Dissertationen: „Public eldery care“

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Holmberg, Nora, und Mikael Toresten. „Tillförlitlig kvalitet – Jämförelse mellan offentlig och privat äldreomsorg“. Thesis, Högskolan i Skövde, Institutionen för handel och företagande, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-20024.

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Under början av 1990-talet infördes reformer som än idag påverkar svensk äldreomsorg. Dessa reformer föranledde till stora förändringar i den offentliga sektorn, där privatiseringen av offentliga tjänster är en del av resultatet. I nästan tre decennier har resultatet av dessa reformer varit väl omdiskuterade i både politiska sammanhang och samhället, där äldreomsorgen är en av de stora reformerna som diskuteras. Föreliggande studie jämför och analyserar tillförlitlig kvalitet på given vård i äldreomsorgen mellan den offentliga och privata sektorn eftersom den privata sektorn ibland har ett vinstintresse, vilket den offentliga sektorn saknar. Syftet med studien var att jämföra och analysera hur chefer uppfattar möjligheten att ge tillförlitlig kvalitet i verksamheten. Arbetet i den dagliga verksamheten utförs av chefer och medarbetare tillsammans, vilket föranledde att det i studien intervjuades åtta chefer på äldreboenden i Sverige, där fyra chefer från respektive offentlig eller privat given äldrevård utgjorde studiens empiriska material. Intervjufrågorna var konstruerade utifrån studiens analysmodell som bygger på karaktäristiska egenskaper för organisationer med hög tillförlitlighet. Föreliggande studie visar att cheferna i både den offentliga och privata sektorn uppfattar, utifrån de förutsättningar som finns i äldreomsorgen, möjlighet till tillförlitlig kvalitet. Dock visar resultatet av studien att det finns brister i den tillförlitliga kvaliteten. Studiens vetenskapliga bidrag visar på kvaliteten utifrån de förutsättningar som chefer har att ge en tillförlitlig kvalitet i äldreomsorgen.
During the start of the 1990´s reforms were introduced that to this day affect Swedish elderly care. These reforms brought forth large alterations in the public sector where in multiple, previously public services were privatized. In the following three decades have these reforms been regularly discussed in both political contexts and society, where the reforms of the elderly care have been prominent. This study compares and analyze reliable quality of administrated care of elderly between the public and private sectors, because of the private sector´s common profit orientation, which the public sector does not have. The purpose of this study was to compare and analyze how management perceive the opportunity to give reliable quality within the organization. Operational labor is performed by both management and coworkers together which resulted in eight managers within the Swedish elderly care being interviewed wherein four worked in the public sector and private, respectively. These interviews became the empirical basis for the study. The interview questions were constructed using the studies analytical model which is based on characteristic properties within organization with high reliability. The result of this study shows that managers in both the public and private sectors perceive the possibility of reliable quality based on the conditions that exist in elderly care. However, the results of the study show that there are shortcomings in the reliable quality. The study´s scientific contribution indicates the quality based on the conditions that managers have to provide a reliable quality in elderly care.

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Chui, Shuk-wah Janet. „A study of the public policy on elderly care in Hong Kong“. Click to view the E-thesis via HKUTO, 2004. http://sunzi.lib.hku.hk/hkuto/record/B31967498.

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Chui, Shuk-wah Janet, und 徐淑華. „A study of the public policy on elderly care in Hong Kong“. Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2004. http://hub.hku.hk/bib/B31967498.

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Huang, Song-Lin. „Towards a different mixed economy of care in Taiwan? : public domiciliary care for elderly people living alone“. Thesis, University of Newcastle Upon Tyne, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.289264.

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Deng, Peiqi. „A study on funding for elder care in China“. Thesis, University of Warwick, 2018. http://wrap.warwick.ac.uk/108843/.

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Today, the rapid growth of aged populations is a pressing issue across the globe. In China, longevity risk is also associated with complex social issues consequent on birth control policies in the 1980s, raising the demand for elder care services in recent years. However, the relatively high cost of elder care services creates financial burdens not only for elderly people themselves, but also for their children. While increasing retirement incomes, the Chinese Government has also promoted new forms of social elder care, introducing market mechanisms into public nursing institutions, to increase financial resources for elder care provision. This thesis analyses these new funding models for elder care, examining supply and demand side factors that shape their effectiveness within a theoretical framework of New Public Management (NPM) and social investment. First, case studies are used to compare funding policies in four types of nursing institutions in and around Wuhan, Hubei Province, to evaluate different Public and Private Partnership (PPP) funding arrangements and their consequent influence on the performance of the nursing institutions. Second, Data Envelopment Analysis (DEA) is employed to calculate and compare the elder care services index in urban and rural areas. The outcomes provide insightful and useful guidance to identify probable problems within the elder care funding system. The results reveal that investment is more efficient when dedicated to financing the incomes of the elderly rather than to the construction of elder care institutions. The conclusions propose the feasibility of public long-term care insurance (LTCI) in China, as an appropriate approach to improve elderly people’s retirement income and thus their ability to purchase long-term care (LTC) in the future.

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Costello, John. „Dying in a public place : an ethnography of terminal care for older people in hospital“. Thesis, Manchester Metropolitan University, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.311072.

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Greener, Joe. „The bottom line : an ethnography of for-profit elderly residential care“. Thesis, University of Nottingham, 2011. http://eprints.nottingham.ac.uk/12395/.

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In the last 20 years the UK’s elderly residential care system has become progressively more privatised with an increase in the number of for-profit organisations delivering these services. This study is a participant observation of care work in one privatised elderly residential care home (‘Meadowvale’), owned and operated by a large provider of such services (‘Moonlight Care’). It provides a rich ethnographic depiction of life at Meadowvale both from the point of view of the workers and the residents. The thesis frames these ethnographic findings against pro-privatisation discourses which argue that serious raises in standards of service delivery are to be made from instilling profit motives within social care systems. I argue that there were a series of contradictions which prevented Moonlight Care from both achieving convincing levels of profitability whilst simultaneously improving the nature of elderly residential care. The fact that the revenue received was largely determined by the local government and the distinctive nature of care work inhibited the company from transforming the service for the better. Regulation, although crucial to ensuring that a base level of service quality was ensured, also represented a constraint on any possible restructuring. Greater gains could therefore only be increased through slashing the costs of production and enlarging the economies of scale. Both processes defined the business plan of Moonlight Care. This thesis, therefore, argues that privatisation was incongruent with quality of elderly residential care at Meadowvale. Privatisation led to a form of ‘parasitic’ production where efficiency gains and innovation were absent but business objectives were met by lowering the standards of living for the people who use the service and the wages and working conditions of the people who deliver the service. Cost rationalisation took an extreme form at Meadowvale with repercussions for both care workers and residents. Primarily the ethnographic data looks at the everyday effects of delivering care in this under-resourced labour process. The tasks of care were highly routinised within a system of bureaucratic control which emphasised the physical, “dirty” tasks of care and necessitated that all tasks were recorded. However, the numbers of workers always fell short of the workload leading to widespread falsification in the records. The high intensity of work at Meadowvale embedded various forms of mistreatment, abuse and neglect within the working routine. The system of bureaucratic control also emphasised the physical, ‘dirty’ tasks of care work, leaving little time for relational work. This instituted a particular form of emotional work which emphasised suppressing emotions in order to move from one task to the next as quickly as possible. This was considered problematic for many of the workers who felt that care work should be underpinned by emotional warmth and intimacy. The organisation of care labour at Meadowvale also ran contrary to the regulatory policy discourse which constructed quality care as personalised to each recipient, supporting lifestyle choice and personal preferences. This ‘personalisation agenda’ was a major component of the regulatory framework, but was impossible to implement under the strict routine which permeated care home existence. The responsibility of implementing the personalisation agenda was also constructed in training courses and official documentation as located with the workers, rather than with organisational structures, regimes or motives. This suggests an individualising process in which regulatory authorities and care companies attempt pass the responsibility and risk associated with providing these poorly resourced care services on to each individual worker. The thesis also explores the implications of the system of production in structuring the inequality experienced both by care workers and residents. The process of accumulation at Meadowvale could be described as ‘parasitic’ because profit arises from reducing the cost of production. Two major strategies for reducing expenditure that Moonlight Care utilised was securing a cheap, highly exploitable workforce and reducing the costs associated with care. The search for a cheap workforce has led to the employment of large numbers of migrant workers. Many of the migrant workers at Meadowvale were unable to find alternative employment because their visa’s either tied them to working in the social care sector, or in some cases, specifically to Moonlight Care. I also argue that immigration status supported higher levels of exploitation by denying welfare rights to migrant workers and their families. At the same time the residents at Meadowvale were subject to a system of care which often failed to cater for their needs. Not only were there were few luxuries associated with life at Meadowvale even basic care rights were frequently denied to the residents. During my time at Meadowvale the conditions for both staff and workers seemed to be deteriorating reflecting the endemic problems in the industry. The demand for cheap highly exploitable forms of labour and the denial of basic care rights for the residents can be theorised as interrelated processes connecting to the current system of residential care provision. At Meadowvale, the search for profit did not, as the proponents of privatisation suggest, lead to a system defined by choice, efficiency or quality.

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Frantz, Allison E. „The impact of the growing elderly population on health care“. Instructions for remote access. Click here to access this electronic resource. Access available to Kutztown University faculty, staff, and students only, 1992. http://www.kutztown.edu/library/services/remote_access.asp.

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Thesis (M.P.A.)--Kutztown University of Pennsylvania, 1992.
Source: Masters Abstracts International, Volume: 45-06, page: 2940. Abstract precedes thesis as [1] preliminary leaf. Typescript. Includes bibliographical references (leaves 147-158).

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Hale, Beatrice, und n/a. „The meaning of home as it becomes a place for care : the emergence of a new life stage for frail older people? : a study in the dynamics of home care for older people“. University of Otago. Department of Anthropology, 2006. http://adt.otago.ac.nz./public/adt-NZDU20070402.143208.

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This work is a study of the day to day experiences of older people in receipt of in-home care, the experiences of their family carers, and of their careworkers, resulting in a hypothesis about the structure of the lifecycle towards the end of life, and a consideration of both structured transition and individual transitions to and within this life stage. It has taken off from Laslett�s (1989,1996) seminal work on age divisions, into Third and Fourth Ages. Through an initial examination of secondary sources, I have hypothesized that the older people in this care bracket are in fact in a new life stage, between that of the independent Third Age and the dependent Fourth Age. I call this life stage the stage of 'Supported Independence'. Further references to the secondary sources, and references to the data, have supported this hypothesis, and have shown that there is a structured transition from the stage of independence to that of supported independence. The value of building such a life stage lies in the ability we then have to emphasize the situation of in-home care, bringing to prominence the experiences of the three stakeholders in this care environment. I have used the rites of passage concept to make known the issues involving the move from independence to dependence and those issues predominant in receiving in-home care, in being the carer at such a time, and in being the careworker within the invisibility of home. This has shown a formalized separation from the independent identity, and a prolonged stage of liminality because of an often uncertain form of service delivery. In this liminal stage also are revealed the emotions of living at home with a disability and with care, the improvisatory practices, the passivity and the assertiveness of this time of ageing. By applying this concept also to the family carers, I show the movement of families into and through the caring role, the joy of caring and the difficulties of taking responsibility without authority. I have shown carers� own improvisatory practices, and their determination to maintain the care recipient at home as long as possible. For the careworker, the rites of passage concept shows how she (and the careworker participants in this study are all women), can act to either maintain the liminal position of the recipients or assist in their reconnection to greater autonomy. Exploring the careworkers� own positions by means of the rites of passage concept highlights their inter-structural position between the public and private sectors, and highlights too, the care industry�s position, between that of a time managed industry and a recipient-directed industry. Whether this can be regarded as liminal depends on the philosophies of care adopted by the industry. In summary, the study examines the significance of the place of care, challenging the dominant ideology that home is best, and putting forward for consideration principles of care for other models of service delivery.

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Brodin, Helene. „Does Anybody Care? : Public and Private Responsibilities in Swedish Eldercare 1940-2000“. Doctoral thesis, Umeå : Univ, 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-419.

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Srithamrongsawat, Samrit. „Financial protection and enabling access to care for Thai elderly : the role of public insurance“. Thesis, London School of Hygiene and Tropical Medicine (University of London), 2005. http://researchonline.lshtm.ac.uk/4646522/.

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Improvement of health status and increased access to modem medical care among Thai elderly was apparent during the 1990s. Various factors explained this including improved socioeconomic conditions, availability of services, improved physical access, and expansion of health insurance. Nevertheless, differences in health status and access to care have persisted across socioeconomic groups and geographical areas. Despite the policy of free medical care for the elderly launched in Thailand in 1992, a substantial number of elderly were still uninsured in 2001, mainly among those residing in urban areas. In 2002, a universal coverage (UC) policy was introduced, to include the approximately 18 million Thais not covered by formal public insurance schemes. The UC scheme is tax funded, with a budget allocated to each province according to the number of beneficiaries (who must register for a UC card and at a primary health care unit). The aim of the study was to assess how effectively the UC scheme has been implemented, and performed the functions of financial protection and enabling access to care for the elderly across all socioeconomic groups and urban and rural geographical areas. Both quantitative and qualitative approaches were employed: document review, cross-sectional household survey, in-depth interviews, and focus group discussions. The study site was Yasothon province, one of the poorest provinces in the Northeast of Thailand. The main constraints in UC policy implementation included lack of appropriate health personnel to provide care in primary care units and lack of management capabilities in purchasing services. Registration of beneficiaries was almost 100%. Access to overall ambulatory care was quite equitable and was solely determined by health need. However, less emphasis was placed on services specific to the needs of the elderly. For hospitalization, urban respondents were admitted more frequently than rural respondents. Take-up of UC benefits was high among cardholding beneficiaries especially for hospitalization. A gradient of burden of out-of-pocket payment across income groups existed, due to the relatively high illness amongst the poor, their extremely low income, and the burden of non-medical expenditure. A few individuals experienced catastrophic payments as a result of non medical care expenditure, noncompliance with the requirements for accessing free care, and informal payments. The study concluded that the UC scheme was quite successful in its implementation; however, inequity in out-of-pocket payment remained and income inequity itself played a substantial role. To improve equity of access and financial protection, attention should be paid to primary geriatric care, non-medical care expenditure and physical access, insurance management and human resources, and the broader policy context relating to income inequity.

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Yu, Sek-ho Felix, und 余錫豪. „Planning an elderly dental programme in a public housing estate“. Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1993. http://hub.hku.hk/bib/B31953967.

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D'Arrietta, Louisa, und n/a. „An investigation of the information needs and information-seeking behaviour of general practitioners in their delivery of patient care to the elderly on the Gold Coast“. University of Canberra. Information, Language & Culture, 1994. http://erl.canberra.edu.au./public/adt-AUC20060426.164122.

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The study investigated the self-reported information needs and information-seeking behaviour of 143 general practitioners in their delivery of patient care to the elderly on the Gold Coast. The study sought to obtain an information profile in order to begin discussion on the need for possible infrastructures that may need to be considered in any planning strategies concerned with access to and provision of relevant, accurate and timely information to general practitioners which affects their delivery of patient care to the growing number of elderly patients. A ten-page questionnaire utilising both structured and unstructured questions was returned by 61.9 percent of the survey population. Demographic characteristics indicated that respondents were representative of general practitioners in Australia. Respondents frequently needed information with 40 percent requiring it '1 - 4 times a week' and 78 percent 'once a month or more often'. Information on medical fact was required most frequently, 29 percent, medical opinion 27 percent, and non-medical information 23 percent. The study found support for the proposition that computerised information systems need to be enhanced and made widely known and available to general practitioners to assist them in obtaining information that they need in delivery of patient care to the elderly. There is a great need by these general practitioners for non-medical information as well as medical information. Therefore, the development of a database of non-medical information containing information on local agencies and services is of high priority. Library information delivery services should also be de-institutionalised in terms of lifting restrictions to services provided to enable general practitioners greater access to information. Library services should aim to provide remote access to information via telephone, fax and modem with emphasis on value added services aimed at solving a particular specific information need as well as straight-out bibliographic search services and document delivery services. Continuing medical education in the form of CME courses, conferences and meetings should focus on specific information needs of general practitioners in this area of patient care to the elderly. The need for information on cardiology, orthopaedics, dermatology, physiotherapy, podiatry, pharmaceutical benefits, home help, Meals-on-Wheels and nursing home placement were areas of particular interest identified by respondents in this study.

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Oishi, Matthew Masayoshi. „A national study of dental care delivery and utilization at programs of all-inclusive care for the elderly (PACE)“. Thesis, University of Iowa, 2018. https://ir.uiowa.edu/etd/6481.

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Background: The Program of All-inclusive Care for the Elderly (PACE) is a program of care that enrolls nursing home eligible and offers them community-based long-term services and supports (LTSS). Many PACE enrollees are “dual eligibles” (DEs) meaning they qualify for Medicare and Medicaid services. Dental care is a unique feature of PACE among LTSS, as many LTSS do not include dental care, even though this population has difficulty in accessing these services. However, little is known about the delivery of dental care at PACE and how dental care and oral health promotion and prevention is being integrated into PACE. Thus, the purpose of this study is to describe the delivery and integration of dental care at PACE. Methods: Based on ten preliminary interviews and the PACE manual from the Centers for Medicare and Medicaid Services (CMS), a 56-question survey was developed to describe the delivery and integration of dental care at PACE across the country. In addition, the survey asked programs to rank their focus among five specialties (dentistry, mental health, optometry, audiology, podiatry), to determine if a program’s focus on dental care would influence the delivery and integration of dental services at PACE, and if this would lead the program to have a very high percentage of new and continuous enrollees with regular dental examinations. A publicly available contact list was obtained from CMS and the survey was distributed to all 124 PACE programs via email. Results: Respondents in this study represented 35 programs (28.2%) in 23 states (74.2%). Most programs had no limits for dental care, minimal waitlists, and provide most dental services without exclusions. This is evident by the 51.4% of programs that have no dental budget, 100% of programs providing preventive and basic restorative dental care, and nearly 100% offering advanced restorative services. Many programs also did not have a waitlist for non-emergent dental care. Few programs include a dentist in the routine operations of the PACE program, as evidenced by few programs having dentists conduct the dental assessment for the initial comprehensive assessment or having a dental director. A statistically significant association with a high percentage of reported utilization of dental examinations was detected with programs having a system for quality assurance for dental care (t=0.358, p=0.024), a protocol for a dental cleaning every 6-12 months (t=0.595, p<0.001), mandating a comprehensive dental examination (t=0.390, p=0.007), and providing preventive dental services onsite with built-in equipment (t=0.454, p=0.001). No factors were statistically associated with the focus ranking for dentistry among the other specialties. Conclusion: This study suggests that compared to nursing homes, PACE enrollees may have greater ability to receive dental care without limitations of the state adult Medicaid dental benefit. Dentistry also appears to be a high focus for some PACE programs. This study has begun to identify structures that support positive outcomes that can be used to develop best practices and guidelines for the delivery of dental care in PACE and other LTSS. Future studies are needed to better understand barriers and facilitators to the delivery of dental care and other specialty services.

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Trydegård, Gun-Britt. „Tradition, Change and Variation : Past and Present Trends in Public Old-age Care“. Doctoral thesis, Stockholm University, Department of Social Work, 2000. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-695.

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The general aim of this dissertation is to describe and analyse how public old-age care in Sweden has developed and changed during the last century. The study applies a provider perspective on how care has been planned and professionally carried out. A broader social policy perspective, studying old-age care at central/national as well as local/municipal level, is also developed. A special focus is directed at the large local variation in care and services for the elderly. The empirical base is comprised of official documents and other public sources, survey data from interviews with elderly recipients of public old-age care, and official statistics on publicly financed and controlled old-age care and services.

Study I addresses the development of old-age care in Sweden during the twentieth century by studying an important occupation in this field – the supervisors and their professional roles, tasks and working conditions. Throughout, the roles of supervisors have followed the prevailing official policy on the proper way to provide care for elderly people in Sweden; from poor relief at the beginning of the 1900s, via a generous level of services in the 1960s and 1970s, to today’s restricted and economy-controlled mode of operation.

Study II describes and compares two main forms of public old-age care in Sweden today, home help services and institutional care. The care-load found in home-based care was comparable to and sometimes even larger than in service-homes and other institutions, indicating that large care needs among elderly people in Sweden today can be met in their homes as well as in institutional settings.

Studies III and IV analyse the local variation in public old-age care in Sweden. During the last decades there has been an overall decline in home help services. The coverage of home help for elderly people shows large differences between municipalities throughout this period, and the relative variation has increased. The local disparity seems to depend more on historical factors, e.g., previous coverage rates, than on the present municipal situation in levels of need or local economy and politics.

In an introductory part the four papers are linked together by an outline of the demographic situation and the social policy model for old-age care in Sweden. Trends that have been apparent over time, e.g. professionalisation and market orientation, are traced and discussed. Conflicts between prevailing ideologies are analysed, in regards to for instance home-based and institution-based care, social and medical culture, and local and central levels of decision-making. ’Welfare municipality’, ‘path dependency’, and ‘decentralisation’ are suggested as a conceptual framework for describing the large and increasing local variations in old-age care. Finally, implications of the four studies with regard to old-age care policy and further research are discussed.

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Bradford, Barbara. „Geriatric nurses' attitudes toward caring for the elderly : a replication study“. Virtual Press, 1997. http://liblink.bsu.edu/uhtbin/catkey/1048382.

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The elderly are the fastest growing population in the United States. Nurses' attitudes toward caring for the elderly are a very real concern and may determine nurses' behaviors with the elderly. The purpose of this study was to examine the attitudes of nurses toward caring for the elderly residing in long term care institutions. A modified questionnaire, "Attitudes Toward Caring for the Elderly" was used. A combination of Jean Watson's theory of caring and the Ajzen & Fishbein's theory of reasoned action was the theoretical framework used for the study. Three research questions were asked. Data were collected from 32 registered nurses in four long term care institutions. Results showed that nurses attitudes toward caring for the elderly were positive. There were no significant relationships between demographic and personal data and nurses' attitudes toward caring for the elderly. Full time versus part time employment was a significant predictor of nurses attitudes toward caring for the elderly. The low reliability of the tool (Cronbach's alpha = 0.57) could have contributed to the lack of significant data. The study should be repeated after further development of validity and reliability of the tool.
School of Nursing

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Roquebert-Labbé, Quitterie. „Formal and informal care arrangements for the disabled elderly in France“. Thesis, Paris 1, 2018. http://www.theses.fr/2018PA01E017/document.

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Le vieillissement de la population et la forte prévalence des incapacités qui lui est associée invitent à s’interroger sur les modes d’accompagnement de la perte d’autonomie. Tandis que l’aide reçue par les personnes âgées dépendantes provient majoritairement de leurs proches, les politiques publiques françaises favorisent le recours à l’aide professionnelle, dite aide formelle, pour les personnes résidant à domicile. Cette thèse se propose d’étudier les configurations d’aides formelles et informelles pour les personnes âgées en perte d’autonomie. Sous quelles conditions les individus ont-ils recours à l’aide professionnelle, et comment se détermine leur niveau de consommation ? Comment les producteurs d’aide familiale et professionnelle s’adaptent-t-ils aux contraintes de production qui leur sont propres ? Les quatre chapitres de cette thèse étudient empiriquement ces questions dans le contexte français. Mobilisant le cadre micro-économique et les outils économétriques, ils s’appuient sur des données d’enquête, des données administratives et des fichiers de gestion d’un service d’aide à domicile. Le premier chapitre porte sur l’aide apportée par les enfants à un parent âgé dépendant. Le deuxième chapitre étudie l’élasticité-prix de la demande d’aide formelle. Le troisième chapitre analyse comment le financement public de la demande et la régulation de l’offre affectent la décision de consommer de l’aide professionnelle. Le quatrième chapitre s’intéresse enfin aux coûts de transport des services d’aide professionnelle, comme contrainte de production pesant sur l’organisation de l’offre. Les résultats montrent que la demande d’aide est relativement peu sensible au prix de l’aide professionnelle, tandis que la régulation de l’offre affecte plus notablement les configurations d’aide
In a context of population ageing, the demand for long-term care is rising. While relatives remain the major source of care provision for disabled elderly, most OECD countries tend to foster the use of professional care, also called formal care, when individuals live at home. This thesis studies the determinants of home care arrangements for the disabled elderly in the context of France. What are the determinants of formal care consumption, at both the extensive and intensive margins? How do formal and informal care providers adjust to their provision constraints? The four chapters present original empirical evidence on these questions in the French context. They build on micro-econometric frameworks and use national survey data, administrative data or management ﬁles from a professional provider. The first Chapter studies the care provided by children to a disabled elderly parent. The second Chapter estimates the price-elasticity of the demand for formal care. The third Chapter analyzes how the decision to consume formal care is affected by the generosity of the public financing and the regulation of home care providers. The fourth Chapter focuses on the travel costs borne by home-care providers and their effect on the home care provision. The demand for formal care is found to be fairly little sensitive to its price, while the regulation of the supply is more likely to affect care arrangements

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Robbins, Wendy L. „A Place for Us? Baby Boomers, Their Elders, and the Public Library“. Thesis, Université d'Ottawa / University of Ottawa, 2012. http://hdl.handle.net/10393/20506.

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Canada’s aging population is expected to have an impact on all public institutions; for public libraries, the emergence of a large, multi-generational user group of older adults challenges the current paradigm of services to seniors. This thesis examines a subset of this user group: baby boomer library patrons who are in a caring relationship with elders. It investigates how these patrons interact with the public library both for themselves, and as carers, in order to reveal library-related issues particular to this growing segment of the population. The study takes place within a conceptual framework derived from the ethic of care, and from emerging theories of library-as-place rooted in the fields of human geography and sociology. Using a qualitative instrumental case study method, long form interviews were conducted with respondents recruited through theoretical sampling extended by snowball sampling. While not generalizable, findings suggest that while these baby boomer respondents value their libraries deeply, there is potential to create services and practices more attuned to the needs of older adults who are in relationships with elders.

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Pajalic, Zada. „How public home care officers reason when making a needs assessment for food distribution to homebound elderly persons in Sweden“. Högskolan Kristianstad, Avdelningen för Hälsovetenskap, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:hkr:diva-10530.

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Food distribution (FD) is a part of the public social and care service in Sweden aiming to prevent improper food intake for persons that they are unable to do their own shopping, and prepare their own meals, and in that way ensure reasonable standard of living. Before a person can be granted the FD service, from any municipality, an assessment of their individual requirements has to be made by a public home care officer. The aim of this study was to explore how public home care officers reason when they make a needs assessment for homebound elderly people. The data was collected through individual interviews (n=18). The transcribed interview material was analysed by means of the grounded theory method. The findings showed that the public home care officers were confronted with many challenges when making an assessment of a person’s individual needs. They are influenced by their subjective feelings related to their personal views as to what should be the right solution for the individual. However, they remained aware that they needed to be guided by the legal requirements. Further, they described that the level of an individual’s living standard is a leading concept in the governing laws that they need to interpret. Interpretation of this concept is very subjective with the possible consequence that an assessment result may lead to inefficient support. In conclusion, the concept of a reasonable standard of living needs to be clearly defined, decision regarding FD should not take long time, need assessment and decision should be based on the whole picture behind each individual case and there are needs to develop general guidelines for making needs assessment. The findings in this study have implications for public administration, nursing and gerontology.

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Nilsson, Ebba. „Från ädelreform till LOV : En analys av New Public Management i svensk äldrevård“. Thesis, Malmö universitet, Malmö högskola, Institutionen för globala politiska studier (GPS), 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-43237.

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This thesis analyzes two bills that has led to two of the most extensive health care reforms in Sweden over the last thirty years by using a descriptive idea analysis. The purpose of the thesis is to explore traces of New Public Management in the bills, through the characteristics decentralization, marketization and customer orientation. Results show that traces of New Public Management can be found in both bills, although in various ways. The bill produced in the 1990’s show evidence of decentralization, while the bill produced in the 2010’s show evidence of marketization and customer orientation.

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Assarsson, Camilla, und Maria Hadarson. „Vi gör vad vi vill men det är inte mycket vi kan göra : Om hur organisatoriska faktorer påverkar mellanchefers möjlighet att arbeta med hållbar utveckling“. Thesis, Växjö University, School of Health Sciences and Social Work, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:vxu:diva-2143.

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The group of elderly people in Sweden will increase significantly in the future and science point out that the future elderly people will not accept today’s standards and offers of assistance in today’s public elderly care. Therefore public elderly care stands before a significant challenge in terms of development that has to be sustainable. New research also points out that middle managers can be a great strategic resource, and a founder of success, in the challenge of sustainable development. The aim of the report was to increase the knowledge about what middle managers in public elderly care think sustainable development has to embrace, when it comes to quality and personnel administration, in order to meet the needs of the future elderly people. The aim was also to deepen the knowledge of how formal and informal organizational factors facilitate or limit middle managers possibilities to work with development in general and sustainable development in specific in their units. Interviews, as a qualitative method, were used to gather empirical data and the result was analyzed with theories as Domain theory, New Public Management and Situational leadership. Our findings showed that middle managers have little possibilities to work with sustainable development in their units and that formal factors as budget had a great impact of the middle managers overall possibilities in their work. According to the result it seemed that development and long term planning in this particular organization were tasks mainly for the management and political domain. According to our findings it seemed as if the introduction of New Public Management increased the underlying initial problems of human service organizations. According to Domain theory these problems consists of disjunction, discordance and conflicts due to the differences between the three domains when it comes to principles, success measures, structure and work modes.

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Pednekar, Priti. „The Impact of Medication Adherence on Healthcare Utilization and Costs among Elderly Patients with Diabetes Who Were Enrolled in a State Pharmaceutical Assistance Program“. Thesis, University of the Sciences in Philadelphia, 2019. http://pqdtopen.proquest.com/#viewpdf?dispub=13856162.

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Objectives: This research identified the potential predictors of medication adherence and studied the impact of medication adherence on healthcare utilization and costs among elderly with diabetes who were enrolled in a State Pharmaceutical Assistance Program (SPAP).

Methods: Pharmaceutical Assistance Contract for Elderly (PACE) programs’ database was used to identify study population and estimate medication adherence as proportion of days covered (PDC) for 12-months post-index observation period (adherent: PDC ≥ 80%; nonadherent: PDC < 80%). Healthcare utilization and costs for the study period were estimated using Pennsylvania Health Care Cost Containment Council’s hospital inpatient discharge records. Healthcare utilization measures included all-cause, diabetes-specific, diabetes-related and diabetes-specific & related number of inpatient hospital admissions and length of stay (LOS). Multiple regression analyzes were performed to determine the predictors of medication adherence and to assess the association of medication adherence with risk of hospitalization, hospital service utilization and costs.

Results: Among 9,497 elderly PACE enrollees with diabetes, 81% were adherent and 21% were hospitalized. Race, marital status, number of unique medications and out-of-pocket payment were the significant predictors of medication adherence. The odds of being hospitalized were higher for nonadherent patients by the factor 2.030 than adherent patients (95% CI: 1.784–2.310). After controlling for covariates, non-adherent patients had significantly a greater number of all-cause (IRR 1.2727; 95% CI 1.1937–1.3569), more diabetes-related (IRR 1.2210; 95% CI 1.0492–1.4210) and more combined diabetes-specific & related (IRR 1.2106; 95% CI 1.0495–1.3965) hospital visits than adherent patients. After adjusting for covariates, LOS for non-adherent patients was longer for all-cause (IRR 1.2388; 95% CI 1.1706–1.3111), diabetes-related (IRR 1.1341; 95% CI 1.0415–1.2349) and for diabetes-specific & related (IRR 1.1271; 95% CI 1.0357–1.2267) hospitalization than adherent patients. GLM models showed that medication nonadherence was associated with significant increase in all-cause hospitalization costs ($22,670 vs $16,383; p < 0.0001) and diabetes-related hospitalization costs ($13,518 vs $12,634; p = 0.0003).

Conclusions: Medication nonadherence was associated with an increased risk of hospitalization, greater number of hospital visits, longer hospital LOS and substantial hospitalization costs among elderly SPAP beneficiaries with diabetes. Utilization of our findings to develop interventions or policies to improve medication adherence would significantly impact the US healthcare system particularly while allocating limited healthcare resources.

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Batljan, Ilija. „Demographics and Future Needs for Public Long Term Care and Services among the Elderly in Sweden : The Need for Planning“. Doctoral thesis, Stockholm : Department of Social Work, Stockholm University, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-6787.

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Kraus, Kalle. „Sven, inter-organisational relationships and control : a case study of domestic care of the elderly“. Doctoral thesis, Stockholm : Economic Research Institute, Stockholm School of Economics (EFI), 2007. http://www2.hhs.se/EFI/summary/719.htm.

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Weicht, Bernhard. „Caring as a moral practice : an analysis of the construction of care for elderly people in Austria and the UK“. Thesis, University of Nottingham, 2010. http://etheses.nottingham.ac.uk/1414/.

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This thesis investigates the meaning of care in our societies. Everyone will be concerned with care in some way at some point in his/her life. In the UK and Austria economic and social developments challenge traditional family arrangements while the need for care for the elderly is increasing. But how do we understand care and which meaning does care have for us, for our relationships, for our identities and for our understanding of society? How do we want to live together, and how do we want to experience the process of ageing? Understanding the construction of care helps to understand aspects of people’s ideals, motives, attitudes, imaginations, aspirations and desires in life. This study bridges the theoretical level of broad moral questions and their application in particular situations. Utilising Critical Discourse Analysis in combination with a sample of newspapers and the organisation of focus groups in each country enable an identification of the ‘moral grammar’ of care, i.e. the discourses in which care is constructed. The result is an everyday morality, referring to the way people understand and make sense of their experiences, histories and emotions about care for elderly people. This moral construction situates care in opposition to an economisation and/or individualisation of society. Care reflects an ambivalent desire of people which can be described as being there for each other. By exploring themes such as relationships, home, community, independence and the commodification of care this thesis demonstrates that, on the one hand, moral assumptions and ideals are underlying the organisation of care and, on the other hand, care itself represents an ideal of being moral. This construction has important consequences for all those involved in caring relationships (as carers and as those being cared for) and any policy making needs to be conscious of it.

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Kelly, Grief Mary C. „Utilization of preventive oral health care by Medicaid-enrolled senior adults during their transition from community-dwelling to nursing facility residence“. Thesis, University of Iowa, 2016. https://ir.uiowa.edu/etd/2231.

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OBJECTIVE: To establish baseline data of dental utilization and determine the predictors of receipt of dental procedures by Medicaid-enrolled senior adults who reside in Iowa nursing facilities. METHODS: This was a longitudinal retrospective analysis of Iowa Medicaid claims data for SFY 2007-2014 of senior adults who were 68 years or older upon entry to a nursing facility and continuously enrolled (eligible 58 out of 60 months) in Medicaid for three years prior to and at least two years after admission. RESULTS: Controlling for the subject and nursing facility level variables, the strongest predictor of dental utilization after entry was the receipt of a dental procedure before entry (p< 0.001). Subjects residing in a facility located in an urban area (p< 0.002) or in two regions of Iowa (p=0.035, p=0.019, respectively) also had increased odds of receiving a dental procedure. CONCLUSION: Our results show that approximately 50% of the subjects never received a dental procedure in the 5-year study period. The strongest predictor of receipt of dental procedures in the 2 years after entry was the receipt of dental procedures in the 3 years before entry. It is important for Medicaid-enrolled senior adults to establish a dental home while community-dwelling.

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Guo, Ming. „Making a Market out of a Welfare State : Swedish Local Politicians’ Perspectives on Elderly Care Marketisation“. Doctoral thesis, Linköpings universitet, Institutionen för kultur och kommunikation, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-142342.

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Market reforms have quite notably been used as a solution to increase the quality of public services and efficiency since the 1990s. Sweden has also introduced marketisation in the field of elderly care since 1992 to cope with increasing care needs while maintaining costs at a reasonable level. Yet, the introduction of a market mechanism in the welfare state is subject to increasing political and public debates. Many are sceptical about the purported benefits of a market, such as increased quality and reduced costs, as proposed by New Public Management. There have also been increasing critiques of the profit-making in care services in recent years. After two decades of marketisation, it is worthwhile to map out local politicians’ attitude patterns, namely, how they perceive the use of a market or quasi-market in a welfare state, where the market mechanism might challenge traditional principles such as universalism, solidarity, and equality. Complementary to studies on attitudes of public welfare, this research uses a unique survey dataset from 2014 to expand current understandings of politicians’ perspectives of marketisation. To be more specific, this study analyses three different aspects of marketisation: production, regulation, and financing. The results show that attitudinal differences between left- and right-wing politicians on private for-profit providers remain distinct. Political orientations of individuals, political majority in municipalities, and the privatisation level already achieved locally are identified as important factors in explaining local politicians’ willingness to privatise further. The preference differences continue to exist between the two blocs, and political ideology plays a major role in explaining these differences, more so than individual factors such as age, gender, or working position. Self-reported answers reveal that political ideology influences attitude formation. To a large extent, left- and right-wing politicians agree on welfare principles such as universalism, and they both recognise potential impacts that the market could have on society, such as inequality. It seems plausible that welfare state pluralism is the direction of the future. This case study serves as a solid example for examining the market development of public welfare in advanced welfare states and also contributes to the discussion of the potential role of political ideology in post-austerity welfare reforms.
Marknadsreformer har i ökande grad använts som en lösning för att öka effektiviteten och kvaliteten på offentliga tjänster sedan 1990-talet. I Sverige har också en gradvis marknadsanpassning ägt rum från tidigt 1990-tal med syfte att klara av ökade vårdbehov och för att upprätthålla kostnaderna på en rimlig nivå. Införandet av marknadsmekanismer i välfärdsstaten har blivit föremål för en livlig offentlig debatt. Många debattörer har varit klart skeptiska till de påstådda fördelarna med en marknadsanpassning, såsom förbättrad kvalitet och reducerade kostnader, som bland annat hävdats av New Public Managementskolans anhängare. Samtidigt har också skett en växande kritik av vinstuttagen och vinsttillväxten inom offentligfinansierad vård och omsorg de senaste åren. Efter två årtionden av marknadsanpassning är det motiverat att kartlägga lokalpolitikernas attityder, avseende hur de ser på den ökande marknadsanpassningen av den traditionella välfärdsstaten, där marknadsmekanismen kan utmana principer som universalism, solidaritet och jämställdhet. Förutom tidigare analyser av attityder beträffande offentlig välfärd är denna studie baserad på en unik enkätundersökning riktad till svenska kommunpolitiker genomförd 2014 i syfte att undersöka politikernas syn på de ökade marknadsinslagen inom offentlig äldreomsorg. Studien analyserar tre olika aspekter av marknadsanpassningen: produktion, reglering och finansiering. Resultatet visar att skillnaderna i attityder mellan vänster - och högerpolitiker avseende inslaget av privata vinstdrivande tjänsteleverantörer är mycket tydligt. Individernas politiska tillhörighet, politisk majoritet i kommunerna och privatiseringsnivån identifieras som viktiga faktorer för att förklara lokala politikernas villighet att öka privatiseringsgraden ytterligare. Det finns tydliga preferensskillnader mellan de två blocken och den politiska ideologin spelar en övergripande roll, medan individuella faktorer som ålder, kön eller politisk position spelar en klart mindre roll. Att ideologin är viktig konfirmeras även av politikernas självskattning avseende vilken betydelse olika faktorer har haft för deras attityder. I hög grad finns en samstämmighet mellan vänster- och högerpolitiker avseende välfärdsprinciper som universalism, och både blocken anser att marknaden kan bidra till ökad ojämlikhet i samhället. Det verkar troligt att välfärdsstatspluralismen är riktningen för framtiden. Denna fallstudie kan utgöra ett exempel för studier av marknadsanpassning i offentlig välfärd i avancerade välfärdsstater. Studien kan också bidra till diskussioner om den politiska ideologins potentiella roll för reformer av välfärdsstaten.

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Sulaiman, Noralifshah. „Opportunities for the transfer of United Kingdom best practices for the provision of public residential care facilities for the elderly to Malaysia“. Thesis, University of Salford, 2011. http://usir.salford.ac.uk/26927/.

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By the year 2020, 9.5 percent of the Malaysian population will be aged 60 years and above. To cope with the increase in elderly, the phenomenon of decreasing family size and other demographic and social factors affecting the family structure has resulted in the need for more public residential care facilities for the elderly to take over the traditional responsibilities of families. Therefore, learning from the best providers is invaluable to establish best practice among the providers in Malaysia. Since the early 1920s, the UK provision of Public Residential Care Homes for the Elderly has evolved continuously establishing UK providers with national frameworks and standards of care practice delivery. With this valuable experience, UK practice, debates, and experiments were followed with great interest by other developing countries such as Malaysia. It would be very beneficial if Malaysia could adapt and adopt the provision structure and best practices from the UK that could be transferred into Malaysia. Facilities Management is gaining increasing recognition in many public organisations in the Western world. Facilities Management can benefit an organisation with its integrated Facilities Management practices at Strategic, Tactical, and Operational levels to deliver best value and best practices to the ultimate users, particularly so in the sector of social care services. The desire to improve both theoretical and practical contributions to the current practices in Malaysia, has ignited the aim of this study to seek opportunities for the transfer of UK best practices for the provision of Public Residential Care Facilities for the Elderly to Malaysia. The purposes of the study were a process of identifying best practices in the UK which could be adopted by Malaysian providers. The lines of inquiries were set to first identify Best Practice Approach in both provisions at each level of practice, seeking to determine Barriers and Enablers for Best Practice Transfer, and finally identifying lessons for the improvement of the provision in Malaysia. A range of research methods consisting of Content Analysis; Visual Photography; Participant Observation; Video Documentary; and Expert Interview were employed to acquire a substantial set of data from selected sources of evidence and research settings in the UK and Malaysia. Lessons learned from the study were considered and a range of important findings emerged. Predominantly, the contributions of this study can be seen as a theoretical contribution, as well as practical contribution, that could finally benefit the Malaysian providers of Public Residential Care Homes for the Elderly.

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Jeffrey, Claudeth. „Fall Prevention in a Neurological Care Unit“. ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4296.

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Patient falls are an ongoing concern for health systems in the US and in the setting where this project took place. Inpatient falls affect consumers and health providers because falls often result in patient morbidity and mortality, legal risk, increased length of stay, and increased costs. The purpose of this project was to evaluate the existing fall prevention protocol at the site where this project took place and to make recommendations for an evidenced-based fall prevention protocol. The professional practice model was the conceptual model that guided the exploratory descriptive project. A review of the site's fall prevention policies and procedures revealed a new fall prevention protocol was in place and included bed alarms, and chair alarms to ring on nurses' phones although observation of nurses revealed that there were problems maintaining the protocol the entire day and 66% of patient falls occurred when the bed alarms were not set. The resulting recommendation was for additional education and a bundled approach with nurse education, patient and family education and a fall risk assessment that was easy to use. Nurses were then surveyed before and after education on the current protocol and the Morse Fall Risk (MFRs) to determine their willingness to use the simpler version for fall risk assessment. Before education 18 nurses confirmed they would use the protocol and MFR tool and all 20 agreed to use it after the education session. An implementation of a bundled approach to the fall prevention protocol that nurses incorporate into their daily practice will lead to a positive social change and as a result may increase patient safety by reducing patient falls.

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Bell, Simon Robert. „Housing and hopes: Mowbray's elderly whites and the effects of reforms in South African property legislation“. Thesis, University of Cape Town, 1993. http://hdl.handle.net/11427/23155.

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Coon, Sharon K. „An investigation of two groups of registered nurses comparing attitudes toward the elderly and the ability to differentiate signs, symptoms and interventions with dementia and depression in the elderly“. Virtual Press, 1992. http://liblink.bsu.edu/uhtbin/catkey/845954.

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The purpose of this study was to compare two groups of nurses's attitudes towards the elderly and the knowledge base of the nurses as to signs, symptoms and interventions with depression and dementia in the elderly. The theoretical framework for this study was Oren's (1985) self-care deficit theory. Attitude was measured using the Koan Attitude Toward Old People Scale (Koan, 1961) and knowledge was measured using a scale developed by (Myton, Allen, and Baldwin, 1991).The population studied was registered nurses working at these state hospitals in a midwestern state and agency nurses from four agencies that provide staff coverage at these hospitals. The convenience sample consisted of state nurses (n=65) and agency nurses (n=38). A cover letter explaining confidentiality and voluntary participation was attached to each survey. Completion of the survey constituted consent to participate in the study. There were no identified risks related to participation in the study.The study did not identify significant differences between groups in any of the variables involving attitude toward the elderly, ability to differentiate signs, symptoms, and interventions for dementia and depression in the elderly. Both groups were able to correctly identify signs, symptoms and interventions for dementia and depression about one-half the time. The treatment modalities are different for dementia and depression. The problem is significant because if signs, symptoms and interventions are not identified correctly the patient will not be assisted toward recovery and self-care may decrease. The recommendation for increased inservice education on gerontological nursing are applicable to both groups.
School of Nursing

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Pajalic, Zada, Lena Persson, Albert Westergren und Kirsti Skovdahl. „Public home care professionals’ experiences of being involved in food distribution to home-living elderly people in Sweden : a qualitative study with an action research approach“. Örebro universitet, Institutionen för hälsovetenskap och medicin, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-26232.

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Background: Research focusing on Food Distribution (FD) from various professionals’ and organisational perspectivesare lacking. The aim of this study was therefore to explore various professionals’ experiences of involvement in FD inorder to get comprehensive understanding of the organisation, responsibilities and roles. Methods: This qualitative study is a part of a larger project with an action research approach focusing on FD in themunicipal home service and care for home-living elderly persons in a municipality in southern Sweden. The data wascollected through participatory observations (n=90 occasions and in total 480 hours), repeated focus group interviews (n =4) with different professionals (n =10) involved in the FD process and one individual interview. The material was analysedby qualitative manifest and latent content analysis. Results: The study indicates that Food Distribution is a fragmentary intervention where a comprehensive perspective andclear roles of responsibility are lacking. The FD organisation seemed to be strictly divided and limited by constraintsregarding time and money. The fragmented organisation led partly to staff only taking responsibility for their part of thechain and no one having the full picture of and responsibility for the FD process, but also to some professionals takingmore responsibility than they were supposed to. Conclusions: The aim of the study was met by using an action research approach. The study was however limited by thatno home help officers were represented. The FD appeared as an extremely complex chain of different but connectedactivities. It is not merely the distribution of a product, i.e. the meal box. The fragmentation of FD means that staff onlytakes responsibility for their part of the chain, and that no one has the full picture of or responsibility for the FD process.Consequently, there is a need for an outline of responsibilities. The findings have implications for nursing, gerontology,and in the care for the elderly.

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Le, Sabin De Anna. „An assessment of elderly health care needs and access in three urban San Bernardino communities“. CSUSB ScholarWorks, 2002. https://scholarworks.lib.csusb.edu/etd-project/2320.

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This project was an assessment of elderly health care needs and access. Three urban San Bernardino communities in zip codes 92405, 92410, and 92411 were targeted. The assessment was structured according to King's theoretical construction of community as a multilevel interaction between personal, interpersonal and social systems. The components of the assessment included digital photographs, web-based internet assessments, key informant interviews, and community business visits.

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Maria, Nilsson, und Andrea Perhage. „Chefer inom äldreomsorgen : En kvalitativ studie om chefernas syn på chefskapet i skenet av New Public Management“. Thesis, Södertörns högskola, Institutionen för samhällsvetenskaper, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:sh:diva-30804.

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Inledning: Forskning avseende ledarskap och chefskap består av en djungel av teorier och dess diskurs är splittrad. På 1990-talet skedde kraftiga reformer inom offentlig sektor i syfte att göra den offentliga sektorn mer lik den privata. En ökad grupp av äldre och omfattande reformer har gjort chefernas arbete inom branschen mer komplex. Massmedia har framställt en bild av att äldreomsorgen under 2000-talet har befunnit sig i en stor kris i takt med den ökade privatiseringen och utvecklingen av New Public Management, vilket i sin tur ställer högre krav på cheferna. Syfte: Studien vill skapa förståelse för hur chefer inom äldreomsorgen ser på chefskap respektive ledarskap samt på krav som kan kopplas till deras roll som chefer. Studiens ambition är att ur ett individperspektiv bidra med en större förståelse för de krav som ställs på dagens chefer och komplexiteten i samband med deras chefskap. Metod: Tolkande förhållningssätt med en kvalitativ ansats, där semistrukturerade intervjuer använts för att samla empiri. Resultat/Slutsats: Chefskap och ledarskap som begrepp har genomgått omfattande förändringar. Chefskapet har blivit mer komplext i och med att rollen har förändrats och kraven har ökat. Detta till följd av ökade regleringar och kontroller i sviterna av New Public Management som till stor del kännetecknas av administration. Trots en distinkt skillnad mellan ledarskap och chefskap dras slutsatsen att krav finns på att dessa roller ska samverka och i ökad grad kommer att behöva göra det. Viktiga element i chefspositionen i enlighet med respondenterna är; coachning, motivering och stöttning av medarbetarna vilket motsvarar deras definition av ledarskap. Utifrån detta går det att dra slutsatsen att det idag inte längre räcker att agera som en traditionell chef som styr utan i chefskapet ska också ledarskapet inkluderas.
Introduction: Managership and leadership science is a jungle of theories with a fragmented discourse. Severe reforms during the 20th century was implemented with the purpose of making the public sector more similar to the private one. An increase in the number of elderly combined with several reforms has resulted in more demands put on the management. During the 21st century media portrays a crisis within the geriatric care due to increased privatization and the development of New Public Management which in turn place greater demands on the leaders within this sphere. Purpose: This paper aims to create an understanding of managership and leadership within the geriatric care from a management perspective. The results may contribute to a greater understanding of the demands put on today’s leaders and the complexity related to their managing from an individual perspective. Method: An interpretive and qualitative approach using semi-structured interviews Results/Conclusion: Managership and leadership as a concept has undergone extensive changes. Increased responsibilities and demands has made managership more complex. This is due to increased regulations and controls as a result of New Public Management which in turn has led to an increased number of administrative duties. Despite a distinct difference between managership and leadership the paper concludes that it exists demands these roles should interact and also increasingly will need to do it. According to the respondents essential elements for a manager is: coaching, motivating and supporting of the employees, which represents their definition of leadership. Consequently, it is possible to conclude there is no longer enough to act as a traditional manager which only controls but in managership should also the leadership be included.

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Soyka, Denise. „"Only seeing the numbers and forgetting the people behind" - The influence of New Public Management on elderly care : A country comparison between Germany and Sweden“. Thesis, Mälardalens högskola, Akademin för hälsa, vård och välfärd, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-55164.

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The elderly care sector is facing high demands in the context of demographic change. In regard to the high potential of efficiency increase, the area has been restructured particularly strongly based on principles of the New Public Management (NPM) since the 1970s. This thesis aims to investigate the influences of NPM on elderly care and the effects on care staff and people in need of care by means of a qualitative approach based on a qualitative content analysis. Through a holistic perspective, the role of social work as a profession and possible changes within the welfare state structures of Germany and Sweden is explored. The findings convey a rather negative experience of the impact of NPM and is characterized in both countries by a high degree of privatization, standardization and economization in care. Due to higher workloads and fewer resources, the pressure on staff in care is high. In addition, services for those in need of care are reduced and the quality of care suffers from the staff’s high workload. The objective of care is affected by the implementation of NPM and entails a change in the profession, which needs to be viewed critically based on the results.

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Eriksson, Natalie, und My Stoltz. „"Konflikter bidrar till en levande verksamhet" : En kvalitativ studie om ledarskapets inverkan vid konflikthantering i privat och offentlig äldreomsorg“. Thesis, Linnéuniversitetet, Institutionen för socialt arbete (SA), 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-44529.

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This study is based on interviews with four managers in public elderly care and four managers in private elderly care. The aim of this paper is to examine how these managers are experiencing their leadership in relation to conflict management, and if the managers leadership differs depending on private or public elderly care. Leadership and conflict management are theories that have been used in order to analyze the empirical findings. Previous research that has been used in the study concerns “leadership/leadership styles”, “conflict management”, “to be active in the private/public elderly care”. Social workers often choose to work as a manager in private and public elderly care. The work as a manager is demanding with pressure from several/different parties and the manager faces new challenges. Conflicts are one challenge that mangers faces, and conflicts can be a sensitive topic. The study deals with the complexity that managers in the private and public elderly care faces, mainly based on the leadership role in conflict management. The results show that the interviewees leadership in this study, for the most part can be linked to the situational leadership style, which means that managers believe that leadership adapts to any situation that arises. They also experienced that the private elderly care has higher demands and that there is a bigger responsibility on the individual manger than it is in the public elderly care. There are many different support functions in the public elderly care that managers have the opportunity to take help from daily, that opportunity does not exist in private elderly care.

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Breberg, Sofia, und Caroline Tengberg. „Genomförandeplanen i hemtjänsten : En kvalitativ textanalys av hur individen beskrivs genom planens innehåll och utformning“. Thesis, Stockholm University, Department of Social Work, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-39933.

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The overall purpose with this study was to examine the influence elderly people have over their granted home help. Specifically, the aim was to examine in what extent the image of the elderly as a unique individual emerges in the plans where the home help is described [“genomförandeplaner”]. A plan which is personally designed is used as an indicator of personal influence. A text analysis inspired by Michel Foucault’s discourse concept, was carried out and the study adopts the concepts standardization and categorization as well as the theory of “Sense of coherence”. The result showed that the content of the plans mainly lacks a personal imprint, which is to be understood as a form of standardization. Furthermore, the analysis reveals that the content that is excluded and included creates an image of the elderly as someone who is not a unique individual. This study highlights the value of establishing more salutogenic infused plans. Also other studies, emphasize that elderly in need of care wants to be able to predict and influence the help they receive, which in turn is a condition for the elderly to achieve a Sense of coherence.

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Ropiak, Dariusz J. „A Causal Layered Analysis of Assistive Technology for the Cognitively Impaired Elderly“. Thesis, Walden University, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10975474.

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Assistive technology may delay cognitively impaired elders’ need for long-term institutionalization, and the promote independence. Its use is on the rise, yet the gap between the needs of the cognitive impaired elderly and what developers of the assistive technologies design, manufacture, and implement, remains to be filled. Using Inayatullah’s 6-pillar approach, as the guide to the future of assistive technology, the purpose of this qualitative study was to explore how assistive technologies may fulfill the daily functional needs of the cognitively impaired elderly with Alzheimer’s or other dementia by 2037. Data were collected from a focus group of 10 seniors at a senior center in a large mid-Atlantic city, as well as survey data from with 5 family members of the cognitively impaired elderly and 16 technology developers from an engineering society. These data were coded according to the thematic content analysis and causal layered analysis. The future triangle analysis served as a second layer of analysis. Findings indicated that the most desirable outcome for 2037 is that of the “happy retiree,” characterized by flourishing cultural and financial opportunities, and the least desirable is that of the “struggling pensioner” characterized by monetary gains of the social elite at the expense of the poor and working class. The most expected outcome, though, is the “caring robot” that is characterized by the use of technology and artificial intelligence to promote equitable social and health care benefits to aging citizens. Positive social change may be achieved through recommendations to state, local, and national policy makers that support the improvement in the elders' well-being, the delay of hospitalization, and greater support for the duties of family members, and greater caretaker independence.

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Freitas, Cibelly Aliny Siqueira Lima. „O idoso vÃtima de violÃncia: desafios do sistema de saÃde para o enfrentamento do fenÃmeno“. Universidade Federal do CearÃ, 2011. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=6211.

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nÃo hÃ
No Brasil a representatividade dos grupos etÃrios no total da populaÃÃo em 2010 Ã menor que a observada em 2000 para todas as faixas com idade atÃ 25 anos, ao passo que os demais grupos etÃrios aumentaram suas participaÃÃes na Ãltima dÃcada. Isso demonstra o alargamento do topo da pirÃmide etÃria, onde houve um crescimento da participaÃÃo relativa da populaÃÃo com 65 anos ou mais, que era de 4,8% em 1991, passando a 5,9% em 2000 e chegando a 7,4% em 2010 (IBGE, 2011). Os dados demogrÃficos mostram a necessidade urgente de mudanÃas que resultem na efetivaÃÃo das polÃticas pÃblicas de atenÃÃo ao idoso, especialmente Ãquele vitima de violÃncia, pois este agravo tem se destacado no processo saÃde e adoecimento desta populaÃÃo. Diante dessa realidade, desenvolvemos esta pesquisa com o objetivo de compreender o modelo de atenÃÃo Ã saÃde do idoso vÃtima de violÃncia no sistema de saÃde de Sobral, CearÃ, considerando os princÃpios da integralidade. Para tanto, realizamos um estudo compreensivo, de natureza qualitativa com profissionais que representam os segmentos gestÃo e atenÃÃo no sistema de saÃde de Sobral, CearÃ, Brasil, constituindo-se de seis coordenadores da gestÃo colegiada, seis enfermeiros e cinco agentes comunitÃrios de saÃde. As informaÃÃes foram coletadas no perÃodo de outubro/2010 a marÃo/2011 atravÃs da tÃcnica do CÃrculo HermenÃutico DialÃtico (CHD) adaptado por Oliveira (2007) e submetidas Ã anÃlise do discurso. Esta pesquisa incorporou os princÃpios da BioÃtica, conforme ResoluÃÃo 196/96 do Conselho Nacional de SaÃde. Os resultados evidenciaram que o sistema de saÃde de Sobral apresenta um modelo de atenÃÃo ao idoso vÃtima de violÃncia que conhece o fenÃmeno e o reconhece como uma realidade que se intensifica no municÃpio de Sobral, CearÃ, apresentando as mais diversas formas de maus-tratos. Esta atenÃÃo aparece negligenciada, nos discursos dos depoentes porque o sistema nÃo atende o idoso na sua totalidade, denunciando dificuldades na operÃncia do princÃpio da Integralidade. Considerando o contexto situacional do idoso que sofre violÃncia em Sobral, o modelo de atenÃÃo Ã saÃde impresso nos discursos dos profissionais e as diretrizes do Estatuto do Idoso, PolÃtica Nacional de SaÃde da Pessoa Idosa e Pacto pela SaÃde, observamos que as polÃticas estudadas sÃo contempladas apenas parcialmente, tendo, o municÃpio, um percurso desafiador para trilhar, no sentido de dar respostas efetivas e eficazes Ãs demandas e necessidades de saÃde da populaÃÃo idosa.
In Brazil the representativity of the age groups in the total population in 2010 is lower than that observed in 2000 for all groups aged up to 25 years, whereas the other age groups increased their participation in the last decade. This demonstrates the widening at the top of the age pyramid, where there was a participation increase relative to the population aged 65 years of more, which was 4.8% in 1991, rising to 5.9% in 2000 and reaching 7.4% in 2010 (IBGE, 2011). Demographic data shows the need for urgent changes that result in the execution of public policies for elderly care, especially those victims of violence, as this aggravation has been highlighted in the health and sickness process of this population. Facing this reality, we developed this survey with the objective of understanding the health care model of the elderly victim of violence in the Health System of Sobral, Ceara, considering the principle of integrality. For which, we performed a comprehensive study, of qualitative nature with professionals who represent the management and care segments in the health system of Sobral, Ceara, Brazil, composed of six coordinators from collegiate management, six nurses and five community health agents. The information was collected in the period from October 2010 to March 2011 by means the Hermeneutic Dialectic Circle (HDC) technique adapted by Oliveira (2007) and submitted to speech analysis. The study incorporated the principles of Bioethics according to Resolution 196/96 from the National Health Council. The results revealed that the health system in Sobral presents a care model to the elderly victim of violence that acknowledges the phenomenon and recognizes it as a reality that is intensified in the city of Sobral, Ceara, presenting the most diverse forms of ill-treatment. This care appears neglected, in the speeches from the deponents on why the system does not attend the elderly in its totality, denouncing difficulties in the operance on the Integrality principle. Considering the situational context of the elderly that suffer violence in Sobral, the health care model defended in the speeches from professionals and the directives of the Elderly Statute, National Health Policy of the Elderly and Health Pact, we observed that the policies studied are only contemplated partially, leaving, the city, a challenging task to lay the way, in the sense of providing effective and efficacious answers to the demands and needs for the health of the elderly population.

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Pham, Tuyet, Hannes Skanung und Ida Söderman. „Sjukt omhändertagande : En studie om sjukfrånvaron inom den kommunala äldrevården“. Thesis, Linnéuniversitetet, Institutionen för organisation och entreprenörskap (OE), 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-35296.

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Titel: Sjukt omhändertagande - en studie om sjukfrånvaron inom den kommunala äldrevården Författare: Tuyet Pham, Hannes Skanung och Ida Söderman Handledare: Kjell Arvidsson Kurs: Företagsekonomi III - organisation, examensarbete (kandidat) Syfte Vårt syfte med denna uppsats var att undersöka om den generellt höga sjukfrånvaron inom äldrevården i kommunal sektor har en organisatorisk koppling. I samband med uppsatsens syfte ställdes följande forskningsfråga: vilka organisatoriska faktorer bidrar till sjukskrivningarna inom den kommunala äldrevården? Metod Denna studie är både en kvalitativ och kvantitativ studie som antagit en abduktiv ansats. Studien går under undersökningsdesignen fallstudie där det empiriska materialet består av en enkätundersökning samt kvalitativa intervjuer. I enkätundersökningen deltar 56 medarbetare och på intervjuerna deltar nio anställda på sex avdelningar under tre enheter. Slutsatser Den empiriska och teoretiska datainsamlingen resulterade i slutsatsen att den generellt höga sjukfrånvaron inom den kommunala äldrevården har en organisatorisk koppling. Organisatoriska faktorer som vi anser påverkar sjukfrånvaron inom den kommunala äldrevården är olika uppfattningar om ansvaret för arbetsuppgifter, låg bemanning, graden av gemenskapen i olika arbetsgrupper och frånvarokultur. Vi menar även att dessa organisatoriska faktorer påverkas av strukturella faktorer som ligger utanför organisationen. Ett exempel på detta är det långsamma vårdsystemet.
The purpose of this study was to analyze if the sickness absence in the public elderly care is due to organizational elements. This study is based on the research question: What organizational elements contribute to the sickness absence in the public elderly care? Method This thesis is based on a qualitative and a quantitative research and presumes an abductive approach. The empirical study consist a survey with 56 employees and interviews with nine employees in six departments within three units. Results The empirical and theoretical study has contributed with the result that the sickness absence in the public elderly care is due to organizational elements. Organizational elements, which are affecting the sickness absence, are different views on responsibility of work tasks, low staffing, the degree of community in various working groups and absence culture. These organizational elements are also affected by structural elements in the external environment. An example of this is the inertial healthcare system

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Carlsson, Julia, und Jennifer Mattsson. „Lean i äldreomsorg – en cylinderformad kloss i ett fyrkantigt hål? : En fallstudie om huruvida lean är en passande modell för svensk kommunal äldreomsorg“. Thesis, Linköpings universitet, Företagsekonomi, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-131072.

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Managementmodellen lean uppstod i bilindustrin men har applicerats på helt andra typer av branscher, varav offentlig sektor är en av dem. Tidigare forskning visar att lean applicerat på offentliga tjänster passar bättre när tjänsten är av mer homogen karaktär såsom sophantering och parkförvaltning. Ändå visar en kartläggning av lean i Sverige att flest kommuner har implementerat lean inom äldreomsorg - vilket är en heterogen tjänst med höga krav på individanpassning. Syftet med den här fallstudien är att undersöka om lean således är en passande managementmodell för kommunal äldreomsorg. Baserat på sju intervjuer i två svenska kommuner har studien utgått från vad som påverkar kommuners möjlighet att arbeta lean på en filosofisk nivå (lean thinking). Resultatet visar att lean thinking i sin helhet inte är passande för äldreomsorgen, vilket framför allt beror på att offentliga verksamheter utöver brukaren ser socialnämnden och skattebetalare som kunder, vilket försvårar arbetet med lean som utgår från värde enligt kundens perspektiv. Däremot visar verksamheterna att de genom att arbeta med lean framförallt förbättrar processer som inte involverar brukaren, exempelvis administration och förråds- och tvätthantering. Det frigör tid till värdeskapande aktiviteter för brukaren. Vi finner också att myndigheten som reglerar svensk äldreomsorg möjliggör för lean-inspirerat arbete inom äldreomsorg, framför allt på grund av arbetet med att utgå och anpassa tjänster till de faktiska behoven för brukaren istället för att begränsas till det redan befintliga tjänsteutbudet.
Lean was first seen in the automotive industry but has since then been applied to a number of different industries, whereof the public sector is one of them. Previous research has shown that lean has a better fit with services when applied to homogeneous services like waste disposal and maintaining parks. Yet an overview of lean in Swedish municipalities has shown that the most frequent use of the concept lean is in elderly care - which is categorized as a heterogeneous customized service. The aim of this case study is to examine the fit between lean and municipal elderly care. The study has investigated what determines the ability of adopting lean thinking based on seven interviews in two Swedish municipalities. The results show that the whole concept of lean thinking cannot be applied, primarily because of the complexity of the customer concept in the public sector. The interviewees identify several customers apart from the end-user of the service. The fact that tax payers and the social welfare board also are considered customers hinders the work with lean, since their interests may diverge from that of the end-user. However, by using lean tools, processes without involvement from the end-user have been improved, for instance services like administration, laundry and storage management. In turn, these improvements made time for value creating activities for the end-user. The results also show that the Social authority regulating the Swedish municipal elderly care, actually enables an approach inspired by lean. This is primarily due to the development towards a service production based on the actual needs of the end-user rather than being limited to the existing services.

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Andersson, Malin. „Valfrihetssystem enligt LOV : Ur ett biståndshandläggar- och organisationsperspektiv“. Thesis, Linnéuniversitetet, Institutionen för samhällsstudier (SS), 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-36692.

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Sweden has one of the best elderly cares in Europe and the Swedish care work is also one of the best in terms of quality, compared to other European countries. In recent years, higher demands have been set on the care work and the number of privatizations of public services has increased. In 2009 a new law came into force, the Act on System of Choice (LOV) which increased individual’s right to a greater participation and a free choice in the selection of health and social care providers. This paper aims to highlight the impact of the law, system of choice. By using the method of qualitative surveys and interviews with care managers, and an exploration of relevant studies and reports, I was able to complete this study. With institutional theory and other sociological concepts such as isomorphism and street-level bureaucracy, I made an analysis of both the care managers and also at an organizational level. In the conclusions I argue that the system of choice has had a greater impact at an organizational level rather than on the care managers. The paper also highlights the fact that the knowledge of processes of implementation and political governance has had a significant role. The three main issues are how the law has influenced care managers work, how organizations have changed, how and if the active choices work in practice.

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Lindström, Linda. „The structuring of management control in Swedish home care units : An explorative discourse study“. Thesis, Umeå universitet, Företagsekonomi, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-103776.

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Background. The research on management in Swedish home care has been conductedmainly from sociological perspectives where structural conditions have been of interest (see for example Hagerman et al., 2013; Andersson, 2014; Österlind, 2013). The conditions impacting on management are described as differing ideals where the main ideals are the care perspective and the cost perspective (see for example Andersson, 2014; Österlind, 2013). The conflict between ideals create tensions between ideology and practice and different expectations (Antonsson, 2013) and may also create problems, dilemmas and paradoxes (Österlind, 2013). The rules impacting on the home care activities are bureaucratic rules stemming from the state and municipality. However, Trydegård (2000) argues that at the same time there is room for autonomy and path-dependence in the home care units. Purpose and research approach. There seems to be a lack of studies on management control in home care, and more especially no study combining a discourse, structures and theories on management control. The purpose of this thesis is to explore management control in home care in the relation between structures and managers’ interpretative repertoires in a social-constructionist perspective. The purpose is also to create a prototype model for further research. The ontological positioning and theoretical framework are building on Giddens’ structuration theory (1979, 1984) in which structures are seen as both the medium and outcome of social interaction and rules are important. The units of analysis are the managers’ accounts on management control in semi-structured interviews. The accounts are analysed in a so called case cluster analysis (McClintock et al., 1979) in the software program NVivo. The codes are building on Ouchi’s theory of management control (1979) as ‘input control’, ‘behaviour control’, ‘output control’ and ‘clan control’, and also building on Giddens’ structuration theory (1978, 1984) defined as 8 characteristics of rules, ‘normative sanctions’, ‘signification of meaning’, ‘authoritative’ or ‘allocative resources’. Findings. The findings reveal that home care is highly bureaucratic in input and output control by the use of formal rules stemming from municipality or state. In behaviour control home care has a medium-low degree of bureaucracy if exercised through ‘signification of meaning’ and medium-high when exercised through ‘authoritative resources’. In clan control home care has a low degree of bureaucracy and can either be positive or negative depending on how informal leaders in the unit impact on cooperation between care personnel and if there is trust and a good communication between manager and care personnel. Two main patterns of structuration appear: creation of structures for an efficient process flow of home care to increase efficiency, and co-creation of new rules for behaviour to increase cooperation. Managers focus on different situations of management control depending on conditions in the home care unit and own interpretations. Two interpretative repertoires are identified; the discourse on hard matters is created in relation to matters that are more rigid in structure, such as legislation and municipal goals and that are difficult to interpret differently, whereas soft matters are created in discourse around dilemmas and human or relational aspects of control.

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Freitas, Adriana Valéria da Silva. „Por trás dos muros: um estudo sobre a vida de idosos em Instituição de Longa P ermanência“. Programa de pós-graduação em saúde coletiva, 2009. http://www.repositorio.ufba.br/ri/handle/ri/10322.

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Este estudo discute a vida de idosos em uma instituição de longa permanência, no contexto da sociedade moderna. O asilo é uma possível alternativa para garantir segurança e cuidado ao idoso. No entanto, esse espaço, que abriga a velhice, torna-se um problema social e de saúde, à medida que se transforma em lugar de segregação, estigma e preconceitos, emergindo situações que facilitam a ocorrência de violências contra o idoso. Vários aspectos vão se agregando para a construção da ambigüidade presente na função social do asilo. Dentre eles, o preconceito histórico sobre viver nesse tipo de instituição permanece, apesar dela procurar acompanhar as mudanças sociais. Analisando as diferenças de gênero, condição social e gerações os objetivos do estudo foram: identificar as razões que levaram os idosos a viver no asilo, observando os laços sociais feitos e desfeitos ao longo do curso da vida; analisar as relações e cuidados dispensados aos idosos pelos profissionais da instituição; discutir sobre as relações interpessoais, com foco nas disputas e competições entre eles no cotidiano e identificar as expressões de violência presentes na vida dos idosos. Para tanto, nos apoiamos em teorias sociais, explorando o conceito de ambigüidade, que pode ser compreendido tanto em relação à instituição asilar quanto ao significado da velhice na sociedade moderna. Para analisar o corpus do estudo usamos a análise de conteúdo além de instrumentos de avaliação em saúde coletiva da estrutura familiar (familiograma) e das relações interpessoais dos idosos entrevistados (ecomapa). Os resultados apontaram que o asilo estudado permanece, ainda hoje, com o discurso da caridade e que a opção de os idosos morarem na instituição foi, em alguns casos deles próprios apesar de que por trás dessa opção encontram-se conflitos e desentendimentos familiares. A convivência entre os idosos é marcada por encontros e desencontros, brigas e casos de agressões físicas, configurando situações de violência nas relações interpessoais. Além disso, constatamos que o cuidado prestado ao idoso na instituição destacou-se como importante vertente para observarmos a presença (ou não) da violência contra idosos. Assim, o asilo pode ser uma alternativa de vida para idosos na sociedade atual, mas que, fundamentando-se apenas na caridade e na filantropia, não garante ao idoso viver uma velhice saudável.
Salvador

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Wallin, van Doesburg Hugo, und Li Houman. „Enhetschefens yrkesroll inom äldreomsorgen : En kvalitativ intervjustudie om enhetchefers yrkesroll inom äldreomsorgen i förhållande till New Public Management“. Thesis, Linnéuniversitetet, Institutionen för socialt arbete (SA), 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-101188.

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Background: In Swedish elderly care, New Public Management (NPM) can be identified in several different ways, for instance it has entailed changed control principles with an increased element of various standardized instruments. Another important feature is that political governance has become increasingly decentralized. The unit managers within elderly care are the professional group that to a large extent has the responsibility to implement various changes. For unit managers, this means a complex professional role with a responsibility for the staff and their work environment, the budget and the realization of the organization's overall goals in practice. Hence the unit managers' professional role often entails conflicts of loyalty between competing interest on different levels in the organization. Purpose: The purpose of the study is to investigate how the unit manager's work processes and professional role in a medium-sized municipality can be understood in relation to NPM. Methods: The study was conducted through individual interviews with eight unit managers in elderly care. Respondents were recruited through e-mail, all respondents worked in the same medium-sized municipality. The interviews were conducted using an interview guide. We used a qualitative empirically driven thematic analysis method to categorize our data. In our analysis we implored a deductive approach, using several concepts from a critical perspective in relation to NPM. Results: Unit managers' professional role in elderly care in the chosen municipality is largely characterized by budget, administrative work and a lot of time is devoted to evaluating different key figures. Thus, the way in which the professional role of unit managers and elderly care in general is organized, managed, and evaluated in the municipality we studied can be understood as a form of NPM. The position of unit managers is an intermediate position between the organization, staff, caregivers, and relatives. Unit managers are faced with many demands from management, from caregivers and from relatives. The biggest challenge both in the present and in the future is the recruitment of educated and experienced staff.

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Rostamian, David, und Julius Peter Odwar. „Äldres upplevelser av kvalitet på särskilda boenden“. Thesis, Södertörn University College, School of Business Studies, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:sh:diva-2751.

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Old people's life situation when receiving municipal help and care in theirlast period of life is sparsely investigated from their own perspective. Thepurpose of this study was focused on the thoughts of the aged people andtheir personal experiences on what quality is within the geriatric care. Inthis qualitative study, 10 elderly people aged 75-90 years wereinterviewed from 3 different nursing homes within Solna Municipality.Qualitative interviews, with the emphasis on their present life situationespecially what brought about a good life, were performed. The interviewswere analysed using qualitative content analysis. The implication of theterm “meaningful existence” is individual and differs from person toperson. This study has identified six categories that could lead to ameaningful existence for the elderly living in nursing homes. These were:to feel secure, maintaining self determination, maintaining relations, to berespected, to feel comfort and to be active. In conclusion it was found thata meaningful existence, what ever it may be to the single individual, isimportant the quality of life for the elderly person residing in nursing homes.

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Zanteré, Rebecca, und Bo Svensson. „Omsorgsgivares känsla av sammanhang inom äldreomsorgen i skuggan av New Public Management : En kvantitativ studie i socialt arbete“. Thesis, Linnéuniversitetet, Institutionen för socialt arbete (SA), 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-90567.

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This study is about the upcoming challenge Sweden face with a population that grows older and in need of elderly care. The challenge lies in that municipality, as it is today, won’t have the personnel to care for the elders. The study presents two problematic factors that need change for the municipality to be able to guarantee reasonable living standards according to social laws. The first factor is the decreasing profession attractiveness that makes it hard to employ personnel. The second factor, which the study focuses on, is the fact the caregivers are overrepresented in the social insurance office statistics of personnel on sick leave. We choose to focus on the caregiver’s work environment to get a perspective on the problem. To be more exact the study focuses on finding a covariance between experienced New Public Management and Sense of coherence. Our second focus is to see if there is an underlying relation between the experienced New Public Management reforms and the three parts of Sense of coherence; meaningfulness, comprehensibility and manageability. A third focus is to see if the relationship is influenced by the caregivers’ age and work experience. Our main findings are that experienced New Public Management has both positive but mainly negative effect on caregivers’ sense of coherence and therefore on caregiver’s health. Our conclusion is therefore that New Public Management can be seen as a factor for care givers high ratings in the social security offices statistics over sick leave from work.

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Oliveira, Aline Azevedo de [UNIFESP]. „Conhecer para intervir: educação em saúde para cuidadores informais de idosos no Programa de Atenção à Saúde do Idoso – Envelhe-Ser – na cidade de Varginha/MG“. Universidade Federal de São Paulo (UNIFESP), 2009. http://repositorio.unifesp.br/handle/11600/9247.

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O presente estudo justifica-se diante da rápida mudança do perfil demográfico brasileiro, com o aumento do número de idosos e, conseqüentemente de seus cuidadores, expondo o despreparo do setor público a esta nova realidade, sendo necessária a adoção de medidas que possam combater iniqüidades e desenvolver ações sob um olhar multidimensional. Além disso, a literatura aponta a importância de capacitação de recursos humanos para a assistência dessa população, tanto no âmbito profissional como no domiciliar, e a carência de um consenso sobre a educação de cuidadores e pouca produção sobre os programas na área de saúde do idoso. Nesse sentido, este trabalho procura investigar o processo de educação em saúde para cuidadores de idosos no Programa de Atenção à Saúde do Idoso – ENVELHE-SER - em Varginha - MG, apresentando assim a importância de se conhecer as reais necessidades dos cuidadores e os desafios enfrentados pela equipe multiprofissional central, visando a proposta de diretrizes para elaboração e implantação de grupos de atenção e apoio para cuidadores de idosos informais.. Neste contexto, a pesquisa tratou-se de um estudo quantitativo/qualitativo com foco no processo de educação em saúde para cuidadores de idosos, sob a ótica da equipe multiprofissional central e dos cuidadores de idosos inseridos no Programa de Atenção à Saúde do Idoso – ENVELHE-SER – na cidade de Varginha - MG. Para tanto, optou-se pela aplicação da entrevista semi-estruturada aos cuidadores informais de idosos compreendendo questões que possibilitaram conhecer o perfil dos idosos dependentes e cuidadores, a provisão de cuidados e a educação em saúde desenvolvida pelo programa. Posteriormente, utilizou-se a técnica de grupo focal com os profissionais da equipe do programa, conhecendo sob a visão deles a educação em saúde para cuidadores de idosos. Após a análise de dados, foi possível propor diretrizes para os grupos de atenção e apoio aos cuidadores de idosos a partir de 3 diretrizes referentes aos próprios cuidadores de idosos, aos profissionais de saúde envolvidos e as estruturas do setor público para tanto.
The study justifies itself due to the rapid change of the brazilian demographic profile caused by the increase of the elder’s population and additionally its caretakers, exposing the public sector’s lack of skills to tackle this new reality, being necessary the assumption of measures which can fight unfairness and develop actions under a multidimensional viewpoint. Moreover, the literature points out the importance of human resources qualification to look after that population either in the workplace or in their homes, the lack of agreement about the caretakers education and the low production of programs of elder’s health care. In this regard, this assignment investigates the education for elder caretakers of the Elder’s Health Care Program – ENVELHE-SER – in Varginha/MG, presenting the importance of knowing the actual caretakers’ needs and the challenges faced by the multi professional central crew aiming the proposal of policies for creation and implantation of attention groups and support for the informal elder’s caretakers. In this context, the research consists of a quantitative/qualitative study focusing on the process of the health education for elder’s caretakers under the point of view of the multi professional central crew and the elder’s caretakers of the Elder’s Health Care Program – ENVELHE-SER – of the city of Varginha/MG. To achieve it, a semi structured interview was applied to the informal elder’s caretakers which consists of questions that allowed to disclose the profile of the dependent elders and caretakers, the care provision and the process of health education of the program. Furthermore, the focal group technique was applied by the program crew professionals which allowed knowing their outlook on health education for elder’s caretakers. After data analysis it was possible to draw policies for the attention groups and give support for the elder’s caretakers from 3 proposals referred to the elder’s caretakers themselves, to the healthcare professionals in question and to the public sector structures required.
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BV UNIFESP: Teses e dissertações

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Lakomaa, Erik. „The economic psychology of the welfare state“. Doctoral thesis, Stockholm : Economic Research Institute, Stockholm School of Economics (EFI), 2008. http://www2.hhs.se/efi/summary/774.htm.

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Kwhali, Josephine. „The faithful few? : what can social work learn from the stories of African Caribbean Christian elders?“ Thesis, University of Sussex, 2012. http://sro.sussex.ac.uk/id/eprint/43281/.

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This thesis considers how Christianity shapes the lives, beliefs and identities of African-Caribbean elders. The topic has been selected because the relevance of the Christian faith to black elders has been under theorised in U.K. anti-racist social work literature. The study is located within a qualitative research tradition and draws upon narrative, ethnographic and life story influences. The research is primarily based on semi-structured interviews with fourteen participants aged seventy one – ninety years. The elders were born and raised in the Caribbean and now live and attend Pentecostal and Baptist churches in London having migrated to the U.K during the 1950's and ‘60's. The interview data is analysed using the voice centred relational method (Gilligan 1982). This method gives primacy to the words of the people being interviewed and the meaning ascribed to their experiences. A number of core themes or ‘stories' emerge from the elders' accounts of their lives and religion. These include the story of growing and belonging, the story of rejection and pain, the story of resistance and faithful compliance and the story of love, care and eternal hope. The stories reveal a complex picture where racism and rejection has been part of the tapestry of black elders' adult experiences in the U.K. Equally, their religious upbringing in the Caribbean and their enduring Christian belief has nurtured the elders' sense of identity and self worth and provided a buttress against their more negative experiences. The study draws upon black theology which aids understanding of how Christianity has influenced the history and religious experiences of black Christians. Black theological literature, along with transactional analysis, also provides the theoretical framework through which the elders' stories are discussed. This approach provides originality as such analysis does not appear to have been undertaken previously. From the elders' stories five key themes have emerged which provide insights in to the research question. These are: - the importance of the elders' Christian belief; - narratives as an integral part of black history and knowledge; - dealing with racism and its intersections; - reconciling differing religious and social values- the challenge for social work; - the care needs of African-Caribbean elders – church, family and / or state? Through these themes the study outlines the necessity of social work embracing a more holistic approach to the meeting of African – Caribbean elders' spiritual and religious needs and beliefs. The elders recognise that they may require practical help as they get older but do not feel that social care services will necessarily be responsive to their religious and cultural experiences or provide for the pray life, bible reading and church attendance that form part of their needs. The concept of heaven and an afterlife is very important to the elders and poses a challenge in how social work might work in partnership with church communities to ensure that elders have the ‘good life/ good death‘ they seek. The study makes a number of recommendations whilst questioning whether a largely secular profession will be equipped to provide or commission appropriate, faith based care to African-Caribbean elders. This is because of the largely hostile / indifferent approach towards religion which the study identifies. The final chapter evaluates the strengths and weaknesses of the study and its methodological approach before concluding with a number of personal reflections.

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