Secure care in Sweden is the most intrusive child welfare intervention, and children and their family members have restricted contact. For each child in secure care, there are at least twice as many affected family members and parents who must manage the consequences of this institutionalization. Clearly, it is just as important to understand how secure care affects parents as it is to understand how secure care affects children. To address this issue, we conducted in-depth interviews with 11 parents to eight children who had been placed in secure care during their childhood, focusing on the institutional and societal structures that affected these parents and their parenting. With a narrative approach, stories alluding to a metaphor of war are identified. These stories reveal how all parents (but especially single mothers) are affected by their diverse socio-economic positions and the rigid frames of family life presumed by child welfare interventions. In these narratives, parenting emerges as a social practice rather than a skill. Above all, the stories demonstrate a great deal of vulnerability and sensitivity of parenting. The findings raise critical questions about the meaning and overarching consequences of institutional interventions in a family life. 

This article applies the concepts of place and space to understand youth and their engagement in risky behavior, such as drunkenness. It is based on the prolonged engagement with 23 underage youth coming from smaller municipalities in the south of Sweden. The study was comprised of semi-structured interviews, field visits, and observations at sites relevant for youths. In the stories narrated by youth, drunkenness is no longer an ad hoc activity conducted somewhere at the margins of society. The construction of drinking spaces was accomplished through highly managed, monitored, and organized practices, such as sending out invitations in advance, planning how much alcohol to drink, designating drivers, and securing transport means. Crucial to this was that spaces were products of relations existing between various youth, with no adults present. Spaces of drinking changed as those who participated in their construction changed. In addition, certain rules and codes of conduct (e.g. taking care of friends who drunk too much) were enforced to assure that the constructed spaces provided a sense of safety and enabled having fun. We conclude this article by arguing that a focus on place and space brings forward vital aspects in understanding the role of transforming party spaces that would otherwise remain obscure to social work knowledge and practice.

Ageism has been shown to have a negative impact on older people's health and wellbeing. Though multiple scales are currently being used to measure this increasingly important issue, syntheses of the psychometric properties of these scales are unavailable. This means that existing estimates of ageism prevalence may not be accurate. We conducted a systematic review aimed at identifying available ageism scales and evaluating their scope and psychometric properties. A comprehensive search strategy was used across fourteen different databases, including PubMed and CINAHL. Independent reviewers extracted data and appraised risk of bias following the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. Of the 29,664 records identified, 106 studies, assessing 11 explicit scales of ageism, were eligible for inclusion. Only one scale, the 'Expectations Regarding Aging' met minimum requirements for psychometric validation (i.e., adequate content validity, structural validity and internal consistency). Still, this scale only assesses the 'stereotype' dimension of ageism, thus failing to evaluate the other two ageism dimensions (prejudice and discrimination). This paper highlights the need to develop and validate a scale that accounts for the multidimensional nature of ageism. Having a scale that can accurately measure ageism prevalence is key in a time of increasing and rapid population ageing, where the magnitude of this phenomenon may be increasing.

Purpose - The main aim of this article is to research the lived experience of difference. In this article, we are interested in the field of working life in the context of entrepreneurship among Turkish women in Sweden.

Design/methodology/approach - The article is based on the stories of two immigrant women entrepreneurs who reflect upon their experience of working life in the context of migration to Sweden. These two stories provide a ground for a discussion regarding the responding to and re-making of difference by individual subjects. Our analysis is grounded in discursive approaches to narratives, particularly in the positioning analysis.

Findings - In our discussion, we focus on the field of work to discuss the changing conditions that affect and are affected by particular constructions of difference in a migration context. In this, we present how difference is experienced and put into use differently by the individuals, even under very similar descriptive categories of difference.

Originality/value - This article contributes with an experiential account of difference. It favors the notion of lived experiences within the intersecting structures in the analysis of complex interactions between structures, agents, times and spaces. It demonstrates the importance of attending to spatial, temporal, structural and subjective dimensions of difference.

This article analyses the visibility of unpaid care work in Scotland by examining the (non-)development of discourse on unpaid care work in economic policy documents. Drawing on the problem approach to policy analysis, the article engages with the Equality Budget Statements (EBS) as policy documents that not only inform the government’s spending plans but are foremost statements of values and norms pursued by the government. This critical reading reveals that certain discourses give different meanings to women’s lives through the political significance of what remains unproblematized as part of the ensuing care discourse in Scotland. The developing discourse on economic policy and equality suggests that equality in Scotland is presupposed on labour market participation. This shrinks discourse on unpaid care work; the problem of unpaid care work is silenced, while the problem of women’s access to employment is redefined to mean a problem of difference and costly childcare only. The way certain issues have or have not appeared in governmental documents is explanatory of the importance and relevance of unpaid care work to the political discourse.

The deinstitutionalization of psychiatric care has not only altered the living conditions for people with severe mental illness but has also greatly affected social services staff. In the Mental Health Act launched by the Swedish government in 1995, a new kind of service called ‘housing support’ and a new occupational group, ‘housing support workers,’ was introduced. However, housing support does not currently operate under any specific guidelines regarding the content of the service. This study explores housing support at local level in various municipalities of one Swedish county. The data is based on discussion with three focus groups: care managers, managers for home and community‐based support, and housing supporter workers. The perspective of institutional logics as a specific set of frames that creates a standard for what should or could be done, or alternately what cannot be questioned, is applied to analyze the constructed meaning of housing support. The meaning of housing support is constructed through three dichotomies: process and product, independence and dependence, and flexibility and structure. These dichotomies can be understood as dilemmas inherent in the work and organizing of housing support. With no clear guidelines, the levels of organizational and professional discretion create a space for local flexibility but may also contribute to tremendous differences in defining and implementing housing support. We discuss the potential consequences for housing support users implied by the identified discrepancies.

Många tycker att deras lärande slutar den dagen de börjar på sitt första jobb. Väldigt ofta hör vi studenter som tar examen säga: "Nu har jag studerat klart, nu får jag jobba!" Med detta kapitel vill vi skicka med det exakt motsatta budskapet: ju mer vi jobbar, desto mer måste vi lära oss. Denna lä­randeprocess är nämligen avgörande för en välfungerande arbetsplats. Ur ett arbetslivsperspektiv fungerar lärandet stimulerande och är dessutom nödvän­digt för att organisatorer ska förändras. Med detta sagt: lärande är en social process som involverar och är beroende av olika sociala aspekter, såsom människor, tid och rum. Hur lärande sker och hur det ser ut beror därför på vad vi lär oss, men även med vem, när och till vilken nytta det sker. 

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.

The role of religion in migration has been a contested subject in previous research and social work practice, with religion being considered both a bridge and a barrier to integration. When considering unaccompanied female minors, struggling to be recognised beyond the prevailing image of the victimised refugee girl, religion is sometimes seen as a force of oppression rather than a tool for integration. In this article, we focus on the embodied practices of young women?s lived religion in a context where such practices are constructed as otherness. Based on an interview study with 11 unaccompanied female minors, this article explores the identity negotiations that emerged when migrating from societies where religion plays an integral part in everyday life to a society with highly secular values. By using the concept of (oppositional) gaze, we explore how these young women negotiate their identities at a point where the normative, invisible gaze meets the embodied practices of lived religion. We demonstrate how these young women are themselves agents of their own faith, and we confirm previous research that points to religion as a support structure for unaccompanied minors; however, not without causing friction in their new society. The study shows how lived practices of religion and the development of an oppositional gaze can function as mutually reinforcing processes in identity negotiation. In social work, understanding the role of religion through lived practices might contribute to a more holistic approach when creating solutions for young people experiencing turbulent circumstances of arriving in a new country.

This study based in Sweden explores family practices and family displays among young adults with a history of secure care, which limits and restricts contacts and therefore causes fundamental changes in relationships. Almost 10 years after institutional placement, narrations of 11 young adults and 11 nominated family members reveal ongoing struggles between imagined and lived realities of family. These struggles are revealed by memories and emotions evoked by the context of secure care and show how deeply the secure care penetrated their family lives. By using the metaphor of shadows, shadows of recalled horror of secure care (reflecting family displacement) and the pressure to make family work (reflecting restricting practices in secure care where only (birth) family were considered as family and relations of (natural) importance) are discerned. We call for more attention to the perversity of secure care arrangements, at both policy and institutional levels.

This article analyses how young people, with experiences of secure care, relate to the contradictory images of children in child welfare: the child in danger and the dangerous child. The study is based in Sweden and consists of in-depth interviews with 16 youths conducted repeatedly (three times) over a period of 2 years. Using the perspective of relational sociology, we demonstrate how abstract images of children are materialized through the institutional practices of broken, interrupted, forbidden and forced relations. Within this context, young people are found to relate differently to being placed in the institution by negotiating, opposing and transposing. All practices display their unfolding agency and struggle to make sense of the experience. The restrictive practices seem to deny young people relations through which a sense of safety and care can be established. We conclude by putting into question the very foundations of secure care within child welfare services.

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.

Studier visar att fattigdom påverkar människors livskvalitet och möjligheter till full delaktighet i samhället, och kan ge upphov till ohälsa och skamkänslor. Fattigdom är ett komplext fenomen som kan definieras på olika sätt beroende på tid och plats. Resultat i denna studie baseras på data och definitioner av fattigdom från Statistiska Centralbyrån (SCB). Två definitioner används som utgår ifrån att fattigdom är brist på resurser som leder till att man inte når en allmänt accepterad levnadsstandard. Relativ fattigdom som innebär att hushåll har inkomster lägre än 60 % av medianinkomsten och absolut fattigdom som innebär att inkomsten inte täcker nödvändiga levnadskostnader. I fokus för rapporten är att undersöka barnfattigdom, fattigdom bland ensamstående med och utan barn, fattigdom bland unga vuxna, samt fattigdom bland äldre.

Sammantager visar rapporten att fattigdom utifrån de valda definitionerna i Jönköpings län varierar mellan olika grupper och kommuner. Bland barn i länet lever i genomsnitt 19,5% i relativ fattigdom, vilket är något högre än riksgenomsnittet på 18,3%. När det gäller låg inkomststandard, är den lägsta andelen 1,8%, och den högsta nivån 10,6%. Rapporten visar också att barn med utländsk bakgrund löper en betydligt högre risk för fattigdom.

För ensamstående föräldrar finns också stora variationer mellan kommuner, där kvinnor med barn löper högre risk för fattigdom än ensamstående män. Yngre ensamstående kvinnor utan barn har högre risk att leva i fattigdom i några kommuner. Rapporten visar vidare att unga vuxna (20–29 år) med utländsk bakgrund har en betydligt högre risk för låg inkomststandard än de med svensk bakgrund i alla kommuner.

När det gäller äldre (65–79 år) visar resultatet att ensamstående kvinnor har högre nivåer av fattigdom jämfört med män, men risken är betydligt lägre för sammanboende äldre.

Rapporten visar också att generellt sett har sammanboende äldre lägre risk för fattigdom, och skillnaderna mellan könen är tydliga men mindre framträdande jämfört med ensamstående med hemmaboende barn i åldersgrupperna 20–29 år och 30–49 år.

Slutsatsen av rapporten är att fattigdom i Jönköpings län varierar avsevärt mellan olika kommuner, utrikesfödda och ensamstående mödrar med hemmaboende barn utgör grupper med ökad risk för ekonomisk utsatthet. Fattigdom är ett komplext fenomen som påverkar flera aspekter av livet, från utbildning och hälsa till socialt välbefinnande. För att effektivt bekämpa fattigdom behövs omfattande strategier som fokuserar på olika faktorer, såsom utbildning, bostad, och vård. Fortsatt forskning är nödvändig för att undersöka långvarig fattigdom och de faktorer som bidrar till socioekonomiska skillnader i regionen.

While there is a growing body of research on the social aspects of older people's dance, studies focusing on emotions are rare. In this study, we use an interactionist sociological perspective to examine the role of emotions in older social dancers' experiences in Sweden. Through qualitative interviews with 29 active or previously active dancers, we found that their experiences of emotional energy and experiences of flow override concerns of age and aging. Age, however, did become significant as the age differences at dance events could bring forth feelings of alienation associated with feeling old. In addition, cultural and gendered norms of appropriate age differences between dancing partners produced shame and pride as well as feelings of being either old or young. Moreover, certain bodily experiences were interpreted in terms of age. Overall, the study contributes to the discussions of the complexity of subjective experiences of age by highlighting its emotional aspects through social partner dancing.

This interpretative literature review discusses research published between 2000 and 2015 that focuses on the media representation of older adults. The key objective is to offer a critical discussion on the knowledge and assumptions underlying such studies. Specifically, the review examines how old age and media, respectively, are conceptualised in the research and the consequence this has for further research in the fields of ageing and media studies. The main finding from this review is that a large part of the research appears to say nothing about what old age and media are, as it either entirely fails to discuss what is meant by these terms or relies on common sense notions. The review concludes that research on older age and media suffers from a lack of dialogue over disciplinary borders and that this issue needs to be remedied. Likewise, for research to move on, it is imperative to take a more reflexive stance on the topics in order to avoid simplistic notions of both ageing and media.

Ingress: Ädre personer med psykisk funktionsnedsättning är till viss del osynliggjorda. En aktuell studie pekar på behovet av att både kommuner och frivilliga organisationer behöver förbättra sitt arbete med att identifiera och synliggöra denna grupp och deras behov av hjälp och stöd.

Older people ageing with severe mental illness (SMI) usually fall in between mental health care and old age care services. The role of informal care in filling this gap is recognized. The role of other welfare providers, such as voluntary organizations, is unclear. The aim of this article is to analyze and discuss local voluntary organizations' ability to recognize and respond to the needs of older people with SMI in the community.

11 local organizations focusing on mental illness, social care or old age were identified in a mid-sized Swedish city. Seven voluntary organizations participated in the study.

Our analysis revealed three overarching themes: 'Age as a non-issue?', 'Public and voluntary sector (non)links' and 'organizational vulnerabilities'. Our results show that older people with SMI are to some extent also invisible in the voluntary sector. We were also able to discern differences in the 'we-for-us' organizations that provide support for their own members with SMI, and 'we-for-them' organizations that provide help to a broader group.

Overall, older people with SMI remain a relatively invisible as a group for the voluntary organizations. We discuss these findings in relation to the specificity of the group and welfare contexts of voluntary work in communities.

This chapter offers a theoretical contribution to the discussions revolving around multiple marginalizations based on age. Our main focus is on gendered ageism, where vulnerability and marginalization is based on the interaction of age and gender, and its potential to highlight the processes and practices of marginalization. Based on the understanding of ageism as a socio-cultural practice involving privilege, subordination, and inequality, we rework existing conceptualizations of multiple marginalizations and of gendered ageism. The understanding of ageism as a form of doing enmeshed in interlocking power structures draws attention to the importance of socio-cultural context and the dynamics involved in the creation and reproduction of social reality, including social inequalities. This chapter draws on a wide range of existing studies to illustrate and explain this new approach. It concludes with an outline of an applicable research programme that yields novel ways of exploring multiple inequalities in later life and gendered ageism more specifically.

OBJECTIVES: The Esther Network (EN) model, a person-centred care innovation in Sweden, was adopted in Singapore to promote person-centredness and improve integration between health and social care practitioners. This realist evaluation aimed to explain its adoption and adaptation in Singapore. DESIGN: An organisational case study using a realist evaluation approach drawing on Greenhalgh et al (2004)'s Diffusion of Innovations in Service Organisations to guide data collection and analysis. Data collection included interviews with seven individuals and three focus groups (including stakeholders from the macrosystem, mesosystem and microsystem levels) about their experiences of EN in Singapore, and field notes from participant observations of EN activities. SETTING: SingHealth, a healthcare cluster serving a population of 1.37 million residents in Eastern Singapore. PARTICIPANTS: Policy makers (n=4), EN programme implementers (n=3), practitioners (n=6) and service users (n=7) participated in individual interviews or focus group discussions. PRIMARY AND SECONDARY OUTCOME MEASURES: Outcome data from healthcare institutions (n=13) and community agencies (n=59) were included in document analysis. RESULTS: Singapore's ageing population and need to transition from a hospital-based model to a more sustainable community-based model provided an opportunity for change. The personalised nature and logic of the EN model resonated with leaders and led to collective adoption. Embedded cultural influences such as the need for order and hierarchical structures were both barriers to, and facilitators of, change. Coproduction between service users and practitioners in making care improvements deepened the relationships and commitments that held the network together. CONCLUSIONS: The enabling role of leaders (macrosystem level), the bridging role of practitioners (mesosystem level) and the unifying role of service users (microsystem level) all contributed to EN's success in Singapore. Understanding these roles helps us understand how staff at various levels can contribute to the adoption and adaptation of EN and similar complex innovations systemwide.

Introduction: The Esther Network (EN) person-centred care (PCC) advocacy training aims to promote person-centred attitudes among health practitioners in Singapore. This study aimed to assess the relationship between the training and practitioners’ PCC attributes over a 3-month period, and to explore power sharing by examining the PCC dimensions of “caring about the service user as a whole person” and the “sharing of power, control and information”. Methods: A repeated-measure study design utilising the Patient-Practitioner Orientation Scale (PPOS), was administered to 437 training participants at three time points – before training (T1), immediately after (T2) and three months after training (T3). A five-statement questionnaire captured knowledge of person-centred care at T1 and T2. An Overall score, Caring and Sharing sub-scores were derived from the PPOS. Scores were ranked and divided into three groups (high, medium and low). Ordinal Generalised Estimating Equation (GEE) model analysed changes in PPOS scores over time. Results: A single, short-term training appeared to result in measurable improvements in person-centredness of health practitioners, with slight attenuation at T3. There was greater tendency to “care” than to “share power” with service users across all three time points, but the degree of improvement was larger for sharing after training. The change in overall person-centred scores varied by sex and profession (females score higher than males, allied health showed a smaller attenuation at T3). Conclusion: Training as a specific intervention, appeared to have potential to increase health practitioners’ person-centredness but the aspect of equalising power was harder to achieve within a hierarchical structure and clinician-centric culture. An ongoing network to build relationships, and a supportive system to facilitate individual and organisational reflexivity can reinforce learning.

What we understand at any given time as “old age” may seem to have a very straightforward and factual base. Yet, in the words of Simone de Beauvoir, “as far as our own species is concerned old age is by no means easy to define” (de Beauvoir, 1996, p. 9). Even the most positivist sciences have to admit that old age is a “a heterogeneous event that some individuals tolerate better than others” (Balcombe & Sinclair, 2001, p. 845). That is, “old age” as a biological and physiological phenomenon has many and variable causes that may become visible at differing points in individual lives. Moreover, the phenomenon of ageing cannot be explained by any one universal theory (Balcombe & Sinclair, 2001, pp. 845-846). What it means to be old in a particular society at any given time is, thus, a matter of social and cultural construction that may vary greatly from place to place and at different historical times (Hazan, 1994). 

PURPOSE: Restless Legs Syndrome (RLS) is a widespread condition that affects sleep leading to daytime sleepiness, depression, and reduced quality of life. This study aims to determine and describe how patients with RLS experience their everyday life, with a focus on facilitators and barriers related to Maslow's hierarchical theory of human needs.

METHOD: Semi-structured interviews were analysed with qualitative content analysis resulting in facilitators and barriers affecting the fulfilment of the five human needs.

RESULTS: Addressing RLS symptoms through medications and a quiet sleep environment fulfils psychological needs. Control over RLS symptoms, engagement in activities, trust in treatments, and social support meet safety and security needs. Social inclusion, close relationships, and meaningful interactions fulfil a sense of belongingness and love needs despite RLS. Competence in managing RLS, effective self-care strategies, confident communication, and trust-building support esteem needs. Finally, comprehensive understanding through person-centred interventions and coping fulfils the self-actualization needs in managing RLS.

CONCLUSION: Holistic and person-centred interventions, including facilitators for the fulfilment of physiological, psychological, and social needs could help healthcare professionals to provide holistic care.

Scotland is a small nation, yet it leads the field in key areas of aging research. With the creation of a devolved government with authority over health and social services, the country has witnessed practice and policy developments that offer distinctive opportunities for innovative research. With multidisciplinary groups of internationally recognized researchers, Scotland is able to take advantage of a unique set of opportunities for aging research: a well-profiled population brings opportunities in population data and linkage to understand people’s interactions with health, social care, and other public services; while research on technology and telecare is a distinctive area where Scotland is recognized internationally for using technology to develop effective, high-quality and well-accepted services at relatively low financial cost. The paper also considers free personal care for older people and the national dementia strategy in Scotland. The potential to evaluate the impact of free personal care will provide valuable information for other global health and social care systems. Exploring the impact of the national dementia strategy is another unique area of research that can advance understanding in relation to quality of life and the development of services. The paper concludes that, while Scotland benefits from unique opportunities for progressive public policy and innovative aging research that will provide valuable lessons at the forefront of a globally aging population, the challenges associated with an aging population and increasing cultural diversity must be acknowledged and addressed to ensure that the vision of equality and social justice for all is realized.

The University of the Third Age (U3A) is an organization widely recognized for its achievements in the field of adult education. However, little research to date has addressed the position of the U3A in the context of the societal discourse on ageing. The aim of this study was to examine stories of ageing told by the U3A in Poland and to place these stories within the contemporary discourse of ageing. The study sought to reflect on the role of the U3A in providing an environment that encourages the growth of an ageing subject. The results of this study indicate that rather than resisting ageist discourses, the U3A simply rejects the idea of old age. The U3A characterizes its members as exceptional people who have nothing in common with old people outside of the U3A. Therefore, the U3A plays only a minor role in changing the social circumstances of old people in Poland