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Ernsth-Bravell, MarieORCID iD iconorcid.org/0000-0003-4149-9787
Alternative names
Publications (10 of 161) Show all publications
Östlund, L., Sandberg, J., Skillmark, M., Ernsth-Bravell, M. & Johansson, L. (2023). A Swedish study about how staff reason and act when they suspect domestic abuse perpetrated by relatives of persons with dementia. European Journal of Social Work
Open this publication in new window or tab >>A Swedish study about how staff reason and act when they suspect domestic abuse perpetrated by relatives of persons with dementia
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2023 (English)In: European Journal of Social Work, ISSN 1369-1457, E-ISSN 1468-2664Article in journal (Refereed) Epub ahead of print
Abstract [en]

Older persons with dementia have several risk factors for being exposed to domestic abuse, for example dependency on others to manage daily life. The purpose of the study was to explore how staff act and reason when suspecting domestic abuse perpetrated by informal caregivers of persons with dementia. Eight semi-structured group interviews were conducted with staff (n = 39) working with persons with dementia living in their ordinary homes. A thematic analysis generated two themes; Missing a map for guidance and Being left to one’s own inner compass for direction indicating that staff experienced a lack of guidelines and protocols to work from when suspecting abuse. This resulted in staff taking actions based on their own norms, values, and experiences when suspecting domestic abuse. Not knowing how to act risks leading to staff ending up doing nothing or being unable to identify effective interventions, accompanied by feelings of guilt and ethical stress. The results highlight the necessity of providing staff with tools for how to act when they suspect domestic abuse, such as collaboration with others, colleagues, and other organisations where different options for interventions can emerge.

Abstract [sv]

Svensk titel: En svensk studie om hur personal resonerar och agerar när demisstänker våld i nära relationer som begås av anhöriga tillpersoner med demenssjukdom.

Äldre personer med demenssjukdom har flera riskfaktorer för att utsättas för våld i nära relationer, till exempel att vara beroende av andra för att klara det dagliga livet. Syftet med studien var att undersöka hur personal agerar och resonerar vid misstanke om våld i nära relationer som begås av anhöriga till personer med demenssjukdom. Åtta semistrukturerade gruppintervjuer genomfördes med personal (n = 39) som arbetar med personer med demenssjukdom som bor i ordinärt boenden. En tematisk analys genererade två teman; karta saknas för att ge guidning och vara utlämnad till en inre kompass för att finna riktning, vilket tyder på att personalen upplevde en brist på rutiner och riktlinjer att utgå ifrån vid misstanke om våld i nära relation. Detta resulterade i att personalen vidtog åtgärder utifrån sina egna normer, värderingar och erfarenheter vid misstanke om våld i nära relationer. Att inte veta hur man ska agera riskerar att leda till att personalen inte gör något eller har svårighter att hitta effektiva insatser, vilket kan leda till skuldkänslor och etisk stress. Resultatet belyser behovet av att ge personalen verktyg för hur de ska agera vid misstanke om våld i nära relationer, såsom samarbete med andra, kollegor och andra verksamheter där olika alternativ för insatser kan växa fram.

Place, publisher, year, edition, pages
Taylor & Francis, 2023
Keywords
Elder abuse, old age care, group interviews, dilemmas, dementia, demenssjukdom, dilemman, gruppintervjuer, våld mot äldre, äldreomsorg
National Category
Gerontology, specialising in Medical and Health Sciences Social Work
Identifiers
urn:nbn:se:hj:diva-62566 (URN)10.1080/13691457.2023.2276653 (DOI)001100045000001 ()2-s2.0-85176309944 (Scopus ID)HOA;;1801546 (Local ID)HOA;;1801546 (Archive number)HOA;;1801546 (OAI)
Funder
Konung Gustaf V:s och Drottning Victorias Frimurarestiftelse
Note

Included in licentiate thesis in manuscript form (submitted to journal).

Available from: 2023-10-02 Created: 2023-10-02 Last updated: 2023-12-11
Johansson, L., Ernsth-Bravell, M. & Östlund, L. (2023). Erfarenheter och uppfattningar av tvång och begränsningar vid vård och omsorg av personer med kognitiv nedsättning i Jönköpings kommun. Jönköping: Jönköpings kommun
Open this publication in new window or tab >>Erfarenheter och uppfattningar av tvång och begränsningar vid vård och omsorg av personer med kognitiv nedsättning i Jönköpings kommun
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2023 (Swedish)Report (Other academic)
Abstract [sv]

Tvång och begränsningar i vård och omsorg är inte tillåtet, men används trots detta ändå ibland vid vård av personer med kognitiv nedsättning. I många fall med goda intentioner. I Jönköping kommun har olika utbildningsinsatser gjorts för att arbeta mot den nollvision som finns på nationell nivå. Ett samverkansprojekt mellan Jönköping kommun och Jönköping University startades upp för att få en tydligare bild av fortsatta utbildningsbehov. Syftet med studien var att kartlägga personals erfarenheter och uppfattningar om användandet av tvång och begränsningar inom kommunal vård och omsorg av personer med demenssjukdom. Totalt fjorton fokusgruppsintervjuer med vård- och omsorgspersonal som mötte personer med demenssjukdom inom ordinärt eller särskilt boende genomfördes och ligger till grund för studien. Materialet analyserades med tematisk analys och visa ratt användandet av tvång och begränsningar var relaterat till både relationella aspekter och det direkta mötet såväl som till strukturella och organisatoriska aspekter. Skillnader bland vård- och omsorgspersonalens kunskap och arbete med tvång och begränsningar skilde sig åt beroende på var i organisationen de arbetade. Vård- och omsorgspersonal har ofta förmåga att själva hitta alternativa lösningar och på så vis undvika tvång och begränsningar, men för att öka kunskapen ytterligare behövs ökade möjlighet att reflektera med kollegorna i det dagliga arbetet. 

Place, publisher, year, edition, pages
Jönköping: Jönköpings kommun, 2023. p. 24
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-59844 (URN)
Available from: 2023-02-16 Created: 2023-02-16 Last updated: 2023-10-02Bibliographically approved
Östlund, L., Ernsth-Bravell, M. & Johansson, L. (2023). Working in a gray area: Healthcare staff experiences of receiving consent when caring for persons with dementia. Dementia, 22(1), 144-160
Open this publication in new window or tab >>Working in a gray area: Healthcare staff experiences of receiving consent when caring for persons with dementia
2023 (English)In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, Vol. 22, no 1, p. 144-160Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Every person has the right to autonomy, and to be involved in decisions about their care. When persons with dementia have difficulties in expressing what they want, their autonomy is challenged. Staff should strive to involve the person in care decisions, to obtain consent and to avoid the use of coercion and restraints. However, care without consent exists and coercion and restraints are being used. In order to improve care, further knowledge is warranted.

AIMS: The purpose of this study was to explore staff's experiences of obtaining consent when caring for persons with dementia.

METHODS: In total 14 focus group interviews were conducted with staff with experience of dementia care who work in either home care or residential care in Sweden. An inductive qualitative content analysis was used to analyze the collected data.

RESULTS: Three categories were generated describing staff experiences of consent in dementia care: the person as the decision-maker, the staff as the decision-makers, and the viability of the consent. Overall, staff found it difficult to know if they really had consent from the individual. Even if the person verbally gave consent, it was challenging to know if the person really understood what they had consented to. Common to all three categories was the significance of the relationship between the person with dementia and staff: getting to know the person, recognizing the person's response in terms of their facial expressions and body language as well as being able to explain and justify specific actions to the person.

CONCLUSION: Staff need better conditions in dementia care, including training and time to reflect on how to obtain consent. A person-centered approach can be one way to develop care and ensure that persons with dementia are allowed autonomy and to share in making decisions.

Place, publisher, year, edition, pages
Sage Publications, 2023
Keywords
consent, dementia, elderly care, focus groups, qualitative content analysis
National Category
Gerontology, specialising in Medical and Health Sciences Nursing
Identifiers
urn:nbn:se:hj:diva-58911 (URN)10.1177/14713012221137472 (DOI)000885685000001 ()36380421 (PubMedID)2-s2.0-85142252508 (Scopus ID)HOA;;1711368 (Local ID)HOA;;1711368 (Archive number)HOA;;1711368 (OAI)
Available from: 2022-11-16 Created: 2022-11-16 Last updated: 2023-10-02Bibliographically approved
Finkel, D., Johansson, L., Westerlind, B., Lindmark, U. & Ernsth-Bravell, M. (2022). AGE AND SITE DIFFERENCES IN PLANNED AND PERFORMED ACTIONS IN RESPONSE TO IDENTIFIED RISKS IN OLDER ADULTS. Innovation in Aging, 6(Supplement 1), 840-840
Open this publication in new window or tab >>AGE AND SITE DIFFERENCES IN PLANNED AND PERFORMED ACTIONS IN RESPONSE TO IDENTIFIED RISKS IN OLDER ADULTS
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2022 (English)In: Innovation in Aging, E-ISSN 2399-5300, Vol. 6, no Supplement 1, p. 840-840Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

The Swedish health care system focuses on allowing older adults to “age in place”; however, that approach assumes that home health services are adequate to support health and prevent unnecessary decline. Data from the Senior Alert national quality register in Sweden were examined to compare the quality of care across care locations. First registration in Senior Alert was available for 2914 adults aged 57–109 (median age = 81): 3.6% dementia unit, 7.8% home health care, 4.4% rehabilitation unit, 62.8% hospital, 21.4% care home. There were significant differences across units in the number of identified risks in 4 categories: falls, malnutrition, oral health, and pressure ulcer. Individuals in rehabilitation units averaged 2.4 risks, individuals in dementia and care homes averaged 2.0 risks, and individuals in home health care and hospitals averaged 1.4 risks. For individuals with identified risks, the differences between planned and performed actions for each risk independently were greatest for those in home health care. Moreover, the correlation between total planned and performed actions in home health care was .79 for adults aged 65–80 years and .39 for adults aged 81 and over. The correlation did not differ across age for the other care units. Results suggest that individuals most in need of actions to address health risks (older adults in home health care) are least likely to have the actions performed. Training and support of workers responsible for home health care need to be improved if the “age in place” policy is to continue.

Place, publisher, year, edition, pages
Oxford University Press, 2022
National Category
Geriatrics
Identifiers
urn:nbn:se:hj:diva-60008 (URN)10.1093/geroni/igac059.3012 (DOI)000913044004187 ()
Available from: 2023-03-21 Created: 2023-03-21 Last updated: 2023-03-21Bibliographically approved
Bülow, P. H., Finkel, D., Allgurin, M., Torgé, C. J., Jegermalm, M., Ernsth-Bravell, M. & Bülow, P. (2022). Aging of severely mentally ill patients first admitted before or after the reorganization of psychiatric care in Sweden. International Journal of Mental Health Systems, 16(1), Article ID 35.
Open this publication in new window or tab >>Aging of severely mentally ill patients first admitted before or after the reorganization of psychiatric care in Sweden
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2022 (English)In: International Journal of Mental Health Systems, E-ISSN 1752-4458, Vol. 16, no 1, article id 35Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The concept of deinstitutionalization started in the 1960s in the US to describe closing down or reducing the number of beds in mental hospitals. The same process has been going on in many countries but with different names and in various forms. In Europe, countries like Italy prescribed by law an immediate ban on admitting patients to mental hospitals while in some other European countries psychiatric care was reorganized into a sectorized psychiatry characterized by open psychiatric care. This sectorization has not been studied to the same extent as the radical closures of mental hospitals, even though it entailed major changes in the organization of care. The deinstitutionalization in Sweden is connected to the sectorization of psychiatric care, a protracted process taking years to implement.

METHODS: Older people, with their first admission to psychiatric care before or after the sectorization process, were followed using three different time metrics: (a) year of first entry into a mental hospital, (b) total years of institutionalization, and (c) changes resulting from aging. Data from surveys in 1996, 2001, 2006, and 2011 were used, together with National registers.

RESULTS: Examination of date of first institutionalization and length of stay indicates a clear break in 1985, the year when the sectorization was completed in the studied municipality. The results show that the two groups, despite belonging to the same age group (birthyears 1910-1951, mean birthyear 1937), represented two different patient generations. The pre-sectorization group was institutionalized at an earlier age and accumulated more time in institutions than the post-sectorization group. Compared to the post-sectorization group, the pre-sectorization group were found to be disadvantaged in that their level of functioning was lower, and they had more unmet needs, even when diagnosis was taken into account.

CONCLUSIONS: Sectorization is an important divide which explains differences in two groups of the same age but with different institutional history: "modern" and "traditional" patient generations that received radically different types of care. The results indicate that the sectorization of psychiatric care might be as important as the Mental Health Care Reform of 1995, although a relatively quiet revolution.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2022
Keywords
Deinstitutionalization, Longitudinal, Older people, Sectorization, Severe mental illness
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:hj:diva-57967 (URN)10.1186/s13033-022-00544-9 (DOI)000824694400001 ()35831905 (PubMedID)2-s2.0-85134237153 (Scopus ID)GOA;;822622 (Local ID)GOA;;822622 (Archive number)GOA;;822622 (OAI)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, STYA‑2015/0003
Available from: 2022-07-18 Created: 2022-07-18 Last updated: 2023-10-02Bibliographically approved
Fristedt, S., Kammerlind, A.-S., Fransson, E. I. & Ernsth-Bravell, M. (2022). Physical functioning associated with life-space mobility in later life among men and women. BMC Geriatrics, 22(1), Article ID 364.
Open this publication in new window or tab >>Physical functioning associated with life-space mobility in later life among men and women
2022 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 22, no 1, article id 364Article in journal (Refereed) Published
Abstract [en]

Background

Life-space mobility is defined as the ability to access different areas extending from the room where the person sleeps to places outside one’s hometown. Life-space mobility is vital to support performance of daily life activities and autonomous participation in social life. However, there is a dearth of research that investigates a wider range of physical functions and functioning in relation to life-space mobility rather than just single aspects. Thus, the purpose of the present study was to identify and describe several measures of physical functioning associated with life-space mobility among older men and women.

Methods

Data used in this study was derived from the OCTO 2 study, a population-based study of health, functioning and mobility among older persons (n = 312) in Sweden. Associations between Life-Space Assessment (LSA) total score and age, sex, Short Physical Performance Battery (SPPB), dizziness, lung function i.e. Peak Expiratory Flow (PEF), grip strength, self-rated vision and hearing were analysed through bivariate and multivariate regression models.

Results

The bivariate models showed that life-space mobility was significantly associated with sex, but also age, SPPB, PEF and grip strength in the total group as well as among men and women. In addition, hearing was significantly associated with life-space mobility among women. Those factors that were statistically significant in the bivariate models were further analysed in multivariable models for the total group, and for men and women separately. In these models, sex, grip strength and SPPB remained significantly associated with life-space mobility in the total group, as well as SPPB among both men and women.

Conclusion

Sex, physical function in terms of physical performance measured by SPPB (balance, gait speed and chair stand), and grip strength are associated with life-space mobility. Consequently, these factors need to be considered in assessments and interventions aiming to maintain mobility in old age.

Place, publisher, year, edition, pages
BioMed Central, 2022
Keywords
Community mobility, Dizziness, Hearing, Lung function, Vision, Older people
National Category
Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-56284 (URN)10.1186/s12877-022-03065-9 (DOI)000787765300002 ()35473475 (PubMedID)2-s2.0-85128861504 (Scopus ID)GOA;;808378 (Local ID)GOA;;808378 (Archive number)GOA;;808378 (OAI)
Funder
Futurum - Academy for Health and Care, Jönköping County Council, Sweden
Available from: 2022-04-26 Created: 2022-04-26 Last updated: 2022-05-10Bibliographically approved
Johansson, A., Torgé, C. J., Fristedt, S. & Ernsth-Bravell, M. (2022). Relationships and gender differences within and between assessments used in Swedish home rehabilitation - a cross-sectional study. BMC Health Services Research, 22, Article ID 807.
Open this publication in new window or tab >>Relationships and gender differences within and between assessments used in Swedish home rehabilitation - a cross-sectional study
2022 (English)In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 22, article id 807Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Home rehabilitation programmes are increasingly implemented in many countries to promote independent living. Home rehabilitation should include a comprehensive assessment of functioning, but the scientific knowledge about the assessment instruments used in this context is limited. The aim of this study was to explore relationships between standardised tests and a self-reported questionnaire used in a home rehabilitation programme. We specifically studied whether there were gender differences within and between assessments.

METHOD: De-identified data from 302 community-dwelling citizens that participated in a municipal home rehabilitation project in Sweden was analysed. A Mann Whitney test and an independent t-test were used to analyse differences within the following assessment instruments: the Sunnaas Activity of Daily Living Index, the General Motor Function assessment scale and the European Quality of Life Five Dimension Five Level Scale. Spearman's bivariate correlation test was used to analyse relationships between the instruments, and a Fischer's Z test was performed to compare the strengths of the correlation coefficients.

RESULT: Gender differences were found both within and between the assessment instruments. Women were more independent in instrumental activities of daily living than men. The ability to reach down and touch one's toes while performing personal activities of daily living was stronger for men. There was a difference between men's self-reported performance of usual activities that included instrumental activities of daily living and the standardised assessment in performing instrumental activities of daily living. The result also showed an overall difference between the self-reported assessment and the standardised test of motor function for the total group.

CONCLUSION: The results indicate that a comprehensive assessment with the combination of standardised tests, questionnaires and patient-specific instruments should be considered in a home rehabilitation context in order to capture different dimensions of functioning. Assessment instruments that facilitate a person-centred home rehabilitation supporting personally meaningful activities for both men and women should be applied in daily practice. Further research about gender-biased instruments is needed to facilitate agreement on which specific instruments to use at both individual and organisation levels to promote gender-neutral practice.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2022
Keywords
Activities of daily living, Adults, Gender bias, Mobility, Motor function, Older adults, Self-reported health
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Occupational Therapy
Identifiers
urn:nbn:se:hj:diva-57583 (URN)10.1186/s12913-022-08177-x (DOI)000814254800001 ()35729529 (PubMedID)2-s2.0-85132278742 (Scopus ID)GOA;;819279 (Local ID)GOA;;819279 (Archive number)GOA;;819279 (OAI)
Available from: 2022-06-22 Created: 2022-06-22 Last updated: 2023-04-26Bibliographically approved
Jarling, A., Rydström, I., Fransson, E. I., Nyström, M., Dalheim-Englund, A.-C. & Ernsth-Bravell, M. (2022). Relationships first: Formal and informal home care of older adults in Sweden. Health & Social Care in the Community, 30(5), e3207-e3218
Open this publication in new window or tab >>Relationships first: Formal and informal home care of older adults in Sweden
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2022 (English)In: Health & Social Care in the Community, ISSN 0966-0410, E-ISSN 1365-2524, Vol. 30, no 5, p. e3207-e3218Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
John Wiley & Sons, 2022
Keywords
community, family caregiving, health and social care, health care, home care, informal care, older people
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-56104 (URN)10.1111/hsc.13765 (DOI)000772823500001 ()35332977 (PubMedID)2-s2.0-85127257006 (Scopus ID)HOA;;803821 (Local ID)HOA;;803821 (Archive number)HOA;;803821 (OAI)
Funder
Futurum - Academy for Health and Care, Jönköping County Council, Sweden, FUTURUM-13282
Available from: 2022-03-29 Created: 2022-03-29 Last updated: 2022-12-18Bibliographically approved
Fauth, E. B., Hooyman, A., Schaefer, S., Hall, A. & Ernsth-Bravell, M. (2021). DISCREPANCIES IN OBJECTIVE AND SUBJECTIVE FINE MOTOR ABILITIES IN OCTOGENARIANS. Innovation in Aging, 5(Supplement 1), 839-840
Open this publication in new window or tab >>DISCREPANCIES IN OBJECTIVE AND SUBJECTIVE FINE MOTOR ABILITIES IN OCTOGENARIANS
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2021 (English)In: Innovation in Aging, E-ISSN 2399-5300, Vol. 5, no Supplement 1, p. 839-840Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Older individuals may have discrepancies between self-reported and performance-based abilities on activities of daily living (ADL). We examined objective and self-reported fine motor abilities (FMA). FMA are required for many ADLs, but are examined less frequently than gross-motor tasks in this population. We used two waves of the population-based OCTO-Twin study including mono-/dizygotic Swedish twins, aged 80+. One twin was randomly selected for analyses (baseline N=262; wave 2 N=198; Meanage =83.27; SDage=2.90; 66.4% female). Participants self-reported their ability to manipulate things with hands (cannot do, some problem, no problem) and completed a timed FMA assessment including five everyday tasks (e.g. inserting a key in a lock). Slow performance was coded as 1+ SD from the mean (=80+ seconds). At baseline, 65.8% of slow performers reported ‘no problems’ with hand manipulation. Over two waves (two years), a two-factor ANOVA (including slowness-by-perception interaction) supported a significant difference in total motor task performance between slow performers reporting ‘no problems’ and fast performers reporting ‘no problems’, for both rate of change (diff = -26 seconds, p<.0001) and wave 2 level (diff = 50 seconds, p < .0001). 82% of slow performers at wave 2 reported ‘no problems’, which is surprising given that they had become even slower over the past two years. Findings suggest that objective FMA measures are needed, as self-report is inaccurate and not prognostic. Future work will examine if discrepancies in performance/perceived FMA predict poorer outcomes, and/or if reporting ‘no problems’ despite slower performance is protective against cognitive adaptation to slowing.

Place, publisher, year, edition, pages
Oxford University Press, 2021
National Category
Geriatrics
Identifiers
urn:nbn:se:hj:diva-58518 (URN)000842009904121 ()
Available from: 2022-09-20 Created: 2022-09-20 Last updated: 2022-09-20Bibliographically approved
Finkel, D., Bülow, P. H., Wilińska, M., Jegermalm, M., Torgé, C. J., Ernsth-Bravell, M. & Bülow, P. (2021). Does the length of institutionalization matter? Longitudinal follow-up of persons with severe mental illness 65 years and older: shorter-stay versus longer-stay. International Journal of Geriatric Psychiatry, 36(8), 1223-1230
Open this publication in new window or tab >>Does the length of institutionalization matter? Longitudinal follow-up of persons with severe mental illness 65 years and older: shorter-stay versus longer-stay
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2021 (English)In: International Journal of Geriatric Psychiatry, ISSN 0885-6230, E-ISSN 1099-1166, Vol. 36, no 8, p. 1223-1230Article in journal (Refereed) Published
Abstract [en]

Objectives

As part of the process of de-institutionalization in the Swedish mental healthcare system, a reform was implemented in 1995, moving the responsibility for services and social support for people with severe mental illness (SMI) from the regional level to the municipalities. In many ways, older people with SMI were neglected in this changing landscape of psychiatric care. The aim of this study is to investigate functional levels, living conditions, need of support in daily life, and how these aspects changed over time for older people with SMI.

Methods

In this study we used data from surveys collected in 1996, 2001, 2006, and 2011 and data from national registers. A group of older adults with severe persistent mental illness (SMI-O:P) was identified and divided into those who experienced shorter stays (less than 3 years) in a mental hospital (N = 118) and longer stays (N = 117).

Results

After correcting for longitudinal changes with age, the longer-stay group was more likely than the shorter-stay group to experience functional difficulties and as a result, were more likely to have experienced 're-institutionalization' to another care setting, as opposed to living independently.

Conclusions

The length of mental illness hospitalization has significant effects on the living conditions of older people with SMI and their ability to participate in social life.

Place, publisher, year, edition, pages
John Wiley & Sons, 2021
Keywords
ageing, deinstitutionalization, longitudinal studies, re-institutionalization, severe mental illness, severe persistent mental illness
National Category
Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-51985 (URN)10.1002/gps.5515 (DOI)000621120500001 ()33577096 (PubMedID)2-s2.0-85101520533 (Scopus ID)HOA;;725389 (Local ID)HOA;;725389 (Archive number)HOA;;725389 (OAI)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2015‐00223
Available from: 2021-03-04 Created: 2021-03-04 Last updated: 2021-12-29Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-4149-9787

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