Dignity equals distance? Pursuing dignity in care for older adults

2021 ◽  
pp. 1-19
Author(s):  
Agnete Meldgaard Hansen

Abstract This paper explores how dignity is articulated and pursued by care workers in two currently prominent policy initiatives seeking to reform Danish care services for older people. Based on ethnographic case studies of ‘reablement’ practices and the use of ‘welfare technologies’, the paper shows how these attempts to create dignified care services transform interactions between care recipients and care workers. The analysis is inspired by a socio-material perspective on dignity as ‘crafted’ and ‘co-laboured’ in daily practices, in an interplay between multiple human and non-human actors. In the cases studied, dignity is articulated as closely related to older people's increasing autonomy and independence of formal care, and is pursued through enhancing care recipients’ self-care ability, and through technological automation of care tasks. However, these articulations and pursuits of dignity do not stand alone. When everyday care practices are closely examined, dignity is also pursued by care workers as increased co-operation and equality between care workers and care recipients, as de-objectification, and as promotion of enjoyment and quality of life. In these practices, care is ambivalently positioned as both a potential threat to dignity, and as a prerequisite to achieving it. The paper concludes by discussing the risks of policy agendas pursuing a narrow understanding of dignity as simply independence of care.

2017 ◽  
Vol 9 (2) ◽  
pp. 138-147 ◽  
Author(s):  
Ali Kazemi ◽  
Petri Kajonius

Purpose National Board of Health and Welfare claims that the quality of elderly care services differ considerably between municipalities in Sweden. This study aims to analyze to what extent these variations can be accounted for by the older person’s municipality affiliation (i.e. receiving elderly care in a certain municipality). Design/methodology/approach Addressing this issue, national survey data from 78,538 older respondents receiving elderly care services in Sweden were analyzed using multilevel modeling (MLM). Findings The results showed that municipality affiliation only marginally explained the variance in satisfaction with care, i.e. its variations were larger within than between municipalities. Instead, user-oriented care accounted for the variation in satisfaction with care. Specifically, the way the care workers behave toward the older person proved to be much more crucial for satisfaction with care than municipality affiliation. Moreover, random effects analyses revealed that the effects of user-oriented care on satisfaction with care varied across municipalities. Care setting (i.e. home care or nursing home) only marginally accounted for its variance. Practical implications Developing care quality should start and primarily be discussed at the interpersonal care level, and not, as is customary, at the municipality level. Originality/value The present research is the first in its kind to quantitatively investigate the sources of variation in perceived quality of Swedish elderly care using MLM.


2019 ◽  
Vol 16 (2) ◽  
pp. 7-24
Author(s):  
Tereza Hronová ◽  
Adéla Souralová

Each culture has a deeply rooted understanding of what constitutes the ideal foreldercare organization. This article investigates the role of family members in the delegation and provision of eldercare by private for-profit agencies in the Czech Republic. In this post-socialist country with a high level of intergenerational solidarity, a new market for eldercare has emerged in recent decades. We are interested in how the dominance of the family in eldercare provision is inscribed in the functioning of forprofit agencies and their caring practices. We examine how the role of family members whose elderly relatives receive paid care provided by private for-profit agencies is conceptualized by those who sell the care services, those who provide these services, and the care recipients themselves. We draw upon interviews conducted with the owners of private agencies, ethnographic observations, and informal interviews with paid care workers.


2015 ◽  
Vol 18 (1) ◽  
Author(s):  
Kudra Khamis ◽  
Bernard Njau

Background: Quality of care is a complex issue influenced by many factors. It is fundamental in assessing health care delivery in health facilities in developing countries. Health care workers’ perceptions help policy makers and planners to identify bottlenecks in the system to improve utilisation and sustainability of health care services in the population. The objective of this study was to explore health care workers’ perception about the quality of health care delivered at the outpatient department in Mwananyamala Hospital in Dar es Salaam, Tanzania.  Methods: A cross-sectional qualitative study was conducted from April to May 2013.  Results: Health care workers’ mentioned extrinsic as well as intrinsic factors, which may influence the quality of health care services. Extrinsic factors included poor physical infrastructure, unavailability of medical equipment and/or essential drugs and poor staffing levels. Intrinsic factors mentioned were motivation for health care workers and workplace training opportunities.Conclusion: Multiple factors influencing perceived quality of health care Mwananyamala hospital have been identified to include physical infrastructure, availability of medical equipment and essential medicines, staffing levels, remuneration and promotion.


2015 ◽  
Vol 36 (8) ◽  
pp. 971-992 ◽  
Author(s):  
Sara Cederbom ◽  
Charlotta Thunborg ◽  
Eva Denison ◽  
Anne Söderlund ◽  
Petra von Heideken Wågert

The study aimed to explore how home help service staff described their role in improving the abilities of older people, in particular, older women with chronic pain who are dependent on formal care, to perform everyday activities. Three focus group interviews were conducted, and a qualitative inductive thematic content analysis was used. The analysis resulted in one theme: struggling to improve the care recipients’ opportunities for independence but being inhibited by complex environmental factors. By encouraging the care recipients to perform everyday activities, the staff perceived themselves to both maintain and improve their care recipients’ independence and quality of life. An important goal for society and health care professionals is to improve older people’s abilities to “age in place” and to enable them to age independently while maintaining their quality of life. A key resource is home help service staff, and this resource should be utilized in the best possible way.


2018 ◽  
Vol 39 (2) ◽  
pp. 129-140 ◽  
Author(s):  
Yeonjung Lee ◽  
Rachel Barken ◽  
Ernest Gonzales

This study investigates how the receipt of formal, informal, and/or a combination of both types of care at home relates to older adults’ perceived loneliness, life satisfaction, and day-to-day lives. Quantitative analyses using the Canadian Community Health Survey ( n = 3,928) reveal that older adults who only received formal care reported lower levels of loneliness and higher levels of life satisfaction when compared with respondents who received informal or a blend of home care. Qualitative analyses of persons aged 65+ years receiving formal and informal home care in Ontario ( n = 34) suggest that formal care bolstered care recipients’ autonomy and reduced their sense of being a burden on family. In turn, receiving formal care served to improve these older adults’ social connectedness and well-being. Findings underscore older adults’ symbolic, functional, and emotional attachment to formal care services, as well as the limitations of a reliance on informal support.


2009 ◽  
Vol 21 (4) ◽  
pp. 779-786 ◽  
Author(s):  
Liat Ayalon

ABSTRACTBackground: Foreign home care services provided to frail older adults by individuals from the developing world are a global phenomenon. This study evaluated the challenges associated with live-in foreign home care from the perspective of older care recipients and their family members.Methods: Qualitative interviews were conducted with 23 family members and seven older care recipients. Interviews were analyzed thematically.Results: Three main themes were identified: (i) the intense fears associated with witnessing the decline of the older care recipient and the subsequent employment of a foreign home care worker; (ii) actual negative experiences within this caregiving setting; and (iii) the ways in which family members and older care recipients coped with these challenging experiences.Conclusions: The key to this caregiving arrangement is the establishment of trust. Yet, many care recipients experienced violations of trust that resulted in abuse and neglect, which served to further intensify fears and concerns about this caregiving arrangement. The same coping methods used to maintain this arrangement, despite fears and concerns, are the ones responsible for maintaining the older care recipient in an abusive situation.


2021 ◽  
Vol 27 (2) ◽  
pp. 202-210
Author(s):  
Nüket Erbaydar

Background: The mother-friendly care model and mother-friendly programmes are powerful responses to solve problems in maternity care services including high rates of caesarean section, low breastfeeding rates, and women’s rights issues. Aims: This paper describes the development and implementation of the mother-friendly hospital programme of Turkey. Methods: The Ministry of Health initiated the mother-friendly hospital programme in 2010. National mother-friendly hospital standards, guidelines and evaluation tools were developed. Implementation began in 2015. Results: Training activities were carried out to enable health care workers (e.g. physicians, midwives, nurses) to train staff of hospitals applying to the programme, and to evaluate and monitor their maternity services; 455 health care workers were trained. Participation in the programme is voluntary and hospitals apply for certification. To apply, the hospital’s caesarean section rate must be lower than the country average. As of January 2020, 73 hospitals have been certified as mother-friendly hospitals. Conclusion: As a practical implementation of the mother-friendly approach, Turkey’s experience may be useful to other health systems.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 833-833
Author(s):  
Jinbao Zhang ◽  
Julia Shu-Huah Wang ◽  
Yu-Chih Chen

Abstract Objectives The consumer-directed care (CDC) program aims to maximize health outcomes by offering older adults more control, choice, and flexibility over the care services they received. However, countries may operate CDC programs in different ways based on heterogenous sociostructural systems. We proposed a comparative framework to evaluate three dimensions of CDC—control and direct services, variety of service options, and information and support—and analyzed how countries varied in their policy design to achieve consumer direction. Methods Using cross-national document analysis, we analyzed eleven CDC programs from seven selected countries (Netherlands, United States (US), United Kingdom (UK), Germany, China, Australia, and Spain) with five CDC care regimes. A total of fourteen indicators capturing three dimensions of CDC programs was developed. We further used these indicators to evaluate and compare similarities and differences of policy features across countries using descriptive statistics and graphical approaches. Results CDC programs in the Netherlands, Arkansas, and the UK ranked at the top in consumer direction. All countries except Germany employed a “service-based” principle in determination of service type. Training care workers was in the most widespread use to assure quality of care. Merely the UK and Germany integrated CDC and conventional agency care without restrictions. Representative with relevant support was only available in the UK and Netherlands. Discussion and Implication: CDC models involve multi-faced aspects, rather than dichotomies and discrete entities. Implications include the need for a systematic reflection with our developed framework and enriching variety of service options to promote consumer direction.


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