This report has been written on behalf of Resurspoolen - Frivilliga uppdrag i Linköping. The aim was to document the volunteers' experience of the importance of older citizens, who organise themselves in the Resurspoolen’s activities, in preventing loneliness and social isolation among older people. The project also had a forward-looking approach regarding how the work by Resurspoolen can be further developed and improved.

The importance of civil society in the welfare society has been raised in Swedish national politics, where voluntary organisations have been highlighted as a key player in managing the challenged situation that the welfare system is facing. Citizens who organise themselves are assumed to play an increasingly important role at the interface with the public support system. At the same time, preventing loneliness among older people has been highlighted as a prioritised area by the state where municipalities and civil society have been pointed out as key actors to prevent loneliness. 

The report focuses on the older volunteers who get involved, get organised with the effort to give “an extra flavour to older people’s life”. An important component is their work, interest, and continued commitment to create activities targeting older people, many of whom live in social isolation. and to create collaboration, between older people within the organisation, and between the volunteer organisation and other actors in the local society. 

The report can also be placed in a broader context as it contributes with knowledge about how a volunteer organisation – Resurspoolen – has a versatile function for the local community, providing social support, social inclusion and shaping social sustainability among Linköping’s citizens.

Within a context where New Public Management [NPM] has become increasingly influential in shaping everyday working practices, social workers often handle risks in their everyday work using formalised bureaucratic procedures, among other strategies. As the COVID-19 pandemic progressed, rapid changes occurred in Swedish elder care that social workers were required to address in their everyday work. Intra-professional case conferences amongst social workers provide one opportunity to discuss individual viewpoints and obtain suggestions from colleagues on how to proceed with a case. These discussions have so far received little scholarly attention. In this study we used a data set consisting of 39 audio-recorded case conferences to analyse social workers intra-professional discussions about risks during the COVID-19 pandemic. In the case conferences, social workers discussed the risks that were accentuated by the pandemic, such as the risk of spreading COVID-19 to clients, the risk of unmet care needs amongst clients, risks related to accountability, and the risks pertaining to blurred boundaries between different organisations. The collegial discussions in case conferences included opportunities for social workers to use their collective professional experience and competency to establish creative solutions on the go and to discuss various ways of handling and balancing different risks while continuing to carry out their work in the changing and unknown situation. Our findings highlight the importance of collegial support in social work in dealing with accentuated risks during the pandemic.

Ärendekonferenser utgör en central del av det sociala arbetets praktik och fungerar som ett informellt forum för beslutsfattande där biståndshandläggare diskuterar ärenden tillsammans med kollegor. Syftet med dessa möten är bland annat att skapa samsyn i bedömningar av ärenden. Hur klienters rätt till stöd skapas och förhandlas i ärendekonferenser kan ha avgörande betydelse för vilket stöd klienter faktiskt får från socialtjänsten. Genomen fallanalys av ett ärende som rör äldreomsorg visar vi i det här kapitlet hur biståndshandläggare i en ärendekonferens diskuterar klientens rättigheter. Analysen visar hur dessa rättigheter tillämpas och utmanas i diskussioner i relation till insatsen särskilt boende genom tolkningar av aktuell lagstiftning och lokala riktlinjer. 

Summary: Social work practice has a history of collegial, intra-, and interprofessionaldiscussions that take place backstage, that is, without the presence of clients. Because oftheir backstage character, these discussions may be considered even more important toexamine than meetings at which clients are present and that are in a way already open tothe public. The purpose of the present review was to provide insight into this practiceby identifying and synthesizing recent empirical findings from existing studies using naturalisticdata, published in English in peer-reviewed journals. Findings: We identified four types of interaction among practitioners in relation tothe case discussed and three types of content that were raised and shared, as well asan apparent mismatch between formal reasons for the discussions and the purposethey serve in practice. A lack of common vocabulary for conceptualizing the discussionsand of attention given to their backstage character was identified in the included studies. Applications: The review highlights an important area for further research and stressesthe importance of not being blinded by formal purposes or ideological underpinningsin examining intra- and interprofessional discussions in social work; it shows that it isimportant to look into what is actually going on in practice.

Research has explored how social workers in team constellations perform assessments of the needs of clients in case conferences. However, the process in which gatekeeping is applied in the categorization of clients as inappropriate receivers of support in collegial discussions has received less attention. This article presents findings from a case study of a complex case where a 64-year-old person with dementia was assessed by two teams of social workers handling the same case under two different forms of legislation (elder care and disability services). The data consist of recordings of two case conferences in one Swedish social work agency. The conferences were analysed using positioning theory. The findings suggest that the conferences contained different storylines where the social workers categorized the client as an inappropriate receiver of support. Furthermore, the discourses for gatekeeping differed depending on how the social workers positioned the client in the different storylines in the case conferences. The study shows that institutional and professional responsibilities are central to the assessments that the social workers perform, and that there is a risk that the client will be subject to gatekeeping when the case is handled on an ambiguous legal basis in different legislations, which may result in the client falling between two stools. The findings suggest that research needs to explore, in a more systematic manner, how social workers’ gatekeeping practices are performed in collegial team discussions.

Background Social day centres can support active and healthy ageing amongst older people. However, little is known regarding the importance of social day centres. Aims/Objectives The aim of this study was to explore how older people visiting social day centres perceive the day centres social influence on their health and well-being. Material and methods Twenty older persons attending social day centres on a regular basis were interviewed regarding activities at the day centre and their importance for active and healthy ageing. The data were analysed using qualitative content analysis. Results The social day centres were described as arenas to provide a structure (and something to do) in the visitors everyday life. By attending a day centre, the participants created a social context with other visitors. Staff acted as facilitators for visitors, helping them to interact with other visitors and to experience the feeling of being needed by others. Conclusions The findings suggest that social day centres are important arenas for creating a sense of context and belongingness amongst older people. Significance This study provides knowledge on how doing and being contribute to healthy and active ageing.

IntroductionCollaboration and coordination of health and care services are key to catering for the diverse needs of a growing population of older people with dementia. When multidisciplinary health and care providers work together, they have the possibility to use resources in a fair, accurate and effective way and thereby do the right thing, at the right time, for the right individual. The aim of this scoping review is to map how different care-providing agencies collaborate and coordinate health and care services for older people with dementia. Methods and analysisA scoping review will be carried out following the proposed methodology by Joanna Briggs Institute and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Scoping Review Extension guidelines. Systematic searches will be carried out in scientific databases. Studies published within the last 10 years will be included based on certain eligibility criteria. All included studies will be critically appraised using the Research Pyramid. Data from included studies will be charted and subjected to content analysis. Ethics and disseminationEthics approval is not required for scoping reviews. The dissemination of findings will be conducted through conference presentations and publication in international scientific journals.

Recommendations for how practitioners “should communicate about their work, so as to become ‘more efficient’ and make better use of their ‘team’” are increasingly being requested. However, if we want social work practice to change or improve, we first need to acquire insight into its actual content(s), that is, what practitioners do in different working contexts and how they interact. Based on a systematic review of recent empirical findings from studies on inter- and intra-professional case discussions in social work practice using naturalistic data, this presentation aims to provide insight into backstage case discussions and to provide directions for further research. Goffman´s concept of backstage implies that the discussions in focus take place metaphorically, away from an audience consisting of clients or significant others. In synthesizing the included studies, we identified five types of interaction among practitioners in relation to the case discussed and three types of content that were raised and shared, as well as an apparent mismatch between formal reasons for the discussions and the purpose they serve in practice. A lack of common vocabulary for conceptualizing the discussions and of attention given to their backstage character was also identified. The presentation will highlight an important area for further research and stress the importance of not being blinded by formal purposes or ideological underpinnings in examining intra- and inter-professional discussions in social work; it shows that we should look into what is actually going on in practice.

Day centers provide opportunities for older people to achieve active and healthy aging. Staff play a significant role in day centers, although evidence is lacking concerning their role. To explore the experiences of staff in promoting active and healthy aging at social day centers, interviews with 12 staff working at day centers for older people were carried out. The findings present two categories: the actions of the staff and conditions affecting activities at the day centers. Staff at day centers may play an important role in providing opportunities for older people to maintain health and participation in meaningful activities.

Background: A growing population of older people will require different types of occupational therapy services in the future. For occupational therapists to provide effective services and to optimize care, their practice must rely on high-quality evidence. Research is one important pillar of evidence-based practice. Therefore, it is important to examine the research published in occupational therapy journals, which guides practitioners in their work with clients. Aim: The overall aim of this study was to review research characteristics in articles with older persons as participants, aged over 65 years, with or without illness, diseases or disabilities, reported in occupational therapy journals during the period 2013-2017. Materials and methods: Data was collected from peer-reviewed occupational therapy journals and categorized in relation to research characteristics using descriptive statistics. Results: The findings show that most articles presented basic research, using quantitative design where the sources of data were instruments. Conclusion: The findings suggest that both qualitative and quantitative articles use appropriate sample sizes. However, descriptions of the studied populations are frequently unclear, which may affect the transferability and generalization of the results.

It has often been argued that identities have a strong connection to stories and storytelling and thus that life stories should be used to individualize care for people with dementia. A problem with this view is that storytellers are seen as individuals, freely reflecting on, composing, and telling life stories. This view becomes especially problematic when persons with dementia tell stories in institutional contexts where certain information is requested and necessary for decision-making. The aim of this study is to investigate how autobiographical stories are used and what functions they have in assessment meetings involving persons with dementia. Fifteen assessment meetings were audio-recorded and transcribed. Narratives were extracted and analyzed by coding who the narrator or narrators were, what the narrator(s) accomplished by telling this story, and what the consequences were for the ongoing meeting. It was found that all interlocutors told stories about the person with dementia. These stories were found to have three functions: (1) to justify why care services were needed; (2) to describe experiences about previous care; and (3) to provide a good working climate. Thus, not all autobiographical stories are the persons story. For care managers in their everyday work it is important to be aware of this and not only be satisfied with a story that suits the organizations needs. Furthermore, stories told in assessment meetings often positioned the person as dependent on others, which could undermine the identity and sense of self of the person with dementia.

This thesis deals with encounters between persons living with dementia and care managers. Dementia often results in progressive care needs that must be met by different social care services. The person’s care needs are assessed in an assessment meeting where the person and their relatives meet with a care manager to negotiate needs and social care services. The assessment is conducted through one or several conversations where the person with dementia meets the care manager; relatives are often present in the meetings. Dementia is a syndrome that involves a cognitive decline and a decreased ability to communicate and interact with others. It may therefore be difficult for a person with dementia to take part in discussions about their care needs and social care services. 15 audio recorded meetings have been studied to explore and understand how persons with dementia use their remaining communicative, cognitive and linguistic resources to invoke, negotiate, and use their rights as citizens in the institutional context where their care needs are assessed. The analysis concerns the organization of talk as a joint activity; the production of social actors in talk-in-interaction; the relation to institutional features of discourse. This dissertation concludes that the practice of citizenship is situation based and varies depending on the participants present. Care managers can facilitate for persons with dementia to overcome communication problems by using different discursive strategies and to make it possible for them to participate or at least be included in the negotiation. Persons with dementia are positioned as less competent than other persons participating in the assessment meeting. This might have an impact on the participation of people with dementia in negotiations regarding their future care. Furthermore, stories told in assessment meetings often position the person as dependent on others, which could undermine the identity and sense of self of the person with dementia.

The overall aim of the study was to investigate if and how persons with dementia were able to take part in negotiations for formal support, as cases of citizenship as practice. The transcripts used for analysis were from 11 assessment meetings conducted in Sweden, in which the formal applicant was a person with dementia. The findings suggest that the actual participation of persons with dementia in assessment meetings varies. Communication problems were found in the meetings to different degrees and were dealt with differently and with various consequences. For those persons with dementia contributing at the same levels as the other participants, there was an attempt at mutual understanding. For those making fewer contributions, the other interlocutors took over the initiative and thus affected the practice of citizenship by persons with dementia in a negative way. The practice of citizenship is situation based and varies depending on all participants. When the person with dementia is able to participate in the conversation, social workers can facilitate for them to overcome communication problems by giving them more time and signaling acceptance. If the person with dementia has great problems in participating, the other participants can find different strategies to at least involve her or him in the conversation

It has been demonstrated that persons with dementia may be positioned as less competent than participants of the same age without dementia, and that persons with dementia possibly also are positioned as less competent than other older persons without dementia. In the present study, we aim to explore this further by analysing Swedish assessment meetings, in which needs and preferences are investigated for older persons without dementia. The material consists five audio-recorded assessment meetings, where there were at least two conversational partners present (a spouse and/or a child) and where the older person applying for social services was not diagnosed with dementia. The ages of the older persons ranged from 81 to 88, while the age of the relatives ranged from 46 to 93. The results of the present study demonstrate that older persons without dementia mainly are positioned as competent. However, it may be related to the degree of frailty, since the frailest person in the present study appears to be positioned as less competent than the other participants. The present paper adds to existing knowledge on how professionals in assessment meetings contribute to the positioning of older persons as competent and capable of making decisions. The results of the present article may be useful to promote development of education and training of communication skills for care mangers in assessments in order to further ensure that older persons with and without cognitive impairments can be actively involved in the creation and interpretation of their applications for social services.

In this paper the authors study if and how persons with dementia are orally positioned by others, and how they position themselves while participating in assessment meetings held in order to discuss access to supportive services. We analysed five assessment meetings where two older persons (one diagnosed with dementia and one without a dementia diagnosis) participated to investigate whether the person with dementia is positioned differently than the other old person. Interactional phenomena used to position the person with dementia were identified by interactional analysis.

The paperidentifies six phenomena that positioned the person with dementia as an individual with less interactional competence than the other participants: ignoring the person with dementia; voicing the feelings, capacity or opinion of the person with dementia; posing questions implying lack of competence; others' use of diagnosis; self-(re)positioning; and elderspeak. Persons with dementia are often orally positioned as less competent, indicating that they suffer further from discrimination than other older persons. We suggest that this has an impact on the participation of people with dementia in negotiations regarding their future care. The results indicate that social workers should be made aware that negative positioning exists and how it may affect the ability of people with dementia to contribute to discussions about their everyday life. Social workers should be encouraged to find strategies to reduce negative positioning in interaction.

We will present voice as an analytical framework to enhance the problematization and investigation of citizenship for people living with dementia. We will also discuss the strengths and the potential of using such a framework when doing research on citizenship in general, and more specifically, for people living with dementia. The analytical framework that we will propose focuses on the multiple accounts of voice in use. Thus, the framework does not only embrace the issue of "whose voices?", but also the various ways voice has been conceptualised, framed and understood in different theoretical and empirical contexts as well as how these together in different ways have the potential to shed light on the possibility for people with dementia to remain participative actors in their neighbourhood, in society and furthermore, to have the opportunity to claim full citizenship.

During recent decades, there has been a growing recognition that people cannot be assumed incapable of making decisions about their own care solely on the basis of a dementia diagnosis and international agreements and legislative changes have strengthened the formal right for people with dementia to participate in decisions on care services. This raises important questions about how these decisions are currently made and experienced in practice. The aim of this presentation is to address this question and highlight directions for further research.

The presentation is based on a systematic review and qualitative synthesis of recent empirical findings. For inclusion in the review, a publication had to meet the criteria of being published between 2005 and 2013 in a peer-reviewed journal, and be written in English. Twenty-four articles were identified, all representing qualitative studies. Relevant findings were extracted and synthesized along dimensions of involvement of the person with dementia in decisions on care services. Three overarching ways in which people with dementia are involved, primarily, in the informal part of a process of decisions were identified: excluded, prior preferences taken into account, current preferences respected. Several articles seemed to be based on the assumption that decisions on care services are invariably and solely made within the family and without participation of the person with dementia.

Our study emphasizes the need for more updated research about international debates and agreements concerning capabilities and rights of people with dementia and about the (potential) formal contexts of care decisions in the country concerned.

Background: During recent decades, there has been a growing recognition that people cannot be assumed incapable of making decisions about their own care solely on the basis of a dementia diagnosis and international agreements and legislative changes have strengthened the formal right for people with dementia to participate in decisions on care services. This raises important questions about how these decisions are currently made and experienced in practice. In this review, we address this question and highlight directions for further research.

METHODS:

We searched CINAHL, PsycINFO, ASSIA, Social Services Abstracts, Science Direct, Academic Search Premier, and PubMed. Twenty-four pertinent articles were identified, all representing qualitative studies. Relevant findings were extracted and synthesized along dimensions of involvement of the person with dementia in decisions on care services, using an integrative approach to qualitative synthesis.

RESULTS:

We identified three overarching ways in which people with dementia are involved, primarily, in the informal part of a process of decisions: excluded, prior preferences taken into account, and current preferences respected. Several (10) articles seemed to be based on the assumption that decisions on care services are invariably and solely made within the family and without participation of the person with dementia.

CONCLUSIONS:

The review emphasizes the need for more updated research about international debates and agreements concerning capabilities and rights of people with dementia and about the (potential) formal contexts of care decisions in the country concerned. This, we argue, is vital for future knowledge production in the area.

OBJECTIVE: Employment rates are significantly lower among individuals with arthritis compared to a general population. There is, however, limited research about how men with arthritis perceive their ability to maintain working. The aim of this study was thus to explore their perception of this.

PARTICIPANTS: Nine employed men with arthritis were purposively sampled.

METHODS: Interviews were performed and were informed by the central concepts of the Model of Human Occupation. The Empirical Phenomenological Psychological method was modified and used to analyze and interpret collected data.

RESULTS: The findings showed that men with arthritis perceived a desire to work, adjusted their activity pattern, were aware of their own capabilities, had good work conditions, had environmental support and used effective medication to maintain their ability to work.

CONCLUSIONS: The findings suggest that health care professionals can help men with arthritis to find strategies and a balance between recreation and work. Ultimately, this knowledge could guide health care professionals to target men needing interventions to prevent sick leave.

Background: Employment rates are significantly lower among individuals with arthritis compared to a generalpopulation. During the last decade new biological medications have revolutionized the treatment for many individuals witharthritis (1), reducing the disease activity and symptoms in a positive way, but also causing major direct costs since thenew medications are very expensive (2). Even though the effect is good some individuals still report disability like pain,fatigue (3) and work disability (4). This indicates that even though biological medicines generate a positive remission ofthe disease, disability such as work disability can still be present and needs to be evaluated. Previous research aboutindividuals with arthritis and their ability to work has mainly had a quantitative design focusing on what affects work andfacilitates the ability to work for women. There is, however, limited research about how men with arthritis perceive theirability to maintain working.Objectives: The aim of this study was thus to explore how men with arthritis perceive their ability to maintain working.Methods: Nine employed men with arthritis were purposively sampled. Interviews were performed and were inspired bythe central concepts of the Model of Human Occupation. The Empirical Phenomenological Psychological method wasmodified and used to analyze and interpret collected data.Results: The findings consist of six themes and fifteen sub-themes. The results showed that men with arthritis perceiveda desire to work, adjusted their activity pattern, were aware of their own capabilities, had good work conditions, hadenvironmental support and used effective medication to maintain their ability to work.Conclusions: This study has provided an understanding of how men with arthritis maintain their ability towork. In conclusion, to treat the symptoms of arthritis, in the more traditional way that for examplehand dysfunction and pain are treated, may prevent sick-leave but as found in the presentstudy the ability to work is complex and new strategies to support ability to work need to bedeveloped in the occupational aspects of rheumatology care.