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Ageing Europeans are today healthier than previous generations and often manage to live independently up to a high age. The proportion of people 80 years of age and older has increased significantly, and with high age the risk of multi-illness and dementia increases. Strong urbanisation processes have changed the demographic structure in rural areas, and young women and men have migrated towards the urban areas to study and work, while older persons have remained behind. This demographic challenge of increasing numbers of persons older than 80 years with care needs living in remote rural areas has become a major European social problem. In tackling this dilemma, many European countries have high expectations for eHealth, digitalisation and welfare technology. In this comparative study of policy debates in Italy, Finland and Sweden, we analyse how – between 2009 and 2019 – the issues of eHealth have been articulated in national and regional policies of the three countries with deep differences in terms of digitalisation and health systems, but with similar ageing populations. We identify in the documents three core topics – the role of technology, the rural issue and responsibility for care. These topics are treated in the documents with differences and similarities between the three countries. Beyond the differences and similarities, the documents reveal both a certain techno-enthusiasm about the role of eHealth in the life of the older adults as well as a limited understanding of the complexity (relationally as well as spatially) of the digital landscape of caring for older adults.
In recent years, Finnish care policy has emphasised that older people should remain at home for as long as possible. Since the final stages of life and death will theoretically happen more often in the home, it is important to identify people's experiences and needs regarding end-oflife care and dying. The aim of this article is to provide knowledge on these questions from the perspective of the Northern Finnish people (N=294). Statistical analysis was used with data gathered from a survey of a random sample. People's wishes for their end-of-life place and carers and their end-of-life plans and concerns, are analysed as part of a social and cultural construction of dying and end-of-life care. The results show that people do have end-of-life concerns and that they consider end-of-life planning important but that few preparations are actually made. In many instances, home is regarded as the best place for end-of-life care and dying, but care institutions are also regarded positively. Reliance on professional care is very strong, even though people hope to receive care from family members as well. The results are discussed in the light of Finnish care policy and end-of-life culture.
Technology has been considered an important means to deliver services in a cost-effective manner in societies that are aging and implementing austerity policies. In this article, we analyze older adults' use of assistive technology, the picturephone, in home care by combining actor-network theory (ANT) and Foucauldian discourse analysis (FDA). We also apply Foucault's concepts of technologies of the self, regimen, and resistance. Our research materials consist of interviews with eight Northern Finnish older adults and observation data. According to our results, technological translation takes place when users associate picturephone technology with the discourses on health and safety, connectedness, and/or learning. When the technology discourse collides with or deviates from these discourses, it disrupts the technological translation, and older adults do not include the picturephone technology in their regimen, their daily life. In Finland, care policy favors technology and pursues its adoption in older adults' care. In our case, private companies, care workers, technology advisers, family members, and older adults are recruited to join this effort. Older adults' position in their social-material networks varies strongly in the different phases of the translation, and their technologies of the self have a significant effect on its outcome. This should be considered when designing and utilizing ICT technologies in elderly care.
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