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  • 1.
    Ek, Kristina
    et al.
    Högskolan i Skövde, Institutionen för hälsa och lärande.
    Browall, Maria
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Högskolan i Skövde, Institutionen för hälsa och lärande.
    Eriksson, Monika
    Skaraborg Hospital, Skövde, Sweden.
    Eriksson, Irene
    Högskolan i Skövde, Institutionen för hälsa och lärande.
    Healthcare providers’ experiences of assessing and performing oral care in older adults2018In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 13, no 2, article id e12189Article in journal (Refereed)
    Abstract [en]

    Aims and objectives

    The purpose of this study was to describe healthcare providers’ experiences, knowledge and attitudes in relation to the assessment of oral health in older adults.

    Background

    Oral health is an important element in the care of older adults. An increasing proportion of older people need the help and support of community‐based healthcare services, which are responsible for providing oral health assessment for this group. Although oral care is an important part of nursing care, studies show that it is often an overlooked area in the care of older people.

    Design

    An inductive qualitative description design was used.

    Methods

    The participating healthcare providers were selected from a municipality in western Sweden. Purposeful sampling was employed and data were collected through focus‐group interviews and were analysed with content analysis.

    Results

    The analysis resulted in four categories: healthcare providers’ knowledge and attitudes to oral health; routines affect flexibility; challenges in assessing and performing oral care and ethical dilemmas. The results showed that oral health was neglected because of several factors. Lack of knowledge, inadequate procedures and time constraints were most prominent. The healthcare providers’ own attitudes affected the performing of oral health assessments. Ethical dilemmas related to the attitudes of those people in receipt of care and their relatives, and their integrity and autonomy, could be seen as complicating factors.

    Conclusions

    The healthcare providers expressed that they did not have the necessary knowledge of oral health that was required in their area of responsibility. In addition, they described their own attitudes as being important when attending to the patients’ oral health.

    Implications for practice

    The healthcare providers themselves identified lack of knowledge and their own attitudes as being especially important factors in the oral care of older adults, and further research in this area is needed.

  • 2.
    Eriksson, Henrik
    et al.
    Department of Caring and Public Health Sciences, Mälardalen University.
    Sandberg, Jonas
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Transitions in Men’s Caring Identities: Placing a partner in a nursing home2008In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 3, no 2, p. 131-137Article in journal (Refereed)
    Abstract [en]

    Objectives.  The aim of this study is to describe, from a gender identity perspective, the experiences of older men involved in the process of caring for a partner at home and the placement into a nursing home.

    Background.  Few studies have paid attention to the importance of gender when considering the social experiences of older men providing care for an ill spouse and finally placing a partner in a nursing home. Further understanding is much needed of how older men experience the process of caring for a spouse from a gender identity perspective.

    Design.  A qualitative constructivist approach was adopted for this study.

    Participants.  Data consists of interviews with seven men that have been informal carers and experienced the placement of their wife in a nursing home.

    Methods.  Interviews were analysed with a constructivist approach.

    Results.  The results indicate that men go through two transitions in their gender identity during the caregiving process and placement. From the mutual loving relationship of being a loving husband, the social responsibility of daily care of their wives changes the situation into that of being a caring husband, and finally with the move to a nursing home there is a transition from intimate care to a relationship based on friendship.

    Conclusions.  The results show that older caregiving men undergo a process involving a reconstruction of gender identity. To formally recognize men’s caring activities and to make them sustainable, we believe that men in an informal caring relationship need support.

    Relevance to clinical practice.  Nurses need to recognize the identity struggles resulting in sadness and suffering that are related to changes in men’s lives during the caregiving process. Understanding the dynamics and changes that occur when men take on a caring task is important for the development of their role as carers.

  • 3.
    Eriksson, Henrik
    et al.
    Mälardalens University, School of Health, Care and Social Welfare, Eskilstuna, Sweden.
    Sandberg, Jonas
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health. Jönköping University, School of Health Science, HHJ, Institute of Gerontology.
    Hellström, Ingrid
    Experiences of long-term home care as an informal caregiver to a spouse: gendered meanings in everyday life for female carers2013In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 8, no 2, p. 159-165Article in journal (Refereed)
    Abstract [en]

    Aims and objectives: In this article, we explore the gender aspects of long-term caregiving from the perspective of women providing home care for a spouse suffering from dementia.

    Background: One of the most common circumstances in which a woman gradually steps into a long-term caregiver role at home involves caring for a spouse suffering from dementia. Little attention has been paid to examining the experiences and motivations of such caregivers from a feminist perspective.

    Methods: Twelve women, all of whom were informal caregivers to a partner suffering from dementia, were interviewed on the following themes: the home, their partner’s disease, everyday life, their relationship and autonomy. The results of these interviews were analysed in relation to gender identity and social power structures using a feminist perspective.

    Results: The findings of this study show that the informants frequently reflected on their caregiving activities in terms of both general and heteronormative expectations. The results suggest that the process of heteropolarisation in these cases can be an understood as a consequence of both the spouse’s illness and the resulting caring duties. Also, the results suggest that the act of caring leads to introspections concerning perceived ‘shortcomings’ as a caregiver. Finally, the results indicate that it is important to recognise when the need for support in day-to-day caring is downplayed.

    Conclusions: Women view their caregiving role and responsibilities as paramount; their other duties, including caring for themselves, are deemed less important. We stress that the intense commitment and responsibilities that women experience in their day-to-day caring must be acknowledged and that it is important for healthcare professionals to find mechanisms for providing choices for female caregivers without neglecting their moral concerns.

    Implications for practice: Female carers face difficulties in always living up to gendered standards and this need to be considered when evaluating policies and practices for family carers.

  • 4.
    Göransson, Carina
    et al.
    School of Health and Welfare, Halmstad University, Halmstad, Sweden / Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.
    Eriksson, Irene
    Högskolan i Skövde, Institutionen för hälsa och lärande.
    Ziegert, Kristina
    School of Health and Welfare, Halmstad University, Halmstad, Sweden.
    Wengström, Yvonne
    Cancer Theme, Karolinska University Hospital, Stockholm, Sweden / Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Langius-Eklöf, Ann
    Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Browall, Maria
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Högskolan i Skövde, Institutionen för hälsa och lärande.
    Kihlgren, Annica
    Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.
    Blomberg, Karin
    Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.
    Testing an app for reporting health concerns-Experiences from older people and home care nurses2018In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 13, no 2, article id e12181Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To explore the experiences of using an app among older people with home-based health care and their nurses.

    BACKGROUND: Few information and communication technology innovations have been developed and tested for older people with chronic conditions living at home with home-based health care support. Innovative ways to support older people's health and self-care are needed.

    DESIGN: Explorative qualitative design.

    METHODS: For 3 months to report health concerns, older people receiving home-based health care used an interactive app, which included direct access to self-care advice, graphs and a risk assessment model that sends alerts to nurses for rapid management. Interviews with older people (n = 17) and focus group discussions with home care nurses (n = 12) were conducted and analysed using thematic analysis.

    RESULTS: The findings reveal that a process occurs. Using the app, the older people participated in their care, and the app enabled learning and a new way of communication. The interaction gave a sense of security and increased self-confidence among older people. The home care nurses viewed the alerts as appropriate for the management of health concerns. However, all participants experienced challenges in using new technology and had suggestions for improvement.

    CONCLUSIONS: The use of an app appears to increase the older people's participation in their health care and offers them an opportunity to be an active partner in their care. The app as a new way to interact with home care nurses increased the feeling of security. The older people were motivated to learn to use the app and described potential use for it in the future.

    IMPLICATIONS FOR PRACTICE: The use of an app should be considered as a useful information and communication technology innovation that can improve communication and accessibility for older people with home-based health care.

  • 5.
    Hallgren, Jenny
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Ernsth Bravell, Marie
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Mölstad, Sigvard
    Department of Clinical Sciences, Lund University, Sweden.
    Östgren, Carl Johan
    Department of Medical and Health Sciences, Linköping University, Sweden.
    Midlöv, Patrik
    Department of Clinical Sciences, Lund University, Sweden.
    Dahl Aslan, Anna K.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Factors associated with increased hospitalisation risk among nursing home residents in Sweden: a prospective study with a three-year follow-up2016In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 11, no 2, p. 130-139Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Hospitalisation of nursing home residents might lead to deteriorating health.

    AIM: To evaluate physical and psychological factors associated with hospitalisation risk among nursing home residents.

    DESIGN: Prospective study with three years of follow-up.

    METHODS: Four hundred and twenty-nine Swedish nursing home residents, ages 65-101 years, from 11 nursing homes in three municipalities were followed during three years. The participants' physical and psychological status was assessed at baseline. A Cox proportional hazards model was used to evaluate factors associated with hospitalisation risk using STATA.

    RESULTS: Of the 429 participants, 196 (45.7%) were hospitalised at least once during the three-year follow-up period, and 109 (25.4%) during the first six months of the study. The most common causes of hospitalisation were cardiovascular diseases or complications due to falls. A Cox regression model showed that residents who have had previous falls (P < 0.001), are malnourished (P < 0.001), use a greater number of drugs (P < 0.001) and have more diseases (P < 0.001), are at an increased risk of hospitalisation.

    CONCLUSION: Nursing home residents are frequently hospitalised, often due to falls or cardiovascular diseases. Study results underscore the relationships between malnutrition, previous falls, greater numbers of drugs and diseases and higher risk of hospitalisation.

    IMPLICATIONS FOR PRACTICE: Preventive interventions aimed at malnutrition and falls at the nursing home could potentially reduce the number of hospitalisations. With improved education and support to nurses concerning risk assessment at the nursing homes, it may be possible to reduce the numbers of avoidable hospitalisation among nursing home residents and in the long run improve quality of life and reduce suffering.

  • 6.
    Hedman, Karl
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Social Work. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue).
    Strengths and support of older people affected by precarity in South Louisiana2019In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 14, no 2, article id e12232Article in journal (Refereed)
    Abstract [en]

    Background 

    Few empirical studies have examined strengths and support of older people in circumstances of precarity. A better understanding of this problem has the potential to contribute to the development of care planning and delivery. 

    Purpose

    To investigate how older people deal with episodes of precarity in South Louisiana. 

    Method

    More than 300 hours of participant observation and interviews were conducted with 20 predominantly older African American women in a housing complex for low-income older persons and two senior citizen centers. 

    Results

    The findings demonstrate five central negative conditions of precarity that older people had to manage: (1) loss and discontinuity of home-based health care services, (2) stress after loss or disruption of social support, (3) problems of poverty, (4) cognitive impairment and declining health, and (5) stress of eviction. Strengths and support that older people used were as follows: (1) spiritual faith, (2) psychological strengths, (3) spiritual relationships, (4) family support, (5) friendships of love and friendships of helpfulness, (6) care and support performed by home-based services, (7) senior center and housing complex activities, (8) church memberships and activities, and (9) grocery store and café contacts. 

    Conclusion

    Home-based services were not sufficient to prevent and reduce precarity for older people because of a lack of and discontinuities in these services.

    Implications for practice

    This study adds to the literature about precarity among community-based older people by demonstrating gaps in care support and medication access. The findings suggest that ongoing state funding and support by home-based services are necessary to support frail older people in precarious living conditions to survive and handle stressful life events by reducing vulnerability and enhancing strengths and supportive resources of older people. 

    The full text will be freely available from 2020-03-12 00:00
  • 7.
    Hellström, Ingrid
    et al.
    Social and Welfare Studies, Linköping University, Norrköping, Sweden.
    Eriksson, Henrik
    The Red Cross University College, Stockholm, Sweden.
    Sandberg, Jonas
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Chores and sense of self: gendered understandings of voices of older married women with dementia2015In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 10, no 2, p. 127-135Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Marital relationships in dementia are forged between the person with dementia and the care partner, and such relationships have an impact on the way in which dementia is understood and experienced. The everyday work that underpins the relationship is usually divided between spouses and based on traditional divisions of household chores.

    AIMS AND OBJECTIVES:

    The aim was to describe how older women with dementia express the importance of their homes and their chores in everyday life.

    METHODS:

    Seven women with dementia, who were cohabiting with their husbands, were interviewed on up to five occasions at home during a five-to-six-year period on the following themes: the home, their dementia illness, everyday life, their relationships with their husbands and dignity and autonomy.

    RESULTS:

    The qualitative analysis showed three different patterns in the women's narratives: keeping the core of the self through the home, keeping the self through polarising division of labour and keeping the self through (re-) negotiations of responsibilities. The feeling of one's home and home-related chores is an essential way to express who you are.

    CONCLUSION:

    The women stated that household chores are the centre of their lives despite their dementia disease and that the home, even though it shrinks, still makes the women see themselves as an important person, namely the 'competent wife'.

    IMPLICATIONS FOR PRACTICE:

    Nurses need to be aware that 'doing gender' may be a means of preserving personhood as well as of sustaining couplehood in dementia.

  • 8.
    Jarling, Aleksandra
    et al.
    University of Borås, Borås, Sweden.
    Rydström, Ingela
    University of Borås, Borås, Sweden.
    Ernsth-Bravell, Marie
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Nyström, Maria
    University of Borås, Borås, Sweden.
    Dalheim‐Englund, Ann‐Charlotte
    University of Borås, Borås, Sweden.
    Becoming a guest in your own home: Home care in Sweden from the perspective of older people with multimorbidities2018In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 13, no 3, article id e12194Article in journal (Refereed)
    Abstract [en]

    Aim and objective

    To describe the meaning of the phenomenon home care from the perspective of older persons who live alone with multimorbidity.

    Background

    In line with worldwide changing demographics, conditions for older people in need of home care are changing. In Sweden there is a stay?in?place policy and older people are expected to live and be cared for in their own home as long as possible. Home care, instituted by different laws, is a challenge affecting the older person when the private home becomes a workplace.

    Design

    This study uses a qualitative design with a lifeworld approach.

    Methods

    The study having been conducted in Sweden in 2016, the researchers interviewed 12 older persons that live alone and receive home care. Data were analysed using qualitative content analysis.

    Results

    The findings illustrate four sub?themes: adapting to a caring culture, feeling exposed, unable to influence care and forced relations. The overall theme reveals that older people experience a life?changing situation when receiving home care and they become a guest in their own home.

    Conclusions

    Becoming older with increased needs means to disrupt one's life when one's private home becomes a public arena. The gap between an older person's rights by law and the older person's experiences of receiving home care needs to be highlighted to meet the oncoming challenges in providing a home care that includes participation of the older themselves. Only then can care be offered that enables older people to have a sense of control and experience their home as their own.

    Implications for practice

    The findings emphasise the need to view older people as being self?determinant and independent. Older people receiving home care need to be seen as individuals, and their entire life situation should be considered by also acknowledging the important role played by relatives and caregivers.

  • 9.
    Jonasson, Lise-Lotte
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ, Quality Improvement and Leadership in Health and Welfare.
    Berterö, Carina
    The importance of approaching older people: a grounded theory2012In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 7, no 1, p. 29-36Article in journal (Refereed)
    Abstract [en]

    Aims and Objectives:  The aim of this study was to identify and describe the ethical values in caring encounters as experienced by older patients in their daily interaction with nurses in wards for older people.Background: Ethical values and morals are important aspects that influence the quality of care.

    Methods: Empirical observational study including follow-up interviews. Twenty-two older patients participated voluntarily in this study. Constant comparative analysis, the core foundation of grounded theory was used. Results: Five categories; Being addressed, receiving respect, desiring to participate, increasing self-determination and gaining self-confidence formed the bases for the core category:

    Approaching: Approaching concerns how people become closer to each other in a physical space .It also includes how people become closer to each other in a dialogue, involving verbal or bodily communication.

    Conclusions and Relevance to Clinical Practice: Approaching indicates the ethical values that guide nurses in their caring encounters with older patients. These values are noted by the patient and have an individual value as well as leading to improved quality of their care. The older patient will be confident and satisfied with the caring encounter if the desired components in the nurse’s approaching are exhibited.

  • 10.
    Karlsson, Christina Elisabeth
    et al.
    Högskolan i Skövde.
    Ernsth Bravell, Marie
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Ek, Kristina
    Högskolan i Skövde, Institutionen för Hälsa och Lärande.
    Bergh, Ingrid
    Högskolan i Skövde, Institutionen för Hälsa och Lärande.
    Home healthcare teams’ assessments of pain in care recipients living with dementia: a Swedish exploratory study2015In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 10, no 3, p. 190-200Article in journal (Refereed)
    Abstract [en]

    Background

    Pain assessment in people living with dementia is a challenge due to the complexity of pain and dementia and the difficulties in self-reporting. In home healthcare, nurses are frequently involved in pain assessment situations and there is a need to explore how home healthcare teams’ manage pain assessment in this setting.

    Aim

    The study aimed to explore home healthcare teams’ experiences of pain assessment among care recipients with dementia.

    Design

    An exploratory qualitative design was used.

    Methods

    Open-ended individual interviews were conducted with thirteen registered nurses and ten nursing assistants, working in three different home healthcare teams in one municipality in western Sweden. Philosophical hermeneutics was utilised to interpret the home healthcare teams’ experiences.

    Results

    Four interpretations emerged: the need for trusting collaboration, the use of multiple assessment strategies, maintenance of staff continuity in care and assessment situations, and the need for extended time to assess pain.

    Conclusions

    The home healthcare teams recognise pain assessment in people with dementia as involving a complex interaction of sensory, cognitive, emotional and behavioural components in which efforts to acquire understanding of behavioural changes mainly guides their assessments. The solid team coherence between registered nurses and nursing assistants aided the assessment procedure. To assess pain, the teams used multiple methods that complemented one another. However, no systematic routines or appropriate evidence-based pain tools were used.

    Implications for Practice

    The team members'concern for care recipients when assessing pain is evident and needs to be acknowledged by the organisation which is responsible for the quality of care. Future studies should focus on further exploration of nurses’ experiences with pain and dementia in home healthcare settings and address what nurses identify and how they deal with their findings. It is imperative to investigate how organisations and nurses can ensure best practices and how the implementation of evidence-based routines for assessing pain may aid in pain assessment situations.

  • 11.
    Lundgren, Dan
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Ernsth-Bravell, Marie
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Kåreholt, Ingemar
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Leadership and the psychosocial work environment in old age care2016In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 11, no 1, p. 44-54Article in journal (Refereed)
    Abstract [en]

    Aims and objectives

    To study leadership factors and their associations with psychosocial work environmental among nursing assistants who are engaged in old age care and to analyse (i) differences in the assessment of leadership factors and the assessment of psychosocial work environmental in nursing homes and home help services and (ii) the association between the psychosocial work environment and factors that are related to leadership in nursing homes and home help services.

    Background

    Leadership factors are an important element of the psychosocial work environment in old age care. The physical distance between leaders and nursing assistants is larger in home help services than in nursing homes. Therefore, it is important to study leadership separately in nursing homes and home help services.

    Design

    Assessments from 844 nursing assistants in nursing homes and 288 in home help services (45 nursing homes and 21 home help service units) were analysed.

    Methods

    The data were analysed using linear regression. Age, gender, number of staff at the unit, number of years at the current working unit and educational level were controlled in Model 1. Summarised indexes that were based on all independent variables except the main independent variable were additionally controlled in Model 2.

    Results

    Psychosocial work environment was related to leadership factors, but stronger associations occurred more frequently in nursing homes than in home help services. Empowering leadership, support from superiors, the primacy of human resources and control over decisions were associated with higher assessments on all the variables that were related to the psychosocial work environment in both the nursing homes and home help services.

    Conclusions

    Organisational differences in conducting leadership in old age care must be considered. Some leadership characteristics are better prerequisites for creating and maintaining a positive psychosocial work environment for nursing assistants in nursing homes and home help services.

    Implications for practice

    Due to the differences in organisational settings, it is important to consider the differences in prerequisites in conducting leadership. To influence nursing assistants' performance and to increase quality in old age care in the long term, appropriate leadership is necessary.

  • 12.
    Sandberg, Jonas
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Eriksson, Henrik
    From alert commander to passive spectator: older male carers' experience of receiving formal support2009In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 4, no 1, p. 33-40Article in journal (Refereed)
    Abstract [en]

    The aim was to describe older male carers' experience of receiving formal support.

    Background. To older male carers, creating new roles seems to be important. Their need for support in their caregiving is poorly understood.

    Design. A qualitative approach with a critical perspective on men and masculinities was used.

    Participants. Focus groups comprising a total of 11 men were used.

    Methods. Qualitative content analysis was adopted.

    Results. Three categories of response were found: `using ad hoc solutions for maintaining a protective environment', `coping but being left behind' and `recapturing the caregiving role'.

    Discussion. Not only the quantity of support services offered to older male carers but also their quality dimension, based on a genuine understanding of the men's support needs, must be addressed.

    Conclusions. Professional caregivers attempt to relieve the men of their care obligations entirely. A reciprocal arrangement involving the men as partners, instead, may help them to regard their caring experience as valuable, which is important to their self-image.

    Relevance to clinical practice. These men's socially based networks need to be recognized by professional caregivers as important, to reframe the men's identity and notion of masculinity.

  • 13. Stenwall, Ewa
    et al.
    Sandberg, Jonas
    Eriksdotter Jönhagen, Maria
    Fagerberg, Ingegerd
    Relatives' experiences of encountering the older person with acute confusional state: experiencing unfamiliarity in a familiar person2008In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 3, no 4, p. 243-251Article in journal (Refereed)
    Abstract [en]

    Aims and objectives.  The aim was to understand the lived experience of close relatives encountering older persons with acute confusional state.

    Background.  Little is known about relatives of patients with acute confusional state and their experiences while encountering a family member exhibiting acute confusional state.

    Design.  A descriptive phenomenological research approach was used.

    Methods.  Data were collected by interviewing 10 close relatives of older people with acute confusional state at two hospital wards.

    Results.  Relatives experience the encounter as encountering a familiar person who has suddenly become unfamiliar, struggling to separate the familiar from the unfamiliar and trying to understand the causes of acute confusional state and the behaviour of the person. Six constituents illuminate the phenomenon: ‘change in the other person’, ‘rapid and unexpected changes’, ‘experiencing insecurity in the encounter’, ‘trusting or mistrusting the other person’, ‘experiencing loss’ and ‘experiencing exposure’.

    Relevance to clinical practice.  It is important for professional carers to support relatives on how to encounter the person with acute confusional state, and to co-operate with relatives to gain knowledge about the unique person behind the acute confusional state.

    Conclusion.  Relatives’ difficulties in dealing with strong emotions evoked within the encounter, experiencing limitation and lack of trust is essential knowledge for professional carers in all care settings.

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