DELAD UTSATTHET
– vård i hemmet ur äldre människors, anhörigasoch professionella vårdares perspektiv
Aleksandra Jarling
Akademisk avhandling
som för avläggande av filosofie doktorsexamen vid Högskolan i Borås försvaras vid offentlig disputation, fredagen den 4 december 2020, kl. 9.30
i hörsalen M404, Sandgärdet, Högskolan i Borås. Disputationen sänds via videolänk, för information se kalendariet på hb.se/forskning.
Fakultetsopponent: Professor Margareta Asp Akademin för hälsa, vård och välfärd
Shared vulnerability
– home care from the perspective of older people, family caregivers, and professional caregivers
Aleksandra Jarling
University of Borås Sweden
ABSTRACT
Aim: The overall aim of the thesis was to deepen the knowledge about home care from the perspective of older people, family caregivers, and professional caregivers.
Approach and method: A lifeworld approach was used to describe different experiences of home care. Lifeworld interviews were performed in three studies, and analyses were conducted according to different methodological principles. Study I describes the meaning of home care from the perspective of older people who live alone, including interviews with 12 participants analyzed with qualitative content analysis. Study II describes the life situation in which responsibility for an older person is imposed upon family caregivers. Ten interviews were conducted and analyzed using a phenomenological method. Study III, using phenomenography, describes perceptions of caring responsibility based on interviews with 14 professional caregivers. Study IV explores health and social network factors related to receiving care in the home among older adults (n = 317). Descriptive statistics and regression analyses were conducted. Finally, a synthesis was carried out and interpreted with a philosophical analysis in order to support the understanding of home care from different perspectives as a whole.
Main results: Becoming older with increased caring needs disrupts one’s life when the private home becomes a public arena. The older person needs to adapt to a caring culture, but they are often unable to influence their care and must deal with forced relations. Family caregivers assume a great responsibility that changes and interferes with their whole life situation and impacts their health and relationships. Professional caregivers are also affected to a great extent, as the burden is high. Responsibility is perceived as limitless, constrained by time, moral, overseeing, meaningful and lonesome. To be cared for in one’s own home is complex from both a medical and psychosocial perspective. The results also give an indication of the importance of relationships and increasing awareness of the social perspectives of home care.
Conclusion: This thesis contributes to the existing knowledge of how home care can be experienced from the perspectives of older people, family caregivers and professional caregivers in order to provide good and safe home care based on individual needs. Home care as a phenomenon is complex—it entails a vulnerable situation for the older person, the family caregivers, and professional caregivers. The results show the importance of a holistic perspective that includes individual experiences. They also highlight the importance of considering social perspectives and relationships in home care rather than merely focusing on medical and/or functional factors.
Keywords: home care, older people, family caregivers, informal care, formal care, professional caregivers, health, lifeworld.
This dissertation is available at: ISBN 978-91-88838-95-7 (printed) ISBN 978-91-88838-96-4 (pdf)
ISSN 0280-381X, nr 113 (writings from University of Borås)
