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Conference paper (other academic/artistic)abstract
- Objectives: To examine the extent to which older women and men (70+) report feelings of loneliness with a focus on: a) changes in reported loneliness as people age, and b) which factors predict loneliness.Methods: Data from the 2004 and 2011 waves of SWEOLD, a longitudinal national survey study, was used. The prediction of loneliness in 2011 by data collected in 2004 was examined in three logistic regression models for the total sample (n=587), for women and for men.Results: Older people moved in and out of frequent loneliness over time, but there was a general increase in loneliness as they aged. Recent widowhood and depression increment were associated with loneliness in both women and men. Loneliness, widowhood, depression and mobility problems measured in 2004 predicted loneliness uniquely in women in 2011; whereas low level of education and social contact reduction predicted loneliness uniquely in men.Discussion: Loneliness is not always a stable condition, demonstrating the importance of longitudinal research. Gender differences in incidence and predictors make it important to look at women and men separately both when researching loneliness and when targeting interventions to prevent or reduce loneliness in older people.
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35. |
- Dahlberg, Lena, 1970-, et al.
(author)
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Predictors of loneliness among older women and men in Sweden : A national longitudinal study
- 2015
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In: Aging & Mental Health. - : Routledge. - 1360-7863 .- 1364-6915. ; 19:5, s. 409-417
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Journal article (peer-reviewed)abstract
- Objectives: Longitudinal research on loneliness in old age has rarely considered loneliness separately for men and women, despite gender differences in life experiences. The objective of this study was to examine the extent to which older women and men (70+) report feelings of loneliness with a focus on: (a) changes in reported loneliness as people age, and (b) which factors predict loneliness.Method: Data from the 2004 and 2011 waves of SWEOLD, a longitudinal national survey, was used (n = 587). The prediction of loneliness in 2011 by variables measured in 2004 and 2004–2011 variable change scores was examined in three logistic regression models: total sample, women and men. Variables in the models included: gender, age, education, mobility problems, depression, widowhood and social contacts.Results: Older people moved into and out of frequent loneliness over time, although there was a general increase in loneliness with age. Loneliness at baseline, depression increment and recent widowhood were significant predictors of loneliness in all three multivariable models. Widowhood, depression, mobility problems and mobility reduction predicted loneliness uniquely in the model for women; while low level of social contacts and social contact reduction predicted loneliness uniquely in the model for men.Conclusion: This study challenges the notion that feelings of loneliness in old age are stable. It also identifies important gender differences in prevalence and predictors of loneliness. Knowledge about such differences is crucial for the development of effective policy and interventions to combat loneliness in later life.
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36. |
- Dahlberg, Lena, 1970-, et al.
(author)
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Psychological, health and social predictors of emotional and social loneliness in older people
- 2013
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In: Proceedings of the 20th IAGG World Congress of Gerontology and Geriatrics, Seoul, Korea.
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Conference paper (peer-reviewed)abstract
- Background: Loneliness in old age has been shown to have negative outcomes such as mortality, physical and mental health problems, and reduced activity levels. To reduce loneliness in older people, factors associated with loneliness and open to intervention must be identified.Methods: Older people (aged 65+, N=1255) from the United Kingdom received a questionnaire-based interview (response rate: 66.0%). The questionnaire covered items on demographic, psychological, health and social characteristics. It also contained the de Jong-Gierveld Loneliness Scale (de Jong-Gierveld & Kamphuis, 1985), measuring Emotional and Social Loneliness.Findings: Eight percent of the respondents were found to be severely or very severely lonely, while another 38% were moderately lonely. Being female, widowed, low well-being, low self-esteem, high activity restriction, and high concern about personal finances were significant predictors of Emotional Loneliness (F(17, 976)=25.59, R2=.31, p<.001). Being female, widowed, low well-being, low self-esteem, high concern about personal finances, low contact with family, low contact with friends, low engagement, and low perceived community integration were significant predictors of Social Loneliness (F(17, 982)=19.63, R2=.25, p<.001).Discussion: This study provides empirical evidence for conceptual separation of emotional and social loneliness. Consequently, different targets for intervention are required in order to reduce emotional and social loneliness respectively, although psychological intervention has the potential to reduce both. Background: Loneliness in old age has been shown to have negative outcomes such as mortality, physical and mental health problems, and reduced activity levels. To reduce loneliness in older people, factors associated with loneliness and open to intervention must be identified.Methods: Older people (aged 65+, N=1255) from the United Kingdom received a questionnaire-based interview (response rate: 66.0%). The questionnaire covered items on demographic, psychological, health and social characteristics. It also contained the de Jong-Gierveld Loneliness Scale (de Jong-Gierveld & Kamphuis, 1985), measuring Emotional and Social Loneliness.Findings: Eight percent of the respondents were found to be severely or very severely lonely, while another 38% were moderately lonely. Being female, widowed, low well-being, low self-esteem, high activity restriction, and high concern about personal finances were significant predictors of Emotional Loneliness (F(17, 976)=25.59, R2=.31, p<.001). Being female, widowed, low well-being, low self-esteem, high concern about personal finances, low contact with family, low contact with friends, low engagement, and low perceived community integration were significant predictors of Social Loneliness (F(17, 982)=19.63, R2=.25, p<.001).Discussion: This study provides empirical evidence for conceptual separation of emotional and social loneliness. Consequently, different targets for intervention are required in order to reduce emotional and social loneliness respectively, although psychological intervention has the potential to reduce both.
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37. |
- Dahlberg, Lena, 1970-, et al.
(author)
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Receipt of Formal and Informal Help with Specific Care Tasks among Older People Living in their Own Home. National Trends over Two Decades
- 2018
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In: Social Policy & Administration. - : Wiley. - 0144-5596 .- 1467-9515. ; 52:1, s. 91-110
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Journal article (peer-reviewed)abstract
- Sweden is seen as a typical example of a social democratic welfare regime, with universal and generous welfare policies. However, in the last decades, there have been substantial reductions in the Swedish provision of care for older people. This study aimed to examine trends in sources of care-receipt in older people (77+) living in their own home and with a perceived need for help with two specific tasks: house cleaning and/or food shopping. Trends in care-receipt were examined in relation to gender, living alone, having children and socio-economic position. Data from the 1992, 2002 and 2011 data collection waves of the national study, Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD), were used. Response rates varied between 86 and 95 per cent, and the sample represents the population well. Trends and differences between groups were explored in bivariate and logistic regression analyses. There was a reduction in formal care-receipt regarding house cleaning and food shopping over the study period. It was more common for women than men to receive formal care, and more common for men than women to receive informal care. Reductions in formal care have affected older women more than older men. Still, living alone was the most influential factor in care-receipt, associated with a greater likelihood of formal care-receipt and a lower likelihood of informal care-receipt. It can be concluded that public responsibility for care is becoming more narrowly defined in Sweden, and that more responsibility for care is placed on persons in need of care and their families.
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38. |
- Dahlberg, Lena, 1970-
(author)
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Risk för ensamhet
- 2013
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In: Äldre i Centrum. - 1653-3585. ; :3, s. 20-21
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Journal article (pop. science, debate, etc.)
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39. |
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40. |
- Dahlberg, Lena, 1970-, et al.
(author)
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Social exclusion and well-being among older adults in rural and urban areas
- 2018
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In: Archives of gerontology and geriatrics (Print). - : Elsevier BV. - 0167-4943 .- 1872-6976. ; 79, s. 176-184
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Journal article (peer-reviewed)abstract
- Background: Social exclusion (SE) is a process that limits participation in society across life domains, and is associated with poor quality of life. Neighbourhood exclusion has been identified as particularly important for older adults. This paper examines the association between SE and well-being in older adults from urban and rural areas, focusing on neighbourhood exclusion. Methods: Using a cross-sectional survey design with a stratified sampling frame, participants (aged 65+) from rural (n = 628) and urban (n = 627) areas of Barnsley, United Kingdom, completed a questionnaire containing indicators of five SE domains: civic activity, material resources, social relationships, services and neighbourhood. Sequential multiple regression models were developed for 1) total sample; 2) rural areas; and 3) urban areas, with well-being regressed on SE indicators after controlling for self-reported health. Results: SE indicators explained 13.4% of the variance in well-being in the total sample (of which neighbourhood exclusion explained 1.2%); corresponding figures for the rural model were 13.8% (3.8%) and for the urban model 18.0% (1.7%); the addition of neighbourhood exclusion significantly improved all three models. Five SE indicators were significant in the rural model, compared with seven in the urban model, with four common to both. Discussion: Neighbourhood exclusion explained more variance in well-being in rural than urban areas, whereas exclusion from services explained more variance in urban than rural areas. Area characteristics and the role of neighbourhood should be considered in policy initiatives to reduce SE and promote well-being.
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41. |
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42. |
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43. |
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44. |
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45. |
- Dahlberg, Lena, 1970-
(author)
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The complementarity norm : service provision by the welfare state and voluntary organisations in Sweden.
- 2006
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In: Health & Social Care in the Community. - : Hindawi Limited. - 0966-0410 .- 1365-2524. ; 14:4, s. 302-10
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Journal article (peer-reviewed)abstract
- Previous research has shown that different providers of social welfare tend to provide complementary services at a local level, but that there is no complete task specialisation. This means that elements of complementarity theory are challenged, especially the so-called 'principle of matching', i.e. that actors only undertake tasks which match their characteristics. The aim of the present study was to explore complementarity between Swedish local authorities and voluntary organisations in their support for relatives of older people. Interviews were carried out with 55 politicians, civil servants and representatives of voluntary organisations drawn from four municipalities. These municipalities were selected from a sampling frame that ensured representation of different combinations of high and low levels of voluntary and statutory services. Qualitative analysis of interview transcripts showed that, while local authorities are seen as responsible for the support for relatives, voluntary organisations are expected to be complementary, offering 'the icing on the cake', i.e. social support and activities which are regarded as less demanding. Overall, substantial support for a norm of complementarity was found. It is argued that, if those who are active in social policy and voluntary work at a local level agree with the ideal of complementarity, this will influence their wish to arrange activities and services. Therefore, the complementarity norm - rather than the principle of matching - influences the outcome in terms of service provision.
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46. |
- Dahlberg, Lena, 1970-, et al.
(author)
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Trends and gender associations in social exclusion in older adults in Sweden over two decades
- 2020
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In: Archives of gerontology and geriatrics (Print). - : Elsevier BV. - 0167-4943 .- 1872-6976. ; 89
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Journal article (peer-reviewed)abstract
- Background: Social exclusion in older adults is associated with lower well-being and poorer health. To date there has been little research on whether the level of social exclusion in older adults changes over time, and its association with gender.Aim: To examine trends and gender associations in social exclusion indicators in older adults for the years 1992, 2002 and 2011.Methods: Three waves of data from the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD), a national survey of adults aged 77 years or older, were analysed: 1992 (n = 537), 2002 (n = 621), and 2011 (n = 904). Summative scales were created for four domains of social exclusion: material resources, social relations and leisure activities, civic participation, and services. Associations between gender and social exclusion within waves were examined as were trends in social exclusion across years.Results: The analyses of trends found significant reductions in exclusion in the domains of material resources and services. Higher levels of exclusion from material resources and civic participation were found in women than men. Within domains, significant trends and gender associations in exclusion were found on several indicators, with indicators showing opposing trends.Conclusion: Although levels of social exclusion have reduced in certain domains during the years examined, our results reflect the persistence of social exclusion in the population of older adults. This underlines the continuing importance of a well-developed welfare and social security system to ensure the social inclusion of vulnerable groups such as older adults.
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47. |
- Dahlberg, Lena, 1970-, et al.
(author)
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Trends in social exclusion among older women and men in Sweden
- 2018
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Conference paper (peer-reviewed)abstract
- Background: Social exclusion is a framework for understanding the complexity of disadvantage across various domains of life such as material resources, social relations, civic activities and services. Reviews have identified a lack of gender perspective in social exclusion research. This paper will introduce the framework of social exclusion, and examine trends over time in the levels of social exclusion across different life domains for older women and men in Sweden.Methods: Data on indicators of social exclusion were analysed from respondents aged 76+ years who participated in the 1992, 2002 and 2011 waves of the nationally representative Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD).Results: There was evidence of a gender different in exclusion from material resources and civic activities, from which women were more often excluded than men. Regardless of gender there were improvements in access to material resources, such as owning a house/apartment. Social contacts (visiting or being visited by friends) decreased over time, while engagement in cultural activities and going to restaurants increased.Conclusions: Trends in social exclusion in older adults over the last 20 years are dependent on the domain considered. Over a range of indicators, older women were more vulnerable to exclusion than men, which needs to be taken into account in policy to combat exclusion.
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48. |
- Dahlberg, Lena, 1970-
(author)
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Welfare Relationships : Voluntary organisations and local authorities supporting relatives of older people in Sweden
- 2004
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Doctoral thesis (other academic/artistic)abstract
- Sweden is often described as a country with a strong welfare state and little voluntary work. This is as would be expected according to substitution theory, in which extensive welfare systems are assumed to crowd out voluntary activity and thereby limit the potential for voluntary work – there is an inverse relationship between voluntary and statutory activity. A second perspective is welfare pluralism, which is siginified by a purposive duplication of activity by different actors resulting in increased choice for service users. A third perspective is offered by complementarity theory. In this theory, different actors are assumed to have different characteristics, strengths, and weaknesses, which make them suitable for performing different tasks.The purpose of the thesis is to examine the variation in welfare service provision by voluntary organisations and local authorities in Sweden. This includes determining whether there is a statistical association between voluntary and statutory service provision. The thesis also explores the interaction between voluntary organisations and local authorities, that is how they are related in terms of collaboration, competition, support, and influence, and the actors’ own views on roles, responsibilities, motives etc. The thesis is based on two national surveys and on in-depth interviews. Questionnaires were sent to 358 Swedish voluntary organisations in 1999, and 365 organisations in 2002. At the same time points, 80 local authorities were also surveyed. In 2001, 55 representatives of voluntary organisations and local authorities were interviewed.Analysis of the surveys showed no negative relationship between voluntary and statutory service provision cross-sectionally or over time. This was true for both the total amount of activity and when considering individual services. In other words, no evidence for substitution processes was found. Although there was an increase in support for relatives in the period studied and a positive relationship between voluntary and statutory activity in 2002, no positive correlation was found within individual support activities. This means that voluntary and statutory activities tended to be of different kinds at a local level. Only rarely could users choose between different service providers, and the situation could not be characterised as indicative of welfare pluralism. Voluntary organisations and local authorities were described in terms of different characteristics by interviewees, as would be expected by complementarity theory. Nevertheless, there were overlaps in service provision, questioning the validity of complementarity theory with its emphasis on matching of characteristics and tasks. However, at a local level voluntary organisations and local authorities rarely carried out similar tasks. There is thus extensive complementarity at a local level. It is argued that this complementarity is due to the strong ideology that voluntary organisations should complement local authorities, rather than due to the different characteristics of the actors.
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49. |
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50. |
- Dsouza, Sebestina Anita, et al.
(author)
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Assessment of time-related deficits in older adults : a scoping review protocol.
- 2021
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In: BMJ Open. - : BMJ. - 2044-6055. ; 11:9
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Journal article (peer-reviewed)abstract
- INTRODUCTION: People with cognitive impairments often have difficulties in managing their time for daily activities. In older adults with cognitive impairments such as dementia and stroke, these may present as disorientation, poor time awareness, time perception, daily time management and so on. Time-related deficits and associated behaviours impede independent living and add considerably to caregiver strain. Several interventions are being investigated to help people with cognitive impairments orient and navigate time and do their daily activities. The provision of interventions requires the use of sound assessment tools. However, it is not clear how time-related concepts are specifically evaluated in practice, what are the available assessments and how these assessments should be selected.METHOD AND ANALYSIS: This protocol follows the Joanna Briggs Institute Reviewer's Manual (2020) for scoping reviews and is registered with the Open Science Framework (https://osf.io/4ptgy/). We will include the following databases: PubMed, CINAHL, Scopus, Web of Science and PsycINFO. Two reviewers will independently screen eligible studies for inclusion against the selection criteria and then review the full-text of the selected studies. We will extract the bibliographic data, study design and setting, and details of assessments used in the studies to evaluate time-related concepts including format, mode and duration of administration, psychometric properties and so on. The identified assessments will be mapped with regard to time-related concepts being evaluated and described using narrative synthesis.ETHICS AND DISSEMINATION: As secondary data analysis, ethics approval is not required for this scoping review. We plan to disseminate the results through peer-reviewed journals and conferences targeting health professionals working with older adults.
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