The number of elderly in Sweden is increasing due to improved living conditions and better medical care. It is important that society adapts to the increase and begins to work preventively to reduce the costs of the increase. An important aspect is the elderly accommodation, the cost of health care in specific accommodation is almost twice as high as those for ordinary housing. Therefore, it is important that we availability adapt dwelling to allow older people to live in ordinary housing for as long as they wish, instead of moving to assisted living before they need it. If we can fulfil the elder?s needs with home care instead, society can save a lot of money.In this report, three different forms of housing has undergone accessibility increases and been inventoried and analysed.

This thesis puts together general guidelines for the design of outdoor environment at nursing homes for people with dementia. The goal is to give the residents a greater quality of life with the garden.The garden must be safe and secure while offering places for fellowship or retirement and experiences of joy and competence. The plant material and other elements in the garden are inserted to stimulate the senses and to inspire to different activities. The paper describes the health promoting effects of nature and gardens by referring to scientific studies. These studies encompass the impact of nature on all human beings as well as how the outdoor environment affects our target group, elderly people with dementia. An essential part of the work focus on the conditions in a garden for people with dementia, on the contact between residence and garden and the access to surrounding life. Eventually, the general guidelines are applied to a real building project ? the Vega project in Lomma,a new nursing home for persons with dementia.

To increase the understanding of how individuals total life situation affects their stress level and health has lately more frequently been discussed in different contexts. Furthermore, it is important to have knowledge of power structures that exist under given circumstances in a society to get an increased understanding of how to structure the health promoting work to get the highest possible benefits. People?s work life is essential to their health, since we spend a lot of time at work. The aim of this study was to find out which factors that relate to nursing staff?s health and stress level from a general perspective.

The aim: was to describe and compare a group of experts and critical care nurses' agreement in detecting delirium in intubated, ventilator treated patients with sedation / analgesia, before and after an in house training intervention with the instrument Confusion Assessment Method for the Intensive Care Unit (CAM-ICU).Method: A quasi-experimental study, one group pretest - posttest design. A convenience sample of 17 critical care nurses in a general intensive care unit included. To detect delirium the instrument CAM-ICU was used, 21 paired tests before and 22 after an educational intervention.Main Results: The results showed that after an in house training intervention sensitivity and kappa coefficient improved of the characteristic 1 "acute onset and fluctuating course," an improvement that was significant. In other features, and overall values were signs of numerical improvement and deterioration in sensitivity, specificity and kappa coefficient but no significant change.Conclusion: Implementing a new instrument for detecting delirium in clinical practice requires education and follow-up. A small sample of critical care nurses with varying ability to use the new instrument and the fact that patients' status may change rapidly making it difficult to draw any conclusions from this study.

Trough the contact with the HR (Human Resources) department of home care management in Halmstad municipality, emerged from the management a wish for a documentation for what should be included in leadership at middle management level in the future. People in middle management positions have a large impact on the operation staff and are also in charge of the individual corporate performance and its success. As we have previously been active in the management of multiple role configurations, including middle-management positions, we have some prior understanding of the complexity of this position. The study was conducted with the aim to investigate different aspects of what leadership for middle managers in home care management in Halmstad municipality may mean to them. With the help of different theories and models various aspects were analyzed due to the impact of leadership.Due to the studies purpose and questions, two focus groups was conducted and interviews with respondents from both the lower and superior positions in home care management in Halmstad municipality was done.

Introduction: The interaction between different care facilities and professions is important in the care of older patients. Patients do not always get enough time to recover and often have a continued need for care. A discharge process of good structure in which the patient and relatives are participating and the continued need of care is assured is of importance in care of older patients.Objective: The overall purpose of this study is to compare the discharge process for patients over 75 years old admitted to a emergency medicine ward respective a emergency medicine ward with geriatric focus at a medicine clinic, to compare discharge process between these wards and evaluate the patients situation at home after discharge.Methods: A survey of medical records with a protocol and a telephone survey have been performed. Data was analyzed with descriptive and analytic statistic. Patients at the medical wards MAVA and care unit number 21/34, which are 75 years or older and are discharged to their own home, within the municipality of Göteborgs stad, in Sweden, are included in this study.Results: The discharge process differed between medicine wards with emergency medicine and geriatric focus.

Bakgrund Diabetes mellitus typ 2 är en snabbt ökande sjukdom i hela värl-den. Den påverkar människors välbefinnande och skapar ofta stort lidande för de drabbade. Det är en endokrin och kronisk sjukdom med påverkan på blodsockernivån. Långvarigt förhöjda blodsockernivåer kan leda till svåra följdsjukdomar som hjärt- kärlsjukdomar. Sjuksköterskan har en betydande roll i att för-medla kunskap genom ett holistiskt bemötande och att stärka pa-tienten genom ökad empowerment.

In this thesis the core of the nursing professional skill will be portrayed through the opportunities of the essay writing. Thus the tacit knowledge, which is at the verge of erosion in a zeitgeist where medical care shall be cost-efficient and where development is mainly based on scientific research, will be articulated. Scientific articulation of knowledge has gained increasing importance on the expense of the practical knowledge. Healthcare professional skill requires a refind ability of judgment, which absorbs its nourishment from both scientific knowledge and the proven proficiency expertise.Professional skill expresses itselfs through action, especially through the acting in unexpected incident. Experience is developed into knowledge through reflection.

Today, palliative care is performed in several different areas. When the curative treatment is no longer effective the objective of the palliative care is to promote the best possible quality of life for dying patients, through an active and overall treatment. In their work nurses see death and the dying. To highlight and to reach an understanding of the significance of their work, this literature study's objective is, using Carnevali´s thoughts about health as a theoretical framework, to describe different aspects of nurses' experiences of working with dying patients within palliative care. Furthermore the occurrence of stress and possible stress factors will be examined, as well as the nurses' access to support and to established coping strategies..

Background: Every year 56 million people die around the world and it is estimated that 60% of these people are in need of palliative care. It has been shown that patients in the palliative care experienced their situation as uncertain. When life no longer was certain, the patients tried to live their life day by day and make the best of it. Problem: When patients were diagnosed with an incurable disease the future became unsure, because their life would come to an end. Therefore patients with a palliative diagnosis could be in need of experiencing feelings of security.

In the early 1990?s more and more companies of the Swedish public sector were exposed to competition, and this started the debate on how such actions might affect the business and even society.The first chapter examines how the public sector and especially health care, is financed and managed. We also explore what it means to be exposed to competition and find that there are many different ways of exposing the public sector to competition. The study examines dental care as an example of a market with both publicly and privately owned companies. The purpose of this paper is to explore how publicly and privately owned health care companies view their relationship with their consumers.

The aim of this study is to investigate how the Swedish language proficiency of pupils in vocational programmes in 1977 was measured and assessed with the aid of a national achievement test, and to investigate whether vocational pupils today, in 2014, have similar language proficiency to that of pupils in the 1970s. The study also discusses how the design of the national achievement test from 1977 reflects the view of knowledge that prevailed in society and in the policy documents. The material for the study consists of a total of 75 national achievement tests, 40 of which were taken by pupils on a vocational programme in 1977 and 35 by pupils on a vocational programme in 2014. The national achievement test consists of two parts, the first of which focuses on isolated elements of language proficiency, while the second involves free text production. The material was analysed quantitatively in accordance with the correction material from 1977.

sjuksköterska (I. Dahl).

Bakgrund: Den äldre populationen ökar och många av de äldre lider av flera olika sjukdomar. Därmed ökar behovet av professionell och god omvårdnad. Den äldre människan som ofta lider av flera sjukdomar bor vanligtvis sista tiden av sitt liv på vård- och omsorgsboende. Äldre människor vårdas inte utifrån ett palliativt perspektiv trots att behov föreligger. Palliativ vård kopplas ofta ihop med människor som är under 65 år och har en obotlig sjukdom exempelvis cancer.Syfte: Att belysa hur den äldre människan vårdas i livets slut på vård- och omsorgsboende, ur de äldres, de närståendes och vårdpersonalens perspektiv.Metod: En litteraturstudie inspirerad av Friberg (2006).

At two nursing homes for people with dementia a qualitative study was performed. The purpose was to investigate the therapy dog?s meaning to people with dementia from their perspective. Two women and five men with dementia were interviewed, everyone being somewhere between 60 and 87 years of age. All but one had previously owned a dog at some point in their lives.