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The Swedish Social Services Act (SFS 2001:453) stipulates since 1982 that the municipal Social Committee should become well acquainted with the living conditions in the municipality. They should also participate in urban planning, and in cooperation with other public bodies, organizations, associations and individuals promote good living environments in the municipality. The development, planning and design of good living environments for older people is an endeavour of great complexity that demands collaboration between many actors. Housing and care for older people is an important area in which social servicesand urban planning could benefit from collaboration. Planning for older people has recently been indicated as urgent and necessary, especially in the light of changed demography in which the proportion of older people is increasing. A built environment that accommodates older people’s everyday needs embraces issues such as age-friendliness, care, socio-spatial inequality, inclusion, and innovation. This research program, CollAge, investigates cross-sectoral collaboration in Swedish municipalities between social eldercare, urban planning and Senior Citizens’ Councils as regards housing and care. With diverse qualitative methodologies the multidisciplinary team of scholars in social work, architecture and urban planning  explore how eldercare interventions and services are managed and understood in municipal urban planning and development, and how older people’s preferences can contribute to improved quality of care in social services and housing provision.  The ultimate aim of the programme is to develop a methodological tool – CollAge – to support, facilitate and structure collaboration between the three actors.

The exercise of self-determination is a human right; however, for people with dementia (PWD), progressive physical and cognitive impairment negatively affects their decision-making processes. For PWD, it is often relatives who make such decisions. This qualitative study included interviews with sixteen relatives of PWD who live in nursing homes. Research questions are as follows: How do relatives understand the participation of PWD who live in nursing homes? How do co-researchers understand participation and the role of relatives? A co-researcher was consulted when the questions were designed. During the interviews with relatives, photos were used to stimulate discussion. Critical situations in nursing homes were discussed with relatives and later interpreted together with a co-researcher. The findings included an understanding of how relatives played a key role in PWD; however, relatives were concerned that PWD were unable to take part in decisions. In addition, relatives named ways that nursing homes opposed human rights, and the co-researchers also highlighted situations that conflicted with human rights. Classifying dementia as a disability at the policy level could strengthen the rights issues of PWD. The key findings of the study are essential for social workers arranging for placement of PWD in nursing homes.

People living in nursing homes have the right to self-determination, and difficulty in accommodating this right can create moral distress in staff. This study aimed to explore experiences of situations of moral distress and to identify nursing home staffs’ needs to act with moral agency. Six group interviews were conducted with nursing home staff. Content analysis of the interview responses showed that moral distress can be rooted in both concrete situations with residents and factors related to the work environment and policy requirements. Personnel can address moral distress through both active and passive means. Staff acted to address moral distress mainly in situations with residents and sometimes in relation to co-workers, but they did not try to influence the policy level.

This article aims to explore how community home care of older people is provided and organized at night. In times of welfare decline, organizational changes, and an increasing aged population, questions arise about home care and support for older people. In Sweden as in many other western countries 'ageing in place' is a guiding principle in care provision for older people, which put increasing pressure on home care services. Still, night-time care represents a research gap within health and social care research, nationally and internationally. This telephone interview survey examines 41 operations managers' perceptions of organization and care provision and how they account for the goals and work of home care at night-time in a selection of 37 Swedish municipalities. The analysis was inspired by thematic content analysis where three central themes were categorized: organizational context of night-time care, working conditions, and challenges of night-time care. Our results reveal that organizational context varied depending on the demography and size of the municipality. The work situation was characterizeded by constantly unforeseen events to manage. Multiple challenges were identified on societal and political levels, as were limited resources and recruitment problems. In conclusion, our analysis has identified unpredictability as a core feature of night-time care work. The complexity of the provision of night-time care was not recognized as important for the municipal organization. To provide high quality care at night in ordinary housing, there is a need to both focus on organizational aspects and to have sufficient resources and time. 

People with dementia (PWD) are fragile and need aid and care in their daily lives. This scoping review explores the extent to which PWD can be involved in society and their daily lives. Publications were selected according to PRISMA guidelines. We graded the level of participation/involvement in daily life and research using a five-level participation model developed by Shier. A higher grade means a greater ambition to involve PWD in decisions. Of the 11 included studies, three reached level three according to Shier’s model. The studies describe ways of and potentials for participation, capabilities of PWD, caregivers’ opportunities to foster involvement, and cooperation between PWD caregivers and relatives. Caregivers and managers must have the attitude that PWD can be involved in decisions and caregivers need opportunities to actively promote such involvement. Shier’s model can be a tool with which organizations strive to involve PWD.

Up to date, we know little about how home care services is organized and performed at nighttime. There are no official statistics of night time care or the number of older people havingassistance at night. This paper aims to report from a survey with operation managers and theiraccounts of organization and provision of care at night.The material consisted of a sample of 37 of Sweden’s 290 municipalities, covering for urbanas well as rural areas, smaller and larger municipalities as well as bigger cities. Individualtelephone interviews were conducted with 41 operation managers responsible for night timecare. Standardised and open ended questions were raised to capture strategies of night timehome care organization and provision. The material was analysed quantitatively andqualitatively.The results revealed similarities as well as differences in organization where smallermunicipalities often had to find special solutions. The care workers had to manage emergencyalarm from the older persons as well as scheduled care work at night. The care work includeda lot of car driving and insecurity at night, such as bad weather and violence in the streets.Safety and dignity were raised by the managers as important values in provision of care, bothfor the elderly and staff.There were several challenges in demographic development and local politics, but also inrecruitment problems and staff’s working conditions. To organize for ageing in place, homecare needs to be user friendly for vulnerable persons, also at night time.

This article aims to explore and analyse how good and dignified care is perceived and expressed at night-time within elder home care services, in which night-time care represents a knowledge gap. Dignity has become a legislated value in Swedish eldercare, aiming to increase the quality of care and to clarify the ethical values of everyday care practice. The data presented here come from a qualitative case study with in-depth interviews with six care unit managers and 14 care workers in four municipalities. The analysis of the interviewees’ perceptions and expressions of good care were informed by Nodding’s concepts: responsiveness, receptivity, and relatedness. The results showed that there was a relative unawareness of the new goals of the dignity policy and there was no specific guidance regarding dignity during night-time care. The care unit managers’ perspective was mainly administrative and related to the policy level and the staff’s ability to care. The care workers’ view of good and dignified care included aspects of ideal characteristics and user-centredness with a focus on older people’s individual needs. However, good care was conditioned by time. The dignity policy, as described in national documents, was perceived by the interviewees as vague and with unreachable goals constructed on the structural level. In social care practice, however, expressions of good and dignified care were already found in care ethics, regardless of the dignity policy. By bringing relationality to the dignity discourse on the structural policy level, recognition of care may be emphasized.