“In August, I Counted 24 Different Names”: Swedish Older Adults’ Experiences of Home Care

Bravell, Marie Ernsth; Bennich, Maria; Walfridsson, Carola

doi:10.1177/0733464820917568

Cited by 12 publications

(9 citation statements)

References 21 publications

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“…The sensitivity of the nurse in being able to understand the various situations that arise requires attentive presence [35]. Although the available time with the patient may be perceived as too short [36], the nurse´s attention to the needs of the moment can clearly make the patient´s day good or bad [37].…”

Section: Discussionmentioning

confidence: 99%

“…New healthcare workers are perceived as representing a lack of continuity making it challenging to establish a close relationship between patient and caregiver [36,43], especially if the caregiver is not fully informed about the patient´s situation [44]. Relationships that are forced upon the patient, as a patient‐nurse relationship is, can be experienced as healing but may equally well be devastating [42].…”

Section: Discussionmentioning

confidence: 99%

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´You are not yourself anymore´: The place of the ethical demand in a practical home care context

Jakobsen

Lind

2022

Scandinavian Caring Sciences

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The study's rationale: The Scandinavian nursing tradition is based on caring science as the ontological backdrop. This means that meeting the patient with openness and respect is essential in care. The experiences of an elderly woman receiving home nursing provide insight into a world many healthcare workers need to understand; meaning what is important in the encounter with the fragile old patient whose voice is not often heard in the society nor in research. Caring science with its personoriented care clashes with the New Public Management's ideal for municipal health care in Norway, at the expense of the needs of the elderly patients. Aims and objectives:This article aims to express the phenomenon of lived experience as presented by an elderly woman, more specifically her experience of care in home nursing run according to the principles of new public management. Methodological design:The article is based on an empirical narrative in the form of an individual qualitative research interview. Findings:The patient has needs that cannot be defined without the nurse having an ethical understanding of what may be important in the patient´s lifeworld. The core findings are: Feeling disregarded as a human being, Broken agreements, Surrendering in anonymous relationships and Each day is a different day with altered needs. Conclusion:The system of New Public Management sets a strain on the time at hand for the nurse to develop a relationship that acknowledges and supports the patient´s life courage. The ethical demand and care ethics can explain how the patient´s will to live can be preserved, and provide knowledge of how the caregiver can best attend to the patient's ways of expressing what is important to her. Nevertheless, within the time at disposal, the nurse has an opportunity to either marginalize or strengthen the old person´s dignity.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

´You are not yourself anymore´: The place of the ethical demand in a practical home care context

Jakobsen

Lind

2022

Scandinavian Caring Sciences

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“…Professional caregivers need to understand how older persons experience their life situations and how they express their needs (Dahlberg, 1996). According to Ernsth Bravell et al (2020) formal competence, such as education, contributes to a sense of security for the older person. When formal competence is lacking, it may be difficult to accurately assess the needs of someone who requires extensive care, and thus provide effective care.…”

Section: Discussionmentioning

confidence: 99%

“…According to Ernsth Bravell et al. (2020) formal competence, such as education, contributes to a sense of security for the older person. When formal competence is lacking, it may be difficult to accurately assess the needs of someone who requires extensive care, and thus provide effective care.…”

Section: Discussionmentioning

confidence: 99%

Relationships first: Formal and informal home care of older adults in Sweden

Jarling

Rydström

Fransson

et al. 2022

Health Social Care Comm

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To a great extent, older people in Sweden, often with extensive care needs, are cared for in their own home. Support is often needed from both family and professional caregivers. This study aimed to describe and analyse different aspects of health, functioning and social networks, and how they relate to formal and informal care in the home among older adults. Analyses were performed utilising data from the OCTO-2 study, with a sample of 317 people living in Jönköping County, aged 75, 80, 85 or 90 years, living in their own homes. Data were collected with in-person-testing. Based on receipt of care, the participants were divided into three groups: no care, informal care only, and formal care with or without informal care. Descriptive statistics and multinomial regression analysis were performed to explore the associations between received care and different aspects of health (such as multimorbidity, polypharmacy), social networks (such as loneliness, number of confidants) and functioning (such as managing daily life). The findings demonstrate that the majority of the participants received no care at home (61%). Multimorbidity and polypharmacy were more common among those receiving some kind of care in comparison to those who received no care; moreover, those receiving some kind of care also had difficulties managing daily life and less satisfaction with their social networks. The multinomial logistic regression analyses demonstrated that age, functioning in daily life, perceived general health and satisfaction with the number of confidants were related to receipt of care, but the associations among these factors differed depending on the type of care that was received. The results show the importance of a holistic perspective that includes the older person's experiences when planning home care. The results also highlight the importance of considering social perspectives and relationships in home care rather than focusing only on health factors.

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“… 11 12 While it is logical that greater need for care should be associated with greater use of services, service use does not necessarily ensure that care needs are met. 13 Low staff competence and poor continuity of care entails a risk of unmet needs 14 and may lead to avoidable ED visits. In Sweden, the proportion of registered nurses in municipal social care for older adults is lower than in neighbouring Norway (9% vs 31%), 15 while currently a person receiving home help meets an average of 16 different carers during a 14-day period.…”

Section: Introductionmentioning

confidence: 99%

Individual and contextual predictors of emergency department visits among community-living older adults: a register-based prospective cohort study

et al. 2022

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ObjectivesTo examine the extent to which contextual factors explain emergency department (ED) visits and ED revisits, additional to that explained by individual factors.DesignA register-based prospective cohort study.SettingSwedish region of Dalarna.ParticipantsParticipants were 16 543 community-living adults aged 80 or older who were residents of the Dalarna region of Sweden, excluding older adults who moved out of Dalarna or into residential care during the study period.Outcome measuresDependent variables were initial ED visit, and at least one ED revisit within 30 days of an initial ED visit.ResultsApproximately 36% of the participants visited the ED during the study period with 18.9% returning to the ED within 30 days. For both initial ED visits and ED revisits, the addition of contextual factors to models containing individual factors significantly improved model fit (p<0.001; p<0.022) and the amount of variance explained in the outcome. In the final models, initial ED visit was significantly associated with older age, number of chronic diseases, receipt of home help, number of primary care visits, proportion of 80+ in the population and shorter distance to the ED; while an ED revisit was significantly associated with greater use of social care, number of hospital admissions and disposition (discharged; admitted to hospital) at initial ED visit.ConclusionContextual factors explain variance in initial ED visit, additional to that explained by individual factors alone, which indicates inequitable access to ED care. These findings suggest considering local variations in contextual factors in order to improve health-related outcomes among older adults.

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“In August, I Counted 24 Different Names”: Swedish Older Adults’ Experiences of Home Care

Cited by 12 publications

References 21 publications

´You are not yourself anymore´: The place of the ethical demand in a practical home care context

´You are not yourself anymore´: The place of the ethical demand in a practical home care context

Relationships first: Formal and informal home care of older adults in Sweden

Individual and contextual predictors of emergency department visits among community-living older adults: a register-based prospective cohort study

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