Tove Harnett

Shaping nursing home mealtimes

ABSTRACT A number of studies stress the importance of positive mealtime experiences for nursing home residents. However, the components that comprise an ideal nursing home meal remain unclear, reflecting the ambiguity of whether nursing homes should be framed as institutions, domestic settings or a type of hotel. In this study, nursing home meals were viewed as situations that the involved parties could continuously modify and ‘work on’. The aim was to analyse how the staff and residents shaped mealtimes by initiating frames and acting according to established social scripts. The study was based on semi-structured interviews with staff and residents and on ethnographic data, consisting of 100 hours of observations at two nursing home settings in Sweden. The analysis revealed how staff and residents interactively shaped meals using institutional, private or restaurant frames. There were three important findings: (a) an institutional meal frame was dominant; (b) there were substantial difficulties in introducing private frames and established private scripts for meals, since such meal versions are personal and not easy to transport into collective settings; (c) successful creation of private or home-like meal situations illustrates an often overlooked skill in care work. Making meals as ‘care-free’ as possible can be viewed as a way to operationalise the goal of providing a non-institutional environment in nursing homes.

Introducing an Equal Rights Framework for Older Persons in Residential Care

This article reconceptualizes residential care for older persons by introducing a framework developed from a rights-based principle of disability policies: the normalization principle. This principle is part of the social model and states that society should make available for people who have impairments living conditions that are as close as possible to those of “others.” Using the framework on the case of eldercare in Sweden shows that although disability policies have used people without impairments as a comparative (external) reference group for claiming rights, eldercare policies use internal reference groups, basing comparisons on other care users. The article highlights the need for external comparisons in eldercare and suggests that the third age, which so far has been a normative reference group for older people, could be a comparative reference group when older persons in need of care claim rights to equal conditions.

Framing spaces in places: Creating “respite spaces” in dementia care settings:

Research on dementia care settings has primarily focused on routine aspects of life, including mealtimes, bathing procedures, etc. However, studies rarely explore how individuals with dementia interact in these settings during the intervals between routines. This study aimed to analyze how residents actively carved out spaces that provided temporary respite from institutional life, termed “framing respite spaces.” Ethnographic data was collected over five months in a dementia care setting in Sweden. Frame analysis was employed to investigate residents’ shared understanding of non-task-orientated situations. The results showed that individuals with dementia adjusted to institutional order, but also actively created respite spaces through conversation. Interestingly, individuals with dementia interpreted conversational cues and often acted logically according to a shared definition of the specific situation. These findings showed that looking beyond task-orientated interactions between staff and residents can provide a more detailed picture of everyday life in dementia care settings.

The Use of Apps for Health in Persons with Multiple Sclerosis, Parkinson's Disease and Stroke - Barriers and Facilitators.

INTRODUCTION The importance of mobile health has increased during recent years but few studies have described the use of apps among persons with neurological disabilities. AIM The aim of this paper was to describe how persons ageing with a neurological disability experience barriers and facilitators in relation to using apps in everyday life. METHOD A qualitative approach was used. 16 persons with neurological disorders participated in two group discussions. Data were analyzed by content analysis. RESULTS The analysis formed four categories; Impairments make apps harder to use, Use of apps is increased by learnability and sharing, Valuating the information in an app, and Apps act supportive and motivating. CONCLUSION The participants used apps in the same way as persons without disabilities. Impairments and trustworthiness were perceived as barriers, which need to be acknowledged when developing apps for this population. Use of apps was facilitated by the possibility to share data and to connect with others. Apps may have the potential to improve self-management for persons ageing with disabilities but further research is needed.

“They are different now” – Biographical continuity and disruption in nursing home settings

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Ethnically profiled nursing home care in Sweden - from culture to lifestyle

ABSTRACT The paper investigates presentations of ethnically profiled nursing homes in Sweden, and in particular what categories these nursing homes target and what problems they are suggested to solve. The findings relate to the construction of older immigrants and to shifting ideas on responsibilities of the Swedish welfare state. Data consisted of 68 articles from newspapers and journals between the period of 1995 and 2015 that were analysed using qualitative methods. Guided by a social constructionist approach focusing on claims-making, two comprehensive ‘problem frames’ were identified: the language and culture frame and the choice of lifestyle frame. The main finding of the paper was that, since about 2007, descriptions of ethnically profiled nursing homes have come to be included in a broader category of profiled nursing homes such as ‘all inclusive’ and ‘hotel-concept’, within a system that focuses on choice based on special needs, lifestyle and interest. The paper concludes that, although this way of framing ethnically profiled nursing homes works against the construction of older immigrants as a problematic category, there is a risk that the emphasis on choice of lifestyle conceals or justifies inequalities based on social class.