Sari Rissanen

Dementia with Lewy bodies according to the consensus criteria in a general population aged 75 years or older

Objective: To estimate the prevalence of dementia with Lewy bodies (DLB) according to the consensus criteria in a general population aged 75 years or older. Methods: The “Kuopio 75+ study” is a population based health survey focused on the clinical epidemiology of dementia and functional capacity among elderly subjects aged 75 years or older. On 1 January 1998, a random sample of 700 subjects was drawn from a total population born before 1 January 1923, living in the city of Kuopio, northeast Finland (n = 4518). The study subjects underwent a structured interview and clinical examination. Results: 601 elderly subjects (86% of the random sample) were examined. A dementia disorder was diagnosed in 137—a prevalence of 22.8% (95% confidence interval 19.4% to 26.2%). The prevalence of DLB was 5.0% (3.2% to 6.7%), comprising 22% of all demented subjects. Probable DLB was diagnosed in 20 subjects (3.3% (1.9% to 4.8%)), and possible DLB in 10 (1.7% (0.6% to 2.7%)). The prevalence of Alzheimer’s disease was 10.6% (47% of all demented subjects), of vascular dementia, 5.3% (23%), and of other types of dementing disorders, 1.8% (8%). Conclusions: In a general population aged 75 years and older, the prevalence of a disorder fulfilling the diagnostic criteria of DLB is half that of Alzheimer’s disease and the same as for vascular dementia.

Impact of computer training courses on reduction of loneliness of older people in Finland and Slovenia

Previous research has shown loneliness as a threat for the quality of life of older people; therefore the goal of the intervention in a quasi-experimental study was to evaluate and discuss the self-reported level of loneliness of older people in Finland and Slovenia before and after a computer intervention. Intervention in a quasi-experimental study was conducted among 58 older participants at the baseline (M=72.4years) and 45 older participants at the follow-up research study (M=72.9years). Inferential statistics showed a significant difference in the reduction of loneliness between the countries, and a decreased level of loneliness of older people after completing the computer training course. Although older people experience many age-related problems which may reduce their interest in learning information and communication technology (ICT) skills, it is important that they are computer-proficient, because computer engagement can reduce the level of loneliness of older people and in this way has a positive effect on their quality of life.

The state and future of social service enterprises—a Finnish case

There has been a rapid increase in private social services in Finland, where the tradition of social care services has placed the main emphasis on public services. The aim of this article is to compare the situation of Finnish social service enterprises in 2001 and 2005/2006, in the light of two national surveys, in order to increase knowledge about the state and the future of such enterprises as providers of social care. Particular attention is paid to the profiles of men and women as entrepreneurs, as these differed somewhat. The composition of private care enterprises and their management remained fairly similar between 2001 and 2005/2006. Most of the enterprises were owned by middle-aged women with an extensive experience of social and health care. The owners of the older enterprises were more pessimistic about the future than the owners of the more recently-established firms. Social workers have not been active in setting up firms, but the public–private processes should be steered and evaluated from the social work perspective, too, because they are actors who have a relevant part to play in the long-term co-operation and development work of public and private social services.

Discursive construction of polyphony in healthcare management.

PURPOSE The aim of the paper is to understand and define how the polyphony of management is constructed in interaction and to describe this through concrete management meeting cases. Polyphony refers to the diverse voices of various organization members, and how these voices are present, disclosed and utilized in management. DESIGN/METHODOLOGY/APPROACH The study is based on the social constructionist and discursive perspectives of management, which question the traditional, individualistic approaches of management. The issue was examined through a qualitative case study by analysing the micro-level management discourse in three healthcare organizations. FINDINGS Discursive practices that enhance or inhibit polyphony are often unnoticed and unconscious. Key moments of management discourse are an example of unconscious mundane practices through which members of organizations construct the reality of management. RESEARCH LIMITATIONS/IMPLICATIONS The empirical results are locally contextual. In the future, research will be able to apply the approach to diverse contexts as well as link micro-level discourses to the construction of broader health and social management discourses. PRACTICAL IMPLICATIONS The paper increases the understanding of how to enhance participation and staff contribution, and how to utilize the knowledge of all members of the organization. SOCIAL IMPLICATIONS Both managers and other staff members are fully involved in the social construction of management. Micro-level discourse should be paid attention to in management work as well as in the education of managers and staff. ORIGINALITY/VALUE The study increases the understanding of micro-level issues of management and challenges the conventional, taken-for-granted assumptions behind organization and management theories.

The match between institutional elderly care management research and management challenges - a systematic literature review

BackgroundElderly care practice and its management together with policy and research play a crucial role in responding to increasing challenges in institutional care for elderly people. Successful dialogue between these is necessary. The purpose of this systematic literature review is to compare how institutional elderly care management research meets the care challenges currently emphasized in international long-term care policy documents.MethodsThis paper was based on a systematic literature review. After screening 1971 abstracts using inclusion/exclusion criteria, 58 refereed articles published between 2000 and 2010 remained for analysis. The articles were analyzed using theory-based content analysis by comparing the results to the framework based on analysis of international long-term care management policy documents.ResultsThe current challenges of long-term care management identified from policy documents were Integrated Care Management, Productivity Management, Quality Management, Workforce Management and ICT Management. The research on institutional elderly care management responded somewhat to the challenges mentioned in policy documents. However, some of the challenges were studied broadly and some were paid only minor attention. Further, only few studies focused on the core items of challenges addressed in policy documents.ConclusionsInstitutional care management research needs to focus more on challenges in integrated care, productivity, ICT and division of labor. Managers, researchers and policy-makers should assume more active collaborative roles in processes of research, policymaking and policy implementation. In addition managers’ and policymakers’ scientific literacy needs to be enhanced.

Global Standards and the realities of multiculturalism in social work curricula

This study highlights social work’s response to socio-cultural diversity by investigating the reality of multiculturalism in social work curricula vis-a-vis the Global Standards debates. Content analysis technique is used from a transcendental perspective to explore the attributes of multiculturalism in social work curricula via the online directory of the International Association of Schools of Social Work. Each curriculum reflects relative attributes of multiculturalism, identifiable as tenets of the Global Standards – a tool for modeling social work education across cultures. A new theory and a practice model for international social work also emerged from the study, and are proposed for testing.

Positive emotions in caring for a spouse: a literature review

This article aimed at identifying the positive emotions connected to spouse caregiving and the advantages for spouse carers. Theoretically, the article is based on the concept of emotion and the assumptions of positive psychology. Data search is conducted via electronic literature databases and the analysis method is partly theory-driven and partly inductive content classification. Our analyses discover and clarify the concepts associated with positive emotions in caring, such as the gains of caregiving, benefit-finding, finding meaning, personal growth, post-traumatic growth and resilience. We also utilise a conceptual framework to describe positive emotions in caregiving, and the identified advantages of positive emotions in spouse caregiving include distress buffering, mediation in coping with stress, increased quality of life and well-being, and finding a sense of purpose. Finally, spouse care is seen in this article as a challenging life situation which at best can support personal growth, if the processing of both positive and negative emotions is included in daily life. Hence, the service and support system should be developed further by utilising the findings of positive psychology as well as studies of personal growth.

Influence of previous work experience and education on Internet use of people in their 60s and 70s

Background Internet use among the elderly is influenced by various demographic backgrounds, social life and health factors. Objective This study aims to identify the impact of several demographic features on 60- to 79-year-old individuals’ intention to use the Internet. Method Finland population data (N = 2508) from the 2012 IKIPOSA project was used with two cohorts: 60s group (n = 1515) and 70s group (n = 990). Descriptive statistic and two binomial logistic regressions have been used with the unadjusted effect and Forward LR method to measure each predictor’s contribution to the model. In addition, a preliminary analysis to measure the multicollinearity was performed. Result Of the 18 independent variables, only nine predictors, namely, age, education, financial situation, having children, entrepreneurship, a leadership position, a higher level white-collar worker and a lower level white-collar worker, were significant factors in predicting the Internet use. Meanwhile, gender, having grandchildren, living alone, marital status, house location and type, stay-at-home mother or father, blue-collar worker, agricultural entrepreneur and social relations satisfaction were not significant predictors. The most significant predictors were education and age, which contributed 19% and 10%, respectively, to the model. Other significant predictors, lower level white-collar worker, higher level white-collar worker and financial situation, had less impact with only around 6%. Conclusion Education and age were influential factors among elderly to use the Internet in their later life. Certain work experiences affect elderly people’s engagement with the Internet after retirement.

Information sources and innovation-linked networking: relations to health and social service enterprises' performance in Finland

Innovation, information sources and networking influence organizations’ performance. Previously, related services have been mostly publicly provided in the health and social sector, at least in some countries, but privatization is advocated as a means to improve innovation and performance in the sector. However, there are uncertainties regarding the relationships involved, particularly in Finland. Thus, this study examines the information sources and networking used to innovate products and services provided by Finnish health and social service firms, using questionnaire responses of 668 entrepreneurs. The relationship between product/service innovations and firms’ performance is also addressed. The results indicate that novel product/service innovations are closely associated with freely accessible information sources such as exhibitions, fairs, the internet and media; that regional support organizations and collaborative partners are important information sources for innovative health and social service enterprises; and that both growth and profitability are related to firms’ innovation in the sector.

Multiculturalism in social agencies for the aged.

This study uses content analysis and visual representation methods to explore how multiculturalism is displayed on the websites of agencies providing social care for the aged. These agencies use strategically planned texts to portray multicultural categories of inclusion, diversity and individuality; and emphasize the text referents through ethno-related pictures as universal equivalence symbols for ethno-cultural diversity. With the few cases of non-text referents, which are open to cultural and sociological relativities, the study posited that the patterns and modes of portraying multiculturalism are similar. It concluded with the need for further studies to establish whether state policies or agencies’ market strategies are behind the liberal multicultural references.