This article discusses the staff's view on dementia and its impact on the care delivered arising out of a qualitative comparative study focusing on long-term care of older people in France, Portugal and Sweden. The aim was to explore the staff's view on the illness dementia; on older people suffering from dementia; the care provided and the impact of various views on the care. The care was studied through observations at 22 care settings in the three countries and the staff's attitudes were explored by means of interviews with 79 people. A relation-oriented phenomenological approach was used. Great differences appeared regarding the various staff groups’ views. The findings also indicated that the staff's view; the cultural context and the organizational environment might have an impact on the care provided. However the impact of professional affiliation and the way of collaborating seemed to be of greater significance than other similarities or differences. An interdisciplinary based starting point, with close collaboration between medical based health care and social care of older people suffering from dementia in integrative care models, is therefore of vital importance.
AlvessonM.SköldbergK. (1994). Tolkning och reflection. Lund: Studentlitteratur.
2.
Alzheimer Europe (2006) Manual do Cuidor[Care Manual]. 2nd ed, Cambridge University Press (CUP).
3.
AnnerstedtL. (1995). On group-living care for demented elderly. (Doctoral dissertation, The Department of Community Health Sciences, Malmö and the Department of Geriatric Psychiatry, Lund University, Lund).
4.
AskhamJ.BriggsK.NormanI.RedfernS. (2007). Care at home for people with dementia: As in a total institution?. Ageing and Society, 27, 3–24.
5.
AstvikW. (2003). Relationer som arbete: Förutsättningar för omsorgsfulla möten i hemtjänsten(Doctoral dissertation, Arbetslivsinstitutet, Stockholm).
6.
BerrC.WancataJ.RitchieK. (2005). Prevalence of dementia in the elderly in Europe. European Neuropsychopharmacology, 15, 463–471.
7.
BlackmanT., (2000). Defining responsibility for care: approaches to the care of older people in six European countries. International Journal of Social Welfare9, 181–190.
8.
BleekerJ. A. C. (1994). Dementia services: A continental European view. In BurnsA.LevyR. (Eds.), Dementia. London: Chapman and Hall Medical.
9.
BlombergS.EdebalkP. G.PetterssonJ. (2000). The withdrawal of the welfare state: elderly care in Sweden in the 1990s. European Journal of Social Work, 3(2), 151–163.
10.
BonsangE., (2009) Does informal care from children to their elderly parents substitute for formal care in Europe?Journal of Health Economics28 (2009) 143–154.
11.
BrookmeyerR.JohnsonE.Ziegler-GrahamK.ArrighiH. M. (2007). Forecasting the global burden of Alzheimer's disease. Alzheimer's and Dementia, 3, 186–191.
12.
ChrzescijanskiD.MoyleW.CreedyD. (2007). Reducing dementia-related aggression through a staff education intervention. Dementia, 6(2), 271–286.
13.
CioffiJ. M.FlemingA.WilkesL.SinfieldM.Le MiereJ. (2007). The effect of environmental change on residents with dementia: The perceptions or relatives and staff. Dementia, 6(2), 215–231.
14.
ClareL.RowlandsJ.BruceE.SurrC.DownsM. (2008). The experience of living with dementia in residential care: An interpretative phenomenological analysis. The Gerontologist, 48(6), 711–720.
15.
ColvezA.RitchieB.LedésertJ.AnkriH.GardentA. (1994). Fontaine-Editions INSERM. France.
16.
EdbergA.-K.HallbergI. R. (2001). Actions seen as demanding with severe dementia during one year of intervention. Comparison with controls. International Journal of Nursing Studies, 38(3), 271–285.
17.
EdebalkP-G.LindgrenB., (1996). Från bortauktionering till köp-sälj-system [From selling at an auction to a by-and-sell-system]. In:EliassonR, ed. Omsorgens skiftningar[The shiftings of the care], 138–150. Lund: Studentlitteratur.
18.
European Comission (1999) Survey on Current status of research into ‘Ageing’ in Europe. Report EUR 18594, Community research.
19.
FernandesL.Gonçalves-PereiraM.LeuschnerA.MartinsS.SobralM.AzevedoL. F.DiasC.MateosR.OrrellM. (2009). Validation study of the Camberwell Assessment of Need for the Elderly (CANE) in Portugal. International Psychogeriatrics, 21, 94–102.
20.
FontanaA.FreyJ. H. (1994). Interviewing. The Art of Science. In DenzinN. K.LincolnY. S. (Eds.), Handbook of Qualitative Research. London: Sage Publications.
21.
FratiglioniL.JormA.GrutF.ViitanenM.HolménK.AhlbomA.WinbladB. (1993). Predicting dementia from the Mini-Mental State Examination in an elderly population. Journal of Clinical Epidemiology, 46(3), 281–287.
22.
GilsonA. M.MoyerD. M. (2000). Predictors of empathy in dementia care staff. American Journal of Alzheimer's Disease, 15(4), 239–251.
23.
GustafsonL. (1990). The clinical diagnosis of dementia of Alzheimer type: Prospects and limitations. In FowlerC. J.CarlsonL. A.GottfriesC. G.WinbladB. (Eds.), Biological markers in dementia of Alzheimer type. London: Smith-Gordon.
24.
HallbergI. R. (1990). Vocally Disruptive Behaviour in Severely Demented Patients in Relation to Institutional Care Provided. (Doctoral dissertation, Umeå University).
25.
HallbergI. R.NorbergA. (1990). Staff's interpretation of the experience behind vocally disruptive behaviour in severly demented patients and their feelings about it. An explorative study. International Journal of Aging and Human Development, 31, 295–305.
26.
HannanS.NormanI. J.RedfernS. J. (2001). Care work and quality of care for older people: a review of the research literature. Reviews of Clinical Gerontology, 11, 189–203.
27.
HellströmI.NolanM.LundhU. (2005). Awareness context theory and the dynamics of dementia. Improving understanding using emergent fit. Dementia, 4(2), 269–295.
28.
HenrikssonB.MånssonS.-M. (1996). Deltagande observation. In SvenssonT.-G.StarrinB. (Eds.), Kvalitativa studier i teori och praktik. Lund: Studentlitteratur.
29.
HolstG. J.EdbergA.-K.HallbergI. R. (1999). Nurses’ narrations and reflections about caring for patients with severe dementia as revealed in systematic clinical supervision sessions. Journal of Aging Studies, 13(1), 89–107.
30.
HubermanA. M.MilesM. B. (1994). Data management and analysis methods. In DenzinN. K.LincolnY. S. (Eds.), Handbook of Qualitative Research (pp. 428–444). London: Sage Publications.
31.
HughesJ.BagleyH.ReillyS.BurnsA.ChallisD. (2008). Care staff working with people with dementia. Dementia, 7(2), 217–238.
32.
JanickiM. P.DaltonA. J.MccallionP.BaxleyD. D.ZendellA. (2005). Group home care for adults with intellectual disabilities and Alzheimer's disease. Dementia, 4(3), 361–385.
33.
JanssonL. (1993). Ethical Reasoning among Experienced Registered Nurses in Relation to Communication with Severely Ill Patients Disclosing personal Knowledge. (Doctoral dissertation, Department of Advanced Nursing, University of Umeå).
34.
JarvieI. C. (1991). The problem of ethical integrity in participant observation. In BurgessR. (Ed.), Field Research: A Sourcebook and Field Manual. London: Routledge.
35.
JönsonH. (2004). Övergrepp mot äldre i två perspektiv. Socialvetenskaplig tidskrift, 11(3–4), 310–328.
36.
JosefssonK.SondeL.WinbladB.Robins WahlinT.-B. (2007). Work situation of registered nurses in municipal elderly care in Sweden. A questionnaire survey. International Journal of Nursing Studies, 44(1), 71–82.
37.
JosephssonS. (1994) Everyday Activities as Meeting-Places In Dementia(Doctoral dissertation, Karolinska institutet, Stockholm).
38.
KaskieB.CoddingtonS.AbramsC. H. (2004). A strategic response to the challenges presented by older patients with Alzheimer's disease and other types of dementia. Journal of Healthcare Management, 49, 32–46.
39.
KitwoodT., (1993) Towards a Theory of Dementia Care: The interpersonal Process. Ageing and Society1351–67.
40.
KitwoodT., (1995) Cultures of care: tradition and change. In Kitwood, T., and Benson, S., ed: The New Culture of Dementia Care. London:Hawker Publications.
41.
KodnerD. L.SpreeuwenbergC. (2002). Integrated care: Meaning, logic, applications, and implications – a discussion. International Journal of Integrated Care, 2(14), 1–6.
42.
KruegerR. A. (1998). Moderating Focus Groups. Thousand Oaks: Sage Publications.
43.
KvaleS. (1996). The social construction of validity. Qualitative Inquiry, 2(3), 275–285.
44.
LarssonK. (2004). According to Need?(Doctoral dissertation, Department of Social Work, Stockholm University).
45.
LothianK.McKeeK.PhilipI.NolanM. (2001). United Kingdom. In PhilipI. (Ed.), Family Care of Older People in Europe. Biomedical and Health Research. Ohmsha: IOS Press.
46.
LyngK. (1996). Den medicinska sjukdomsmodellens användning på demens: en kritisk diskussion. In SolemP. E.IngebretsenR.LyngK.NygårdA.-M. (Eds.), Demens - psykologiska perspektiv. Lund: Studentlitteratur.
47.
MacdonaldA. J. D.WoodsR. T. (2005). Attitudes to dementia and dementia care held by nursing staff in UK. ‘Non-EMI’ care homes: What difference do they make?. International Psychogeriatrics, 17, 383–391.
48.
McIntyreM. (2003). Dignity in dementia: Person-centered care in community. Journal of Aging Studies, 17, 473–484.
49.
Melin EmilssonU. (1998). Vardag i olika världar: Om dementa och vårdbiträden på tre gruppboenden(Doctoral dissertation, Arkiv förlag, Lund).
50.
Melin EmilssonU. (2001). A Supervisão como Método de Pesquisa em serviço social. Projecto sobre Idosos e Doença Mental na Suécia. Interaççoes, 1 Outubro, 50–64.
51.
Melin EmilssonU. (2004). Gruppboende för dementa – en omsorgsform eller ett begrepp i försvinnande?. Socialvetenskaplig tidskrift, 11(3–4), 252–274.
52.
Melin EmilssonU. (2005). Recognizing but not acknowledging: On using research information in social work with elderly people suffering from dementia. The British Journal of Social Work, 34(8), 1393–1409.
53.
Melin EmilssonU. (2006). Supervision as pedagogy and support in the Swedish eldercare – A developmental project. Journal of Gerontological Social Work, 47(3−4), 83–102.
54.
Melin EmilssonU. (2008). Identity and relationships: On understanding social work with older people suffering from dementia. Journal of Social Work Practice, 22(3), 317–328.
55.
MertonR. K.FiskeM.KendallP. L. (1956). The Focused Interview. A Manual of Problems and Procedures,. 2nd edn. New York: The Free Press.
56.
MossP.CameronC. (2004). Does ‘care work’ have a future?. Socialvetenskaplig tidskrift, 11(3-4), 223–237.
57.
MurphyK. (2005). A Qualitative study explaining nurses’ perceptions of quality care for older people in long-term care settings in Ireland’. Journal of Clinical Nursing, 16, 477–485.
58.
NolanM.RyanT.EnderbyP.ReidD. (2002). Towards a more inclusive vision of dementia care practice and research. Dementia, 1(2), 193–211.
59.
NordbergA.WinbladB. (1996). Alzheimer's disease: Advances in research and clinical practice. Acta Neurologica Scandinavica. Supplementum, 165(93). Copenhagen, Munksgaard.
60.
NygårdL. (1996). Everyday Life with Dementia. Aspects of assessing and understanding the consequences and experiences of living with dementia(Doctoral dissertation, Karolinska institutet, Stockholm).
61.
OharaK. (2004). Housing policy towards a super aging society: From building specifications to special needs measures. Geriatrics and Gerontology International, 4, 210–213.
62.
OnishiJ.SuzukiY.UmegakiH.EndoH.KawamuraT.ImaizumiM.IguchiA. (2006). Behavioral, psychological and physical symptoms in group homes for older adults with dementia. International Pshychogeriatrics, 18, 75–86.
63.
ParksS. M.HaineC.ForemanD.McKinstryE.MaxwellT. (2005). Evaluation of an educational program for long-term care nursing assistants. Journal of American Medical Directors Association, Clinical Experience, January/February, 61–65.
PavoliniE.RanciC., (2008) Restructuring the welfare state: reforms in long-term care in Western European countries. Journal of European Social Policy 2008;18; 246.
66.
PekkarinenL.SinervoT.ElovainioM.NoroA.Finne-SoveriH.LeskinenE. (2006). Resident care needs and work stressors in special care units versus non-specialized long-term care units. Research in Nursing and Health, 29, 465–476.
67.
PhilpI. (2001). Family Care of Older People in Europe. Amsterdam: IOS Press.
68.
PriouxF.MandelbaumJ. (2005) Recent Demographic Developments in France. Institut National d’Études Démographiques. English ed, 60, No. 4371-399+401- 414.
69.
RitchieK.LedésertB. (1992). The families of the institutionalized demented elderly: A preliminary study of stress in a French caregiver population. International Journal of Geriatric Psychiatry, 7, 5–14.
70.
RogersC. (1967/1994). On becoming a person. A therapist's view of psychotherapy. London: Constable.
71.
RogersC. (1969). Freedom to learn. Columbus, Ohio: Merrill Publishing Company.
SabatS., R.HarréR., (1992) The Construction and Deconstruction of Self in Alzheimer's Disease, Ageing and Society, 12, pp. 443–461.
74.
SandierS.ParisV.Polton’D., (2004) Health Care System in Transition, France. Copenhagen, WHO Regional Office for Europe on behalf of the European Observatory on Health Systems and Policies.
75.
SantanaS.DiasA.SouzaE.RochaN. (2007). Projects and developments. The domiciliary support service in Portugal and the change of paradigm in care provision International. Journal of Integrated Care, 7(15), 1–8.
76.
SloneD. G.RobinsonP. A. (1996). Bringing staff teamwork up-to-speed for dementia. Nursing Homes, 45, 22–34.
77.
SurrC. A. (2006). Preservation of self in people with dementia living in residential care: A socio-biographical approach. Social Science and Medicine, 62, 1720–1730.
78.
Swedish Institute (2007). The Health Care System in Sweden. Faktablad, Svenska Institutet. Stockholm.
79.
Swane Christine E (1996) Hverdagen med demens. Billeddannelser og hverdagserfaringer i kulturgerontologisk perspektiv (Köpenhamn, Munksgaard) (diss).
80.
ThorslundM. (2002). Dagens och morgondagens vård och omsorg: Om gapet mellan behov och resurser. In AnderssonL. (Ed.), Socialgerontologi (pp. 231–257). Lund: Studentlitteratur.
81.
TrainG.NurockS.KithcenG.ManelaM.LivingstonG. (2005). A qualitative study of the view of residents with dementia, their relatives and staff about work practice in long-term care settings. International Psychogeriatrics, 17(2), 237–251.
82.
TrydegårdG.-B. (2000). Tradition, Change and Variation: Past and Present Trends in Public Old-age Care. (Doctoral dissertation, Stockholm University).
83.
WallA. L.CollingK. B.KolanowskiA.KimH. J.Son HongG.-R.DeCiccoB.RonisD. L.RichardsK. C.AlgaseD.BeckC. (2008). Factors associated with aggressive behavior among nursing home residents with dementia. The Gerontologist, 48(6), 721–733.
84.
WibeckV. (2000). Fokusgrupper. Om fokuserade gruppintervjuer som undersökningsmetod. Lund: Studentlitteratur.
85.
WilkinsonH.KerrD.CunninghamC. (2005). Equipping staff support people with an intellectual disability and dementia in care home settings. Dementia, 4(3), 387–400.
86.
ZimmermanS.SloaneP. D.HeckE.MaslowK.SchulzR. (2005). Introduction: Dementia care and quality of life in assisted and nursing homes. The Gerontologist, 45(Special Issue), 5–7.
