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  • 1.
    Anbäcken, Els-Marie
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Almqvist, Anna-Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Johansson, Carl
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Kinugasa, Kazushige
    Obata, Miho
    Doshisha University, Japan.
    Hyun, Jinhee
    Daegu University, South Korea.
    Lee, Jinsook
    Daegu University, South Korea.
    Park, Young Joon
    Daegu University, South Korea.
    Older adults and care: reshaped family roles in societal change: A comparative study of Japan, South Korea, and Sweden2021In: Aging and the Family: Understanding Changes in Structural and Relationship Dynamics / [ed] Patricia Neff Claster; Sampson Lee Blair, Bingley, UK: Emerald Group Publishing Limited, 2021, 1, p. 1-38Chapter in book (Refereed)
    Abstract [en]

    Purpose: The aim is to explore how family relations are affected by societal

    changes in relation to informal and formal caregiving and self-determination

    of older adults.

    Design/methodology/approach: Care managers (CMs)/social workers (SWs)

    (N = 124) participated in a comparative vignette study including Japan, South

    Korea, and Sweden. Systems theory was used.

    Findings: Japanese CMs/SWs clearly describe their efforts to create networks

    in a relational way between formal and informal actors in the community. South

    Korean CMs/SWs balance between suggesting interventions to support daily

    life at home or a move to a nursing home, often acknowledging the family as the

    main caregiver. In Sweden, CMs/SWs highlight the juridical element in meeting

    the older adult and the interventions offered, and families primarily give social

    support. Regarding self-determination, the Japanese priority is for CMs/SWs

    to harmonize within the family and the community. South Korean CMs/SWs

    express ambivalent attitudes to older adults’ capability for self-determination in

    the intersection between formal and family care. Swedish CMs/SWs adhere to

    the older adult’s self-determination, while acknowledging the role of the family

    in persuading the older adult to accept interventions. The results suggest emerging

    defamilialization in South Korea, while tendencies to refamilialization are

    noticed in Japan and Sweden, albeit in different ways.

    Research limitations/implications: In translation, nuances may be lost. A

    focus on changing families shows that country-specific details in care services

    have been reduced. For future research, perspectives of “care” need to be studied

    on different levels.

    Originality/value: Using one vignette in three countries with different welfare

    regimes, discussing changing views on families’, communities’ and societal caregiving

    is unique. This captures changes in policy, influencing re- and defamilialization.

  • 2.
    Asztalos Morell, Ildikó
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Department of Urban and Rural Development, Swedish University of Agricultural Sciences (SLU), Uppsala, 75007, Sweden.
    De, S.
    College of Nursing, Bharati Vidyapeeth Deemed University (BVDU), Pune, 411043, India.
    Mahadalkar, P.
    College of Nursing, Bharati Vidyapeeth Deemed University (BVDU), Pune, 411043, India.
    Johansson, Carl
    Mälardalen University, School of Health, Care and Social Welfare.
    Gustafsson, Lena-Karin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Silence or voice?: Agency freedom among elderly women living in extended families in urban India2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 23, p. 1-18, article id 8779Article in journal (Refereed)
    Abstract [en]

    The preferential form of living for the elderly in India is within the extended family. India is undergoing rapid economic development, an increase in mobility, and changes in gender norms due to an increase in women’s labour force participation, which places challenges on traditional intergenerational relationships. Ageing and the well-being of the elderly is a rising concern, especially considering that their proportion of the population is expected to grow rapidly in coming decades. There is a lack of universal state provision for the elderly’s basic needs, which is especially profound for elderly women, since most do not have an independent income. This leaves the elderly dependent upon the benevolence of their adult children’s families or other relatives. This paper explores, with help of narrative analysis and critical contributions from capability theory, elderly women’s agency freedoms and how this can be contextualised with their varying capability sets. With help of Spivak’s notion of the silent subaltern, the paper anchors elderly women’s abilities to voice to their agency freedom. The master narrative of the silent supportive wife and side-lined mother-in-law as well as three counter-narratives explore alternative agencies taken by elderly women.

  • 3.
    Asztalos Morell, Ildikó
    et al.
    The Swedish University for Agricultural Sciences, Uppsala, Sweden.
    De, Santa
    Science in Nursing, RN RM, Sandra Shroff ROFEL College of Nursing, Vapi, India.
    Johansson, Carl
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Gustafsson, Lena-Karin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Middle-class older adults living alone in urban India: Older adults’ understandings of ageing alone2023In: Journal of Religion, Spirituality & Aging, ISSN 1552-8030, p. 1-26Article in journal (Refereed)
    Abstract [en]

    This study sheds light on the value systems of the middle-class metropolitan older adults living alone, on the ageing self and the person's relationship to the surrounding society based on eight interviews. Ageing research has emphasized the traditional features of elderly care in India including its collectivist values rooted in filial piety and the extended family as well as embracement of disengagement influenced by the Hindu texts on two phases in later life: "hermit" and "renunciate". Increased social and geographical mobility, however, challenges traditional family systems. Using the example of the urban middle-class older adults living alone, this study explored whether living alone constitutes a challenge to the norms that previous research associated with Indian elderly care. Using abductive phenomenographic analysis the study found that the understandings of older adults in the study show great reflexivity concerning key aspects of their lives. Although the life conditions of older adults living alone deviated in many aspects from dominant traditional norms of filial piety and a care regime based on strong intergenerational interdependence, their responses and reflections mirrored assemblages of values deeply rooted in Hindu Vedic philosophy of the Ashramas and perceptions of independence, autonomy and self-reliance associated with Western "productive" aging.

  • 4.
    Gustafsson, Lena-Karin
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Asztalos Morell, Ildikó
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Department of Urban and Rural Development Swedish University of Agriculture, Uppsala, Sweden.
    Johansson, Carl
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Ray, Santa De
    School of Nursing Bharati Vidyapeeth University deemed College, Pune, India.
    Informal caregiving from the perspectives of older people living alone in India2022In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743Article in journal (Refereed)
    Abstract [en]

     Background:  The cultural and social norms in India stipulate that family and preferably children of the older person, provide the support and care that is needed. In recent years, we have witnessed an overall upsurge in interest in informal care from all countries in the developed world considering their ageing populations. The older people living alone group is, especially interesting in this matter, since it seems to deviate from the expectations of extended family living.

     Objective:  The aim was to describe older persons' experiences of informal care when living alone in India.

     Methods:  The study has a hermeneutic design, analysing interviews of older persons living alone in India.

     Results:  Findings revealed informal care as the thematic patterns: Informal care as a fundamental human responsibility, an obligation and thereby a way to act in 'common sense'. It was a way of 'paying-back' care that they had received from others in their life history, motivated by governmental care was not presented as an option. Informal care also created safety by the provision of alert and actionable care by loved ones, including spatial safety. Most of the informants experienced themselves as informal caregivers assisting others in need even if they themselves were old and fragile. Providing self care was also seen as a part of informal care conducted by capable and worthy persons. They also pointed out their own obligation to seek informal care and even to listen to the suggestions of younger generations regarding the type and scope of care.

     Conclusions/implications for practice:  Informal care in India is not only dependent on having children who ensure that you receive the care you need. Extended family, neighbours and friends feel a basic human obligation to care for the older people in their environment. This responsibility is deeply rooted even within the older people who become fragile in old age.

  • 5.
    Johansson, Carl
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Asztalos Morell, Ildikó
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Lindberg, Daniel
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Gustafsson, Lena-Karin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Spotting good ageing: using welfare theory of health to frame the agency of older adults with immigrant backgrounds to attain good ageingIn: Nordic Social Work Research, ISSN 2156-857X, E-ISSN 2156-8588Article in journal (Refereed)
    Abstract [en]

    Care providers for older immigrants in Sweden find themselves in a paradox. Individuals and associations call for culturally sensitive elderly care. However, implementing this comes at the risk of over-culturizing needs and behaviours, drawing a negative picture of ‘the problem of immigrants’ that needs to be solved with special interventions. To find a balance in this paradox, we applied the welfare theory of health to grasp a new understanding of the phenomena and draw a holistic picture of a person’s needs and resources available to achieve good ageing, reaching beyond the cultural paradox. Semi-structured qualitative interviews were conducted with older adults with immigrant backgrounds in Sweden. The interviews were analysed using content analysis. Combining welfare theory of health with immaterial capital theories offered a holistic theoretical approach to good ageing. This took its departure from the agency of older adults, mitigating the gap between their vital life goals and available resources to reach these goals. Although informants wanted caring interventions from close family, we identified distinct responses to mitigate the diminished trust older adults had in the capability of welfare institutions to provide adequate elderly care.

  • 6.
    Johansson, Carl
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Gustafsson, Lena-Karin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Lindberg, Daniel
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Asztalos Morell, Ildikó
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. School of Urban and Rural Development, Swedish University of Agriculture, Uppsala, Sweden.
    Culturally sensitive active ageing seen through the lens of the welfare theory of health: assistant nurses’ views2023In: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 14, article id 1161688Article in journal (Refereed)
    Abstract [en]

    Assistant nurses caring for older adults with immigrant backgrounds are on the front lines of a practical, theoretical, and policy battlefield. They need to implement culturally sensitive care provision while not overstating the importance of culture, thereby, contributing to a negative picture of older immigrants as especially problematic. One proposed way to strike such a balance is the welfare theory of health (WTH). In this article, we let assistant nurses apply the WTH to a series of questions in four different vignettes representing the life stories of older persons who characterize typical dilemmas described by the theory. The results show that, through the lens of the WTH, assistant nurses looked for individual care preferences rather than stereotypical ideas about cultural characteristics. Further, the assistant nurses expressed a desire to get to know the persons more deeply to better interpret and understand their individual preferences. Thus, the theoretical framework is useful not only for exposing vulnerabilities to which some older adults with immigrant backgrounds may be exposed, but also for finding ways to mitigate the vulnerability by illuminating vital life goals and using them as a framework to organize care. This approach allows for mitigating the gap between the vital life goals and available resources to achieve a holistic state of health.

  • 7.
    Johansson, Carl
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Lindberg, Daniel
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Asztalos Morell, Ildikó
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Gustafsson, Lena-Karin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Culturally sensitive active ageing through the Welfare Theory of Health. Views of assistant nursesManuscript (preprint) (Other academic)
  • 8.
    Johansson, Carl
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Lindberg, Daniel
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Asztalos Morell, Ildikó
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Gustafsson, Lena-Karin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Holistic health amongst older adults – A validation study of the health measure Health as Ability of ActingManuscript (preprint) (Other academic)
  • 9.
    Johansson, Carl
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Lindberg, Daniel
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Asztalos Morell, Ildikó
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Swedish Univ Agr Sci, Dept Urban & Rural Dev, Uppsala, Sweden..
    Gustafsson, Lena-Karin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Swedish experts' understanding of active aging from a culturally sensitive perspective - a Delphi study of organizational implementation thresholds and ways of development2022In: Frontiers in Sociology, E-ISSN 2297-7775, Vol. 7, article id 991219Article in journal (Refereed)
    Abstract [en]

    BackgroundInternational migration and aging populations make for important trends, challenging elderly care regimes in an increasingly globalized world. The situation calls for new ways of merging active aging strategy and cultural sensitivity. This study aim to illuminate the gap between cultural sensitivity and active aging to identify perceived thresholds by Swedish municipal officials in the understanding of older late-in-life-immigrants situation. MethodsDelphi methodology in three rounds. Twenty-three persons in municipal decision-making positions participated and generated 71 statements, of which 33 statements found consensus. ResultsThe 33 statements show that the decision makers prefer not to use cultural sensitivity as a concept in their work, but rather tailor interventions based on individual preferences that may or may not be present in a certain culture. However, as the complexity of care increases, emphasis drifts away from personal preferences toward text-book knowledge on cultures and activity.

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