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Constructing loneliness: home care providers' notions of older adults' social needs and the possibilities of the home care profession to support social participation
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy.ORCID iD: 0000-0002-0729-5361
Umeå University, Faculty of Arts, Department of culture and media studies.ORCID iD: 0000-0002-8758-5704
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy.ORCID iD: 0000-0002-8265-5769
2023 (English)In: Journal of Aging Studies, ISSN 0890-4065, E-ISSN 1879-193X, Vol. 65, article id 101130Article in journal (Refereed) Published
Abstract [en]

Quality of care is determined not only by political decisions but also by how those policies are understood and managed by professionals when put into action. Home care services, the most common form of elder care in Sweden today, should include social support, which is very important for health and wellbeing. And yet, support for social participation seems to be lacking. Understanding prevalent social constructs and their possible impacts on focus and content of social practice in home care could reveal ways to address social support in home care. Therefore, this article highlights how professionals in home care provision talk about older home care recipients' loneliness and social needs, and how these repertoires are related to professionals' opportunities and obligations to support those social needs. The study included 22 persons from different professions in home care provision, from two municipalities in northern Sweden. Nine individual interviews and four group interviews were conducted, recorded, transcribed, and analyzed using a discourse psychology approach. The results show two interpretative repertoires in which notions of otherness and likeness guided definitions and support regarding loneliness, social needs, and social support. This study reveals assumptions that underpin and structure the practices of home care. As the interpretative repertoires provided differing and partly opposing views on how to provide social support and combat loneliness, it seems important to also address the broader issues of professional identities and how loneliness is defined and approached.

Place, publisher, year, edition, pages
Elsevier, 2023. Vol. 65, article id 101130
Keywords [en]
Home care services, Occupational therapy, Discourse analysis, Interpretative repertoire, Older adults, Aging
National Category
Occupational Therapy Ethnology Nursing
Research subject
Occupational therapy; Ethnology
Identifiers
URN: urn:nbn:se:umu:diva-205993DOI: 10.1016/j.jaging.2023.101130ISI: 000952643200001Scopus ID: 2-s2.0-85150042171OAI: oai:DiVA.org:umu-205993DiVA, id: diva2:1745913
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2016-07089Available from: 2023-03-26 Created: 2023-03-26 Last updated: 2023-09-05Bibliographically approved
In thesis
1. Harnessing togetherness: perceptions of loneliness and promotion of social participation in the home care context
Open this publication in new window or tab >>Harnessing togetherness: perceptions of loneliness and promotion of social participation in the home care context
2023 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Att fånga känslan av gemenskap : uppfattningar av ensamhet och främjande av social delaktighet i hemtjänstkontext
Abstract [en]

Introduction: It is well known that older adults have a higher risk for loneliness, which is detrimental to health. Home care in Sweden has a responsibility to address social needs, but systematic approaches are lacking and there is a know–do gap. The overall aim of this thesis was to develop knowledge about older home care recipients’ and home care providers' perceptions of loneliness and social participation among older adults, and furthermore, to develop a work model for supporting social participation in home care and explore that process.

Methods: Four studies were included. In the first study, care recipient interviews explored perceptions of social participation. In the second, a total population survey investigated the association between perceived care quality and loneliness. The third study used individual and group interviews with home care providers to explore discourses on loneliness and social support. The fourth applied a participatory action research(PAR) process with care workers to develop strategies to alleviate care recipients’ loneliness.

Findings: Enjoying personally relevant occupations, both in solitude and with others, was found to be important for satisfactory social participation. Low perceived quality in home care quality was statistically associated with loneliness. Two discourses, one in which care recipients were described as valued but vulnerable “others”, and another in which they were described as competent peers, were identified. A work model facilitating social participation was created, and the process was applied to a “framework for occupational enablement for change in community practice”.

Conclusion: The understanding of loneliness and social participation in the complex home care context has been nuanced, as have discourses that affect home care practice. The work model itself could become a first step towards systematically addressing loneliness and social needs, and the application of an occupational enablement framework onto the PAR process ties the methodologies together and facilitates participatory research for occupational therapy and science.

Place, publisher, year, edition, pages
Umeå: Umeå University, 2023. p. 100
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 2236
Keywords
Loneliness, Older adults, Home care services, Home care delivery, Social participation
National Category
Social Work Occupational Therapy Nursing
Research subject
Occupational therapy
Identifiers
urn:nbn:se:umu:diva-206318 (URN)978-91-8070-043-6 (ISBN)978-91-8070-044-3 (ISBN)
Public defence
2023-04-28, Rotundan, Universumhuset, Universums gränd 8, Umeå, 09:00 (Swedish)
Opponent
Supervisors
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2016-07089
Available from: 2023-04-06 Created: 2023-04-03 Last updated: 2023-04-04Bibliographically approved

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Nordin, ThereseLundgren, Anna SofiaNilsson, Ingeborg

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