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U-Age

Rationale

The scientific rationale for this programme is

  • the current shortness of international data on the effects and feasibility of person-centred, knowledge-based and person-centred interventions in aged care at home and in institutions,
  • a lack of longitudinal data that highlights the population health and quality of life of frail older people in residential aged care in relation to the characteristics and organisation of care provision.

Aim

  • To explore effects and feasibility of innovative, knowledge-based and person-centred interventions in home care and residential aged care,
  • To compare health outcomes between Trygghetsboende and ageing in place,
  • To collect nationally representative data on resident health and quality of life and the characteristics and organisation of care provision in Swedish residential aged care facilities.
  1. Does an innovative knowledge-based and person-centred home-care service that focuses on quality of life for older people result in better health, quality of life and thriving compared to traditional home-care services focusing on functional abilities?
  2. Does an "award-winning airline model" for service delivery excellence in aged care increase staff work satisfaction and satisfaction for residents and family?
  3. Does Senior/Trygghetsboende associate stronger with health, thriving and quality of life compared to ageing in place?
  4. What is the prevalence of resident health and quality of life, and the characteristics and organisation of care provision in a nationally representative sample of Swedish residential aged care facilities?

Home care

Results from research in home care point to that home care services today do not support multidimensional health and Quality of life (QoL) in older people living at home. One major criticism is the limited consumer involvement. A way to increase consumer involvement might be implementation of person-centred care which is often described as quality care for older people. The overall aim of this project is to evaluate effects and meaning of person-centred home care service on home care recipients' QoL (primary endpoint), thriving and satisfaction with care, family members' care giver strain and satisfaction with care, and home care personnel's job satisfaction and stress.

Nursing home

Person-centred care (PCC) is described in contemporary literature as high quality, best practice care of older people in residential aged care facilities. However, there is limited research evidence on how PCC could best be operationalised to promote wellbeing and satisfaction for all residential aged care stakeholders, i.e. residents, their relatives, and staff. The aim of this project is to evaluate effect, meaning and significance of a person-centred and thriving-promoting care model in residential aged care in Australia, Norway and Sweden. The study is designed as a multi-centre, controlled group before-after design with participating sites in Melbourne (Australia), Oslo (Norway) and Västerbotten (Sweden). Staff in the intervention facilities will follow a structured 12-month educational protocol to implement the person-centred and thriving-promoting care model. The care model comprise of three dimensions: To give the little extra, To develop a caring environment, To assess and meet highly prioritsed psychosocial needs. The effect of the intervention will be evaluated by ratings of residents´ thriving, family members´ satisfaction with care, and job satisfaction of staff (primary endpoints) at baseline, directly after the intervention is ended, and at six month follow up. The meaning and significance of the intervention will be evaluated by interviews with staff and family members after the intervention is ended.

SVENIS

Swedish national inventory of health and care

The aging population introduces great challenges to aged care. Residents eligible for care in Swedish aged care facilities need extensive support to manage daily living. There is a shortage of nationally and internationally representative studies on the prevalence of symptoms that inhibit experiences of health, and comparable data on care-provision is also lacking.

The SVENIS study addresses the fact that Sweden has no nationally representative and scientifically valid and standardized measures of models of care and person-centredness, as well as on cognitive impairment, neuropsychiatric symptoms, pain and ADL function for the population of residents in aged care facilities. In addition, there is a shortness of data on positive outcomes in aged care such as experiential health and thriving. The SVENIS survey was developed from well-regarded international assessment scales, and newly constructed ones to evaluate the person-centredness of care together with resident health and QoL at cross-sectional and longitudinal time points.

Out of the 290 Swedish municipalities, 60 were randomly selected. The final sample contained 188 facilities from 38 municipalities. Data were collected between November 2013 and September 2014 using a 3-part-survey:

  1. Resident Survey: characteristics, functional and cognitive status, health indicators, HRQoL and thriving.
  2. Staff Survey: information on person-centredness and leadership.
  3. Facility Survey: organisational variables such as staffing levels, mortality, care and activity content.

The SVENIS data set enables international comparison and collaboration on resident health and thriving in relation to care practices and organisational structures, and provides a national benchmark to which smaller studies can compare.

Sheltered housing

Trygghetsboende is a relatively new form of accommodation in Sweden and therefore, the knowledge of the people who live there is lacking. In U-age, the National Board of Housing, Building and Planning definition of Trygghetsboende is used. This means that at least one of the persons moving in should be at least 70 years old. Furthermore, the Trygghetsboende have to have common areas for socializing and there must also be a host at certain times of the day is available for residents. The study of these accommodations focus on health, thriving and how residents rate their quality of life. All people in Sweden who lives in a Trygghetsboende will be contacted and asked to answer a questionnaire that deals with questions about health, if you provide care to someone and if you get the care of a loved one.

The same survey is sent to as many who do not live in Trygghetsboende, and these controls are important in order to be able to compare the two groups. The controls are matched on sex, age and municipality of residence.

In order to get as complete picture as possible, data from registries will be gathered regarding the health care contacts and care needs, and medication use. No person can be identified and data will be used at the group level.