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In Scandinavia, work in elderly care is a principal occupation and constitutes an important part of professional care work. Over the last decade, this sector has become a test piece for New Public Management (NPM). It is the area where NPM-inspired rationales and methodologies have been applied to the greatest extent. This book explores the challenges and future possibilities in elderly care from a working life perspective. Researchers from three Scandinavian countries present new studies of the daily work in elderly care, the change of tasks and services, and the reconstruction of a semi-profession. The specific translation of NPM into the Scandinavian context is examined, and how this affects: the meaning and identity of work in elderly care and the possibilities to reconstruct meaning under standardized working conditions * the new ideals of line management of elderly care and the ambiguities between bureaucracy and professionalism * subjectivity and emotions as a decisive element of the work in elderly care * the creation of new professionalism in pockets of the sector * the shifts in valuation of experience-based knowledge and care orientation. The book draws attention to new trends in the sector that may make way for transforming the logic of NPM, and thus points to possibilities that will enrich working life.

Background Implementing digital technology in home care services challenges care arrangements built on face-to-face encounters. Digital welfare technology has been suggested as a solution to increasing demands on health care services from an ageing population. Medication delivery is a major task for home care services, and digital medication devices could lessen the need for resources. But technology has scripts based on how designers picture its use, and these might not fit with users’ needs and practices. New technology must go through processes of domestication among its users. In the present study, we investigate how health professionals experienced the implementation of a digital medication dispenser into home care services in Norway. Methods This was a qualitative interview study with 26 health professionals from home care services in five municipalities. Results All five municipalities had implemented a digital medication dispenser in home care services. Prior to the introduction of the dispenser, medication practices had been based on home visits. The safety of medication practices was the main concern of health professionals who had to negotiate the technological script in order to make it work in a new care arrangement. Rationalities of effectiveness collided with rationalities of care, symbolized by warm hands. Professionals who had been used to working independently became dependent on technical support. Being unfamiliar with the new medication arrangement led to resistance towards the digital dispenser, but more direct experiences changed the focus from technology to new care arrangements. Negotiating practical and organizational arrangements led health professionals to trust the digital medication dispenser to contribute to safe and good care for service users. Conclusions Implementing digital technology in home care services must be informed by previous practices in the field, especially when it concerns safety for patients. Through processes of domestication, health professionals negotiate technological scripts to make them fit professional ideals and practices. Policymakers and managers must address questions of care arrangements and individualized adaptions to patients’ needs in order to receive support from health professionals when implementing digital technology in home care services.

Abstract Background and Objectives This study uses the care poverty framework, focusing on both individuals and structures. In this context, structures are represented by 2 welfare states: Taiwan, an East Asian welfare system and Finland, a Nordic welfare state. This study explores multidimensional care poverty rates and examines 3 realms of individual factors (health status, sociodemographic factors, and care support availability) among older adults in these long-term care (LTC) models. Research Design and Methods We analyzed data from the 2019 Taiwan Longitudinal Study on Ageing Survey and the 2020 Daily Life and Care in Old Age Survey in Finland to compare the rates and factors of care poverty in these 2 culturally and structurally different countries. Results Our analysis revealed different rates of care poverty in personal, practical, and socioemotional care needs in the 2 countries. Under a familistic welfare regime, Taiwanese older adults had higher personal care poverty rates than their Finnish counterparts. Those living alone faced more personal and practical care poverty. Conversely, Finnish older adults, under the Nordic welfare model, experienced more practical and socioemotional care poverty. Those with high care needs and disadvantaged social status and support were more likely to experience personal and practical care poverty. Socioemotional care poverty varied with the availability of support and health status in both countries. Discussion and Implications The study highlights the impact of 2 LTC policies and cultures on older adults’ multidimensional care poverty, identifying disadvantaged older adults under different welfare-transforming LTC models. Taiwan’s budget-constrained LTC policies and high family reliance contrast with Finland’s inadequate attention to the practical and socioemotional needs of its aging population. This study suggests that holistic LTC policies are needed in both countries to improve the well-being of older adults with limited support and health issues.

Aims: This article reviews current practice relating to arts and culture on prescription in Sweden, Norway, Denmark and in the United Kingdom. It considers future possibilities and also each of the Scandinavian countries from a culture and health policy and research perspective. The United Kingdom perhaps leads the field of Arts on Prescription practice, and subsequent research is described in order to help identify what the Scandinavian countries might learn from the UK research. Method: The method adopted for the literature search was a rapid review which included peer-reviewed and grey literature in English and the respective languages of Scandinavia. Results: The discussion considers the evidence to support social prescription and the potential obstacles of the implementation of Arts on Prescription in Scandinavian countries. Conclusion: The article concludes that of the Scandinavian countries, Sweden is ahead in terms of Arts on Prescription and has embraced the use of culture for health benefits on a different scale compared to Norway and Denmark. Denmark, in particular, is behind in recognising ways in which art and culture can benefit patients and for wider public health promotion. All three countries may benefit from the evidence provided by UK researchers.

We analyse the impact of the provision of care on the health and quality of life (QoL) of adult female informal caregivers using a representative sample drawn from the survey of health, ageing and retirement in Europe (SHARE). We match each informal caregiver with a non-carer using propensity score matching and test whether matched individuals differ on self-assessed health and a functional indicator of QoL and whether this relationship differs across European regions. We find a North–South gradient both for self-assessed health and QoL, and our results show that the provision of caregiving to close relatives in Europe impacts on the caregivers' QoL and health in a way that depends on their geographical location, the degree of formal care and specific cultural and social factors of the area. We find that informal caregiving is a complex phenomenon which may bring both psychological rewards and distress to providers of care and this complexity, along with the geographical gradient highlight the importance of ensuring that policies match the needs of individual carers in their own geographical areas and cultural contexts.

BackgroundThe aim of this study was to determine when and how rapid response vehicles (RRVs) make a difference in prehospital care by investigating the number and kinds of RRV assignment dispatches and the prehospital characteristics and interventions involved.MethodsThis retrospective cohort study was based on data from a quality assurance system where all assignments are registered. RRV staff register every assignment directly at the site, using a smartphone, tablet, or computer. There is no mandatory information requirement or time limit for registration. The study includes data for all RRVs operating in Region Stockholm, three during daytime hours and one at night – from January 1, 2021 to December 31, 2021.ResultsIn 2021, RRVs in Stockholm were dispatched on 11,283 occasions, of which 3,571 (31.6%) resulted in stand-downs. In general, stand-downs were less common for older patients. The most common dispatch category was blunt trauma (1,584 or 14.0%), which accounted for the highest frequency of stand-downs (676 or 6.0%). The second most common category was cardiac arrest (1,086 or 9.6%), followed by shortness of breath (691 or 6.1%), medical not specified (N/S) (596 or 5.3%), and seizures (572 or 5.1%).ConclusionThe study findings confirm that RRVs provide valuable assistance to the ambulance service in Stockholm, especially for cardiac arrest and trauma patients. In particular, RRV personnel have more advanced medical knowledge and can administer medications and perform interventions that the regular ambulance service cannot provide.

This paper develops a dynamic structural lifecycle model to study how heterogeneous health and medical spending shocks affect the savings behavior of the elderly. Individuals are allowed to respond to health shocks in two ways: They can directly pay for their health care expenses (self-insure) or they can rely on health insurance contracts. There are two possible insurance options, one through formal contracts and another through informal care provided by family. Formal contracts may be affected by asymmetric information problems whereas informal insurance depends on social ties (cohesion) and on bequeathable wealth. I estimate the model on SHARE data using simulated method of moments for four levels of wealth in a sample of single retired Europeans. Counterfactual experiments show that health, medical spending, and health insurance are indeed the main drivers of the slow wealth decumulation in old age. I also find that social cohesion rises with age, declines with wealth, and is higher in Mediterranean countries than in Central European and Scandinavian countries. Finally, high social cohesion appears typically associated with increased life expectancy.

This article examines sustainable food consumption in the Nordic context, studying to what extent people in Denmark, Finland, Norway, and Sweden have food consumption patterns that are in the current discourse promoted as sustainability enhancing. The article analyses the association of sustainable food consumption to attitudinal support for environmental policy measures, interest in cooking, and healthy eating practices as well as sociodemographic background factors. The comparison of four countries enables an analysis of the importance of the national context in sustainable food consumption. The study is based on data from a 2012 Nordic Web survey ( N  = 8248). The results show that carrying out sustainable activities was not very widespread. Buying local food was the most popular, eating meat less often the most unpopular sustainable activity. The level of participation in sustainable practices varied across the four countries. Swedish respondents were the overall most active, Norwegians the least. However, results from analysis of variance ( anova ) indicated that the individual explanatory factors of sustainable food consumption were relatively similar in the four countries. Healthy eating patterns, interest in cooking, and supporting environmental policy measures were all positively correlated to sustainable food consumption. Women and the elderly were more active in sustainable practices than were men and the young. Education and occupational position played a role, too, but their effect was not totally systematic across countries. The findings suggest that sustainable food consumption is not a strongly socially stratified phenomenon, but it is related to other practices of eating regarded as “proper,” such as interest in cooking and healthy eating. Broader and more inclusive policies are needed to better engage people in sustainable activities.