The importance of addressing ageism in Swedish healthcare

Ageism is discrimination against individuals or groups based on their age. In the Swedish healthcare context, the term is uncommon, despite the fact that older people are a significant class of users. One of every five individuals in Sweden is 65 years of age or older, and the proportion of older people in the population is rising. Therefore, ageism in healthcare warrants more awareness and focus. In three recent articles that we have published relating to nutritional, depression and continence care for older people, we found indications of ageism even though we did not aim to study it. There is a need to identify the manifestations of ageism and label them, and to become alert to both the visible and invisible expressions of ageism. This will help in the development of interventions and policies to eliminate ageism in healthcare. With health inequalities growing and seemingly becoming the norm rather than the exception in Sweden and other European countries, it has become imperative to address and eliminate health inequalities through a range of initiatives and mechanisms. Fighting ageism in different settings must be a part of this larger goal.

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Primary palliative care for older people in three European countries: a mortality follow-back quality study

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2019-001967 ◽

2019 ◽

Vol 10 (4) ◽

pp. 462-468 ◽

Cited By ~ 1

Author(s):

Kim de Nooijer ◽

Lara Pivodic ◽

Luc Deliens ◽

Guido Miccinesi ◽

Tomas Vega Alonso ◽

...

Keyword(s):

Palliative Care ◽

Older People ◽

Patient Communication ◽

European Countries ◽

Epidemiological Surveillance ◽

Palliative Care Services ◽

Complex Health Problems ◽

Almost All ◽

Care For Older People

BackgroundMany older people with serious chronic illnesses experience complex health problems for which palliative care is indicated. We aimed to examine the quality of primary palliative care for people aged 65–84 years and those 85 years and older who died non-suddenly in three European countries.MethodsThis is a nationwide representative mortality follow-back study. General practitioners (GPs) belonging to epidemiological surveillance networks in Belgium (BE), Italy (IT) and Spain (ES) (2013–2015) registered weekly all deaths in their practices. We included deaths of people aged 65 and excluded sudden deaths judged by GPs. We applied a validated set of quality indicators.ResultsGPs registered 3496 deaths, of which 2329 were non-sudden (1126 aged 65–84, 1203 aged 85+). GPs in BE (reference category) reported higher scores than IT across almost all indicators. Differences with ES were not consistent. The score in BE particularly differed from IT on GP–patient communication (aged 65–84: 61% in BE vs 20% in IT (OR=0.12, 95% CI 0.07 to 0.20) aged 85+: 47% in BE vs 9% in IT (OR=0.09, 95% CI 0.05 to 0.16)). Between BE and ES, we identified a large difference in involvement of palliative care services (aged 65–84: 62% in BE vs 89% in ES (OR=4.81, 95% CI 2.41 to 9.61) aged 85+: 61% in BE vs 77% in ES (OR=3.1, 95% CI 1.71 to 5.53)).ConclusionsConsiderable country differences were identified in the quality of primary palliative care for older people. The data suggest room for improvement across all countries, particularly regarding pain measurement, GP–patient communication and multidisciplinary meetings.

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But does it work? The role of regulation in improving the quality of residential care for older people in Europe

Quality in Ageing and Older Adults ◽

10.1108/qaoa-09-2014-0021 ◽

2015 ◽

Vol 16 (2) ◽

pp. 118-128 ◽

Cited By ~ 3

Author(s):

Ciara O'Dwyer

Keyword(s):

Older People ◽

Residential Care ◽

Command And Control ◽

European Countries ◽

Comparative Approach ◽

Content Type ◽

Financial Investment ◽

And Control ◽

Care For Older People

Purpose – Regulation is the tool preferred by policy-makers to manage the quality of residential care for older people. However, it remains unclear which form of regulation is most effective. The residential care sector for older people in Europe offers a unique opportunity to explore this issue as countries vary in how they control quality in the sector. The paper aims to discuss this issue. Design/methodology/approach – The study used a comparative approach, collating secondary data from various sources and conducting qualitative comparative analysis on the data. Findings – Three regulatory approaches were in operation – many Northern European countries operate on a self-regulatory basis, and are associated with the highest quality. Many continental countries, the UK and Ireland operate a command-and-control regulatory approach, with a moderate standard of care. Mediterranean and Eastern European countries have limited regulation, with care of a lower standard. However, the type of regulation appears to be a product of the prevailing culture and philosophy of care within each country. Thus, quality outcomes are a measure of financial investment in care. Social implications – Consistent calls for command-and-control style regulation may be misguided; high-quality care requires high-public investment and a professional workforce with the freedom to focus on quality improvement mechanisms. Originality/value – The paper provides a framework for analysing outcomes associated with different types of regulation. While a self-regulatory model is linked with the best outcomes, financial investment and the philosophy of care may be more important factors influencing the quality of care.

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Improving the mix of institutional and community care for older people with dementia: an application of the balance of care approach in eight European countries

Aging & Mental Health ◽

10.1080/13607863.2015.1078285 ◽

2015 ◽

Vol 20 (12) ◽

pp. 1327-1338 ◽

Cited By ~ 9

Author(s):

S. Tucker ◽

C. Sutcliffe ◽

I. Bowns ◽

D. Challis ◽

K. Saks ◽

...

Keyword(s):

Older People ◽

Community Care ◽

European Countries ◽

People With Dementia ◽

Care Approach ◽

Balance Of Care ◽

Care For Older People

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A Typology of Caregiving Situations and Service Use in Family Carers of Older People in Six European Countries

GeroPsych ◽

10.1024/1662-9647/a000031 ◽

2011 ◽

Vol 24 (1) ◽

pp. 5-18 ◽

Cited By ~ 8

Author(s):

Mirko Di Rosa ◽

Christopher Kofahl ◽

Kevin McKee ◽

Barbara Bień ◽

Giovanni Lamura ◽

...

Keyword(s):

Health Services ◽

Older People ◽

Support Services ◽

Family Caregiving ◽

Service Use ◽

European Countries ◽

Limited Resources ◽

Family Carers ◽

Policy Initiatives ◽

Typology Of Care

This paper presents the EUROFAMCARE study findings, examining a typology of care situations for family carers of older people, and the interplay of carers with social and health services. Despite the complexity of family caregiving situations across Europe, our analyses determined the existence of seven “caregiving situations,” varying on a range of critical indicators. Our study also describes the availability and use of different support services for carers and care receivers, and carers’ preferences for the characteristics of support services. Our findings have relevance for policy initiatives in Europe, where limited resources need to be more equitably distributed and services should be targeted to caregiving situations reflecting the greatest need, and organized to reflect the preferences of family carers.

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Residential care for older people with mental disorders: What are the appropriate settings?

PsycEXTRA Dataset ◽

10.1037/e537072013-009 ◽

1996 ◽

Author(s):

Joyce O'Connor ◽

Michael Walsh

Keyword(s):

Mental Disorders ◽

Older People ◽

Residential Care ◽

Care For Older People

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Valuing End-of-Life Care for Older People with Advanced Cancer: Is Dying at Home Important?

The Patient: Patient-Centered Outcomes Research ◽

10.1007/s40271-021-00517-z ◽

2021 ◽

Author(s):

Patricia Kenny ◽

Deborah J. Street ◽

Jane Hall ◽

Meera Agar ◽

Jane Phillips

Keyword(s):

Older People ◽

End Of Life ◽

Advanced Cancer ◽

End Of Life Care ◽

Life Care ◽

Dying At Home ◽

Care For Older People ◽

At Home

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Patient Flow or the Patient’s Journey? Exploring Health Care Providers’ Experiences and Understandings of Implementing a Care Pathway to Improve the Quality of Transitional Care for Older People

Qualitative Health Research ◽

10.1177/10497323211003861 ◽

2021 ◽

pp. 104973232110038

Author(s):

Cecilie Fromholt Olsen ◽

Astrid Bergland ◽

Jonas Debesay ◽

Asta Bye ◽

Anne Gudrun Langaas

Keyword(s):

Health Care ◽

Older People ◽

Health Care Providers ◽

Transitional Care ◽

Care Pathway ◽

Patient Flow ◽

Care Pathways ◽

Care Providers ◽

Patient Centered ◽

Care For Older People

Internationally, the implementation of care pathways is a common strategy for making transitional care for older people more effective and patient-centered. Previous research highlights inherent tensions in care pathways, particularly in relation to their patient-centered aspects, which may cause dilemmas for health care providers. Health care providers’ understandings and experiences of this, however, remain unclear. Our aim was to explore health care providers’ experiences and understandings of implementing a care pathway to improve transitional care for older people. We conducted semistructured interviews with 20 health care providers and three key persons, along with participant observations of 22 meetings, in a Norwegian quality improvement collaborative. Through a thematic analysis, we identified an understanding of the care pathway as both patient flow and the patient’s journey and a dilemma between the two, and we discuss how the negotiation of conflicting institutional logics is a central part of care pathway implementation.

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