Marjaana Seppänen

The effect of loneliness and change in loneliness on self-rated health (SRH): a longitudinal study among aging people

The association between adverse health and loneliness among aging people is known, but most of the studies are cross-sectional. In addition, the associations between changes in loneliness with health are less well known, especially in the case of aging people. The present study examined whether absence of loneliness in 2005 predicted subsequent good SRH in 2008, and whether changes in loneliness were associated with SRH in 2008. Longitudinal, questionnaire-based data were collected from three age cohorts (born in 1926-30, 1936-40, and 1946-50) living in southern Finland. Baseline data was collected in 2002 (n = 2815, 66%); the follow-ups were done in 2005 (n = 2476, 60%) and 2008 (n =2 064, 73%). Logistic regression analyses were used to derive the results. Never or seldom experiencing loneliness was a strong predictor for good SRH. In addition, good health was common among those who never felt lonely. Among men the group experiencing decreasing loneliness had the highest OR of good health. Thus, loneliness is a significant contributor to poor SRH among aging people. In addition, favorable SRH is indicated not only by the absence of loneliness at both measurement points, but also by decreased loneliness. Preventing loneliness is important for health promotion.

Lost and unfulfilled relationships behind emotional loneliness in old age

ABSTRACT Using a qualitative approach, this article examines how the experiences of emotional loneliness are embedded in the everyday lives and relationships of older adults. Ten in-depth interviews were conducted in 2010 with older people who reported feeling lonely, often or all the time, during a cohort study in southern Finland. The research reveals the multifaceted nature of loneliness and its causes. Behind emotional loneliness, we identified lost and unfulfilled relationships, involving the loss or lack of a partner, the absence of a meaningful friendship, complex parenthood and troubling childhood experiences. Most of the interviewees have faced loneliness that only began in old age, but for some, loneliness has been present for nearly a lifetime.

Assessment, support and care-taking: gerontological social work practices and knowledge

Abstract The purpose of this article is to identify, analyse and interpret key practices and knowledge in gerontological social work. This article explores social work practices and knowledge in the context of gerontological rehabilitation using data gathered through thematic and dialogical interviews with seven social workers. In those interviews, social workers described their daily work with older adults. Using frame analysis, the data revealed assessment, support and care-taking frames which included many practices. The social work knowledge consist of factual, theoretical, procedural and practical and personal knowledge. Furthermore, clients’ personal knowledge is essential in social work practices of every kind. The study findings identify the importance of support and care-taking practices in gerontological rehabilitation, as well as a need for extensive social work knowledge.

Responsibilities between the church and state in the field of elderly care in Finland

Abstract In the coming years, Finland will be faced with the challenges of an ageing population, including a rapid increase in the need of resources required for their care and support. Elderly care is being reformed in the Finnish society and the third sector, including religious institutions, it is considered to create opportunities to address problems in the current economic situation. This paper will focus on how public sector social workers define the role of church diaconal work performed by the Evangelical Lutheran Church of Finland (ELCF) in the field of elderly services. The data were collected from 10 theme-based interviews conducted in 2009 with public sector social workers who worked with the elderly. Using frame analysis as a methodological tool, three frames were formed: ‘the Church providing psychosocial support’, ‘the Church organising communal activities’ and ‘the Church as safety net’. Analysing these frames through contractualism as a theoretical tool, it became clear they each represent a different form of contractual cooperation; these forms respectively being network, market and hierarchy. The results of this study suggest that social workers emphasize neutrality towards religious matters, but consider churches to be a trustworthy companion and are willing to transfer psychosocial support to the ELCF.

Negotiating needs. Processing older persons as home care recipients in gerontological social work practices

The focus of Anna Olaison’s dissertation is the assessment process that older people undergo to gain access to home care. The study examines the joint assessment of the need for in-home assistance. Older persons, their relatives, and municipal care managers participate in the assessment discussions, which form the main interest of the dissertation. Anna Olaison strives to acquire an insight into these processes and to study how older persons, their relatives and care managers organize their interactions and what services are made available for the older persons. She also examines the significance of these processes in terms of the decisions that are made. The dissertation is based on four sub-studies published (or submitted) in international journals. This review is based on the report, while the above-mentioned articles are not included in the dissertation. However, the main findings of the articles are well presented in the dissertation, which was published by the University of Linköping in Sweden. The National Institute for the Study of Ageing and Later Life has been the research milieu for this and many other interesting studies directed at a wide variety of questions concerning ageing. The topic of the research is especially interesting in the contemporary societal situation, where the restructuring of old-age care is proceeding, taking different forms in different welfare models. As the author claims, research is needed about the manifestations of the changes at the level of every-day practices. This research addresses the implementation of care and the relationships that evolve in the assessment process when older persons become clients and are assimilated into the public old-age care system. The four sub-studies examine the assessment process from slightly different perspectives, but the central starting point is in understanding assessment as a communicative practice in which talk and text are the tools used in the process. The focus is the assessment conversations, which constitute the core of the process. Documents connected to these conversations are also studied as the communication is formalized in writing in social welfare services reports. The substudies address the following questions: