Objectives: To contribute to furthering the understanding of how people with mild Alzheimer's disease (AD) reason about physical activity as part of everyday life, with a specific focus on the meanings attached to such activity.
Method: In-depth interviews were conducted with 14 individuals with mild AD. Qualitative content analysis was used to interpret the data.
Results: The analysis revealed three sub-themes reflecting interrelated perspectives on how people with mild AD reason about physical activity: (1) striving to be physically active, mirrors the concrete approaches used for handling the consequences of having AD in relation to being active; (2) perceptions of physical activity, reflect how their thoughts and beliefs regarding written and tacit norms encouraged them to remain physically active, and (3) physical activity as a means to well-being, alludes to feelings and emotions related to the performance of physical activity. Interpretation of the underlying patterns in these sub-themes revealed one overarching theme: Physical activity as a means to selfhood maintenance, which suggests that physical activity can help to shift the focus from the dementia diagnosis (i.e. ill health) to a more healthy and able self.
Conclusion: The findings suggest that physical activity, apart from maintaining body functions, can be a way to sustain well-being and selfhood in mild AD. This aspect of physical activity is important to consider in research, policy and practice when addressing the needs of people with dementia.
Late in life immigrants are often at risk of psychological stress and social isolation because of language problems, small social networks, and cultural differences from the host society. Community intervention programs can reduce such stress and isolatio
The globalisation of international migration is challenging social work practice in general and elder care in particular all across Europe. This article gives insight into social work practice with elderly people in Sweden by focusing on older migrants and their families. The article addresses the changes that Swedish elder care has undergone through the past few decades and how elder care is organised. The cases of two migrant families who care for their elderly relatives are described also in an attempt to draw attention to some of the specific challenges that social work practice with older migrants and their families can pose. The article argues that social work practice with these specific populations needs to become aware of the implications that understandings of ethnic 'Otherness' have for how elder care is planned and provided. Moreover, it is argued that the globalisation of international migration we are witnessing across Europe and the ethnic diversity in older populations that it brings about demand that social work is delivered in a more generationally aware way. Aiming to solely increase the social integration of older migrants can end up jeopardizing the social and economic integration of their families.
Artikeln diskuterar den ökande internationella migrationens utmaningar för äldreinriktat socialt arbete. Konkret undersöks erfarenheter hos äldreomsorgens biståndshandläggare gällande att möta sent-i-livet-invandrare som önskar anhörigomsorg med betalning genom anhöriganställning eller kontantbidrag. Biståndshandläggarna erfar situationer där de i rollen som myndighetsutövare upplever sig sakna såväl kunskap som resurser att hantera sådana önskemål.
Research on care managers' experiences of the needs assessment process is scarce even though the literature on needs assessment practice is relatively extensive. One of the research areas that has not received attention yet is the way in which care managers experience the challenges that are presumably posed by increased ethnic, cultural, linguistic and religious diversity among prospective elder care recipients. This article addresses this research gap. It is based on a project that aims to shed light on care managers' experiences of the needs assessment process in general and cross-cultural needs assessment meetings in particular. The data are constituted of focus group interviews with care managers in Sweden (N=60). In this article we focus on care managers' experiences of needs assessment with older people who have immigrated late-in-life, who come from cultures considered different from the Swedish one and who have not mastered the Swedish language. This was the group of older people that the care managers mostly thought of when asked to describe their experiences of cross-cultural needs assessment meetings. The interviewed care managers discussed the challenges that these meetings present, which were related to communication due to language barriers, different demands and expectations, insecurity regarding what is customary in such meetings, as well as perceived passivity among late-in-life immigrants. The article discusses the contributions of the findings to research on care management practices in general, as well as to needs assessment practice in particular.
This article contributes to the debate on dependence and independence through a study of how a group of 29 cognitively healthy Swedish home-help care recipients between the ages of 77 and 93 perceive their situation. Two overall themes with regards to how the constructs of dependence and independence are understood were found. One of them concerns how being in need of help can be justified (i.e. the why of receiving help) and the other how the very situation of being in need of help and care can be regarded (i.e. the how of receiving help). The study reveals a clear distinction between receiving help and care and feeling dependent, as well as between receiving help and care and being able to remain an active agent. On the basis of these findings we argue for the fruitfulness of distinguishing between ‘being’, ‘feeling’ and ‘acting’ as aspects of dependence and independence.
The aim of the present study is to explore how older home-help recipients regard their life situation in terms of subjective well-being. The background is that there seem to be two counteracting forces affecting the achievement of subjective well-being among home-help recipients: on one hand, both diminished everyday competence and dependence on others' help are supposed to reduce subjective well-being, and on the other hand, living in one's own home is supposed to affect subjective well-being positively. The analysis is based on qualitative interviews with 21 home-help recipients between the ages of 78 and 93. The findings indicate that the informants' expressions of subjective well-being fall into four main categories: 'well-being', 'well-being despite it all', 'well-being so far', and 'lack of well-being'. Three comprehensive core themes were identified as relevant to a deeper understanding of the informants' various expressions of well-being. These core themes are acceptance, predictability, and control. The findings point to the possibility of experiencing subjective well-being despite diminished everyday competence and dependence on help and support from others. They suggest, in short, that subjective well-being among older people who receive help and support in their everyday lives is not only related to socio-contextual factors - such as physical and mental capability, activities and/or engagement in the outside world, the spatial and social consequences of physical limitations, social and emotional relations, as well as the social support they receive - but also to how they regard and handle these matters in terms of acceptance, predictability and control.
Most research on disclosure issues in dementia has focused on what it is like to receive a dementia diagnosis. Little is known about the disclosure preferences that people with dementia and their cohabiting spouses have. In this study, we explore disclosure preferences and focus on what couples living with dementia want to know and tell about the disease. The study is based on 40 qualitative interviews (20 with people with dementia and 20 with their spouses). The analysis revealed five preference patterns regarding what the couples wanted to know and how they felt about sharing information concerning the disease with others. The patterns have been called: (1) want to know and tell (no reservations about it); (2) want to know and tell (some reservations about it); (3) want to know but do not want to tell; (4) want to know but cannot decide if we want to tell and (5) cannot agree on either knowing or telling. They show that couples' preferences about what they want to know are related to what they are willing to tell. The findings also show that it is usually the preferences of the person that has a dementia diagnosis that guide the stand that couples take as far as disclosure issues are concerned. Thus, the findings show the type of interdependence that exists when one person in a couple has received the diagnosis, and the life of the two people as a couple is challenged as a result of this.
Research on spousal relations and caregiving, when one of the persons in the dyad has a dementia diagnosis, has recognized that the degree of diminished everyday competence (DEC) the person with dementia is experiencing has implications for these relations and for how spousal caregiving is ultimately experienced. The present exploratory study uses an inductive approach to analyze data from 22 qualitative interviews with and observation notes on couples living with dementia to shed light on the ways in which the person without dementia views the DEC his/her partner is experiencing. The findings show that spouses can choose to disregard their partners’ DEC or to acknowledge it in either an egocentric or a couple-centered way; they also show that spouses’ choice of approach does not seem to be dictated by how cognitively impaired their partners have become. This suggests that spouses’ approach to partners’ DEC deserves more of our attention as it could have implications not only for transitions into spousal caregiving but also for caregiving experiences as such.
The way in which persons with dementia and their spouses regard the future could influence how they experience the disease itself. This study aims to explore how the future is understood by couples living with dementia. The analysis reveals different ways in which couples understand the future. The findings show that persons with dementia describe the here and now in ways that take the gloomy future they dread as a point of reference, and as a result of this, they operate in what we term the not yet horizon. But while they take for granted that there is a horizon that they have not yet reached, their spouses always seem to focus on the horizons that they have already crossed. The article discusses the findings in relation to ideas such as critical periods, existential coordinates and possible selves, and problematizes the implicit assumptions about the future that dementia researchers tend to operate from.
Research on older people’s ICT usage tends to focus on either the ways in which they go about learning to use these technologies or the impact that ICTs have on their lives. This research seems, in other words, to take for granted that older people are ‘digital immigrants’ as the digital divide debate proposed. Research that specifically looks at the ways in which older ICT users make sense of their engagement with these technologies is still limited. This article explores therefore – through focus group interviews – how a group of older people who are active ICT users make sense of their ‘digital nativeness’. The analysis shows that the interviewees are well aware that their ICT proficiency differentiated them from their peers, which is why they make sense of their ICT usage by making reference to the issues that make them ‘exceptional’ older people. These include the fact that they have used computers for many years and therefore made ICT usage an everyday habit early on; the fact that most older people do not have the skills that they themselves have, which is why they feel the need to share them with others; and the fact that their lifelong experience means they can use these technologies in judicious ways. By bringing attention to how older active ICT users make sense of their engagement, this article contributes to the notion of the digital spectrum and the debate on the inequalities that ICT proficiency brings about.
Critical Internet and media scholarship has primarily focused on contributing to theoretical debates within the field of media and communications but few empirical studies have applied this theoretical approach. This article uses data on older active ICT users’ understandings of digitisation. It draws inspiration from Boltanski’s pragmatist sociology of critique and the notion that people’s own take on their situation are fruitful sources of information in the quest for emancipation. It employs the notions of ideology, power and inclusion – which are central to critical scholarship – to make sense of older active ICT users’ understandings of digitisation. In doing so, it explores the fruitfulness of the critical lens for studies of ICT users while bringing attention to older active ICT users’ critical capacities.
This paper builds on an on-going project that aims to contribute to the scholarly debates on the “digital divide” and “digital inclusion” by bringing to fore the complexities of older people’s understandings and usage of digital technologies. Older people are often considered one of the vulnerable groups and are among the key targets of the digital inclusion policies, which tend to focus on user-centered solutions on the micro-level. The critical approach employed in this paper allows reconsidering the normative, inclusionary, micro-level foundations of digital inclusion discourses that often inform the policy. The paper builds on the analysis of focus group interviews with 30 older adults (65+) who are active internet users in Sweden, the country often considered as one of the leading IT nations worldwide. We analyze how active older users construct, reproduce and negotiate ideological notions of participation, inclusion and their privileged position of (active) users as imperatives and prerequisites of “keeping up with the (information) society”. Additionally, the analysis suggests that discourses on digital inclusion need to acknowledge the divide that older people themselves create as they discursively position themselves against non-users when describing when, how and why they engage with digital technologies.