Violence towards staff has become an important issue, since it has been reported to be common in various health care settings. This study aimed to describe emotional reactions among staff being exposed to violence in residential community care for the elderly: to investigate consequences from violent incidents and to describe the management of violent incidents. Data were collected by telephone interviews with nursing staff reporting incidents of violence. During the period of investigation, 97 of 848 staff (11.4%) reported that they had been exposed to violence. More than one-third of them reported subsequent wound and bruises from the incident and two of the exposed staff consulted a doctor because of the violent incident. The most frequently reported reactions among the staff were aggression, astonishment, and antipathy against the perpetrating care recipient, as well as insufficiency, powerlessness, insult and fear. A majority of the incidents were judged as intentionally perpetuating from the care recipient. Most of the violent incidents were managed by informal discussions in the working team. A low number of the reported incidents of violence involved formal discussions with nurse managers.

The aim of the present study was to describe violent events as narrated by care providers involving themselves. During a 12-month period, care providers reported 149 violent events. Using consecutive purposive sampling with maximum variation, 61 events were further investigated using narrative interviews with involved care providers. They were involved either as victims, perpetrators or as witnesses. The narratives were analysed using a qualitative descriptive analysis. The presentation of the result includes contextual aspects and three themes: 'misunderstanding each other', 'invasion of personal space' and 'acceptance of violence in work'. These themes represent a process of violence in the narratives. Mutual misunderstanding may be seen as an antecedent to violent events. Invasion of personal space is a theme revealing what violence is about. Acceptance of violence seems to be a natural consequence for the caregivers because the events are seen as unavoidable, impossible to solve and as a constituent of daily work.

This article presents an integrative literature review of the experience of dementia care associated with the extended palliative phase of dementia. The aim was to highlight how dementia is defined in the literature and describe what is known about the symptomatology and management of advanced dementia regarding the needs and preferences of the person with dementia and their family carer/s. There was no consistent definition of advanced dementia. The extended palliative phase was generally synonymous with end-of-life care. Advanced care planning is purported to enable professionals to work together with people with dementia and their families. A lack of understanding of palliative care among frontline practitioners was related to a dearth of educational opportunities in advanced dementia care. There are few robust concepts and theories that embrace living the best life possible during the later stages of dementia. These findings informed our subsequent work around the concept, 'Dementia Palliare'.

The aim of this study was to describe the awareness among Swedish general practitioners (GPs) of elderly patients at risk of or suffering from abuse during a 12-month period. A questionnaire was sent to 110 GPs working in one regional health care district in Sweden, and 59% answered and returned the questionnaire. Seventy-seven per cent of the GPs reported having one patient at risk of abuse and or neglect, and 25% were aware of patients who were subjected to verified or suspected elder abuse. Risk situations commonly involved patients with dementia, carers with problems of their own or who felt angry about the burden of caring, or paid carers who were unable to meet the needs of the elderly person. There were GPs who had contact with colleagues, district nurses and others, as well as those who had few or no contacts at all. It is important to take seriously the large number of GPs who have elderly patients in situations where there is a risk of abuse or neglect. If elder abuse is not primarily a medical problem--it is essential that there should be a clearly identified authority to which GPs can refer cases.