Informal caregivers play a crucial role in the care of individuals with dementia, and their caregiving may significantly impact their own health and well-being. This cross-sectional survey study focuses on the perceived importance of various types and characteristics of formal support in a convenience sample of caregivers aged 65 years or older (N = 175) caring for a spouse with dementia. Participants completed a questionnaire containing 17 items describing different types of support and 12 items describing different characteristics of support, rating their importance. The questionnaire also contained questions on various caregiving-related factors. Principle components analysis (PCA) was carried out on the importance ratings, separately, on the types of support items and the characteristics of support items. Each PCA produced three components. For types of support, they were Proficiency and Opportunity, Supportive Structures, Flexible Counselling. For characteristics of support, they included Respectful and Competent, Timely Support, and Accessible and Acceptable. The three characteristics of the support components all had higher mean importance ratings than the three types of support components. The content of some components indicated that while spouse caregivers rate support for their caregiving needs as important, they may not always differentiate their own needs from those of their partner with dementia. The negative impact of caregiving was the factor most strongly and consistently associated with the components’ importance ratings. This study emphasizes the need for health and social care providers to address the unique needs of spouse caregivers while simultaneously ensuring the delivery of quality care for individuals with dementia.

The purpose was to compare selection, use and outcomes of assistive products among older home care clients with and without dementia in Sweden, and to explore the relations between the use of assistive products and perceptions of home care, loneliness and safety. Self-reported data from 89,811 home care clients aged 65 years or more, of whom 8.9% had dementia, were analysed using regression models. Excluding spectacles, 88.2% of them used assistive products. Respondents without dementia were more likely to use at least one assistive product but less likely to use assistive products for remembering. Respondents with dementia participated less in the selection of assistive products, used less assistive products, and benefited less from them. Users of assistive products were more likely to be anxious and bothered by loneliness, to feel unsafe at home with home care, to experience that their opinions and wishes regarding assistance were disregarded by home care personnel, and to be treated worse by home care personnel. The findings raise concerns about whether the needs for assistive products among home care clients with dementia are adequately provided for. They also indicate a need to strengthen a person-centred approach to providing home care to users of assistive products.

In Sweden, older people in residential care had the highest mortality rates, followed by those who received home care, during the coronavirus disease 2019 (COVID-19) pandemic. Staff working in the care of older people assumed responsibility for preventing the spread of the virus despite lacking the prerequisites and training. This study aimed to investigate the psychosocial work environment during the COVID-19 pandemic among staff in the care of older people and examine the factors associated with staff’s perceptions of the clarity of instructions and the ability to follow them. A cross-sectional study design was employed using a web survey. The staff’s perceptions of their psychosocial environment were analysed using descriptive statistics. The association between organisational and individual factors, as well as the degree of clarity of the instructions and the staff’s ability to follow them, were assessed using multivariate (ordinal) regression analysis. The main findings show that perceptions of the clarity and adaptability of the instructions were primarily correlated with organisational factors, as higher responses (positive) for the subscales focusing on role clarity, support and encouragement in leadership at work were associated with the belief that the instructions were clear. Similarly, those indicating high job demands and high individual learning demands were less likely to report that the instructions were clear. Regarding adaptability, high scores for demands on learning and psychological demands were correlated with lower adaptability, while high scores for role clarity, encouraging leadership and social support, were associated with higher adaptability. High job demands and individual learning demands were demonstrated to decrease the staff’s understanding and adoption of instructions. These findings are significant on an organisational level since the work environment must be prepared for potential future pandemics to promote quality improvement and generally increase patient safety and staff health.

Denna artikel sammanställer genomförda studier om Vårdarsång inom demensvård. Begreppet Music Therapeutic Caregiving, på svenska Vårdarsång, myntades år 2001 med definitionen ”när vårdare sjunger för eller tillsammans med personer med demenssjukdom under omvårdnad”. Som en del av sjukdomen har personer med demenssjukdom svårigheter att kommunicera. Detta resulterar ofta i beteenden som motsträvighet och verbal och fysisk aggressivitet i interaktion med andra. Dessa reaktioner är vanliga under vardagliga integritetshotande omvårdnadssituationer, såsom hjälp med kroppshygien och toalettbesök. Forskningresultat med Vårdarsång har visat sig kunna underlätta dessa situationer, då vårdarens sång för eller tillsammans med den demenssjuka ger förbättrad möjlighet till kommunikation, samarbete och genomförande av omvårdnadshandlingar.

Background Older people in residential care had the highest mortality rates, followed by those who received home care during the COVID-19 pandemic in Sweden. Staff working in the care of older persons assumed responsibility for preventing the spread of the virus in spite of lacking the prerequisites and training to do so. This study aimed to investigate how staff in the care of older people described their psychosocial work environment during the COVID-19 pandemic; it also aimed to examine the perceived clarity of the instructions and the staff’s ability to follow the instructions to prevent the spread of the virus and its association with individual factors and organisational factors regarding the psychosocial work environment.Methods A cross-sectional web survey was conducted for the data collection. The staff’s perceptions of their psychosocial environment were analysed using descriptive statistics. The association between organisational and individual factors, as well as the degree of clarity of the instructions and the staff’s ability to follow them, were assessed using multivariate (ordinal) regression analysis.Results The main findings were that perceptions of the clarity and adaptability of the instructions were primarily correlated with organisational factors, as higher responses (positive) for the subscales focusing on positive challenges, role clarity, control, support and encouragement in leadership at work were associated with the belief that the instructions were clear. Similarly, those indicating high job demands and high individual learning demands were less likely to report that the instructions were clear.Conclusions High job demands and individual learning demands were demonstrated to decrease the staffs understanding and adoption of instructions. These findings are significant on an organisational level, since the work environment must be prepared for potential future pandemics to promote quality improvement and to generally increase patient safety as well as the health of staff.

Introduction: Despite strong commitments, translating person-centered and dementia care principles into practice remains challenging in homecare settings. In Sweden, national and regional frameworks such as Nära Vård (Good and Close Care) and the Sörmland Dementia Strategy promote autonomy, participation, and collaboration. Yet, their enactment unfolds within layered institutional systems characterized by multiple logics, documentation demands, and fragmented responsibilities, which often dilute the intent of person-centered policies. The study applied a policy enactment perspective to examine how person-centered and dementia-related policies are interpreted, negotiated, and translated into municipal homecare services. It further explores how participatory, design-driven methods can support policy enactment by providing structured arenas for collective sensemaking and resource negotiation across system levels. Methods: A qualitative design was employed in the county of Sörmland, Sweden, combining 17 semi-structured interviews with policymakers, municipal managers, and homecare staff, and two participatory workshops ( n = 14–18) involving actors ranging from frontline staff to managerial levels. Interview data was analyzed using inductive and abductive thematic analysis, while workshop data were examined using the framework method to identify shared interpretations and enactment conditions. Patient and Public Involvement (PPI) activities with people living with dementia and unpaid carers informed the design and validated the findings. Results: Findings show that policy enactment is constrained by fragmented organizational structures, limited prioritization of dementia, uneven (dementia-specific) knowledge across roles, workforce instability, time pressures, and weak feedback mechanisms. Documentation-heavy routines often reinforce biomedical notions of “good care,” limiting the mobilization of relational, person- centered practices. Participatory workshops facilitated the development of provisional, middle-level interpretations that can help bridge abstract policy ideals and situated care practices. Discussion: Our study contributes by extending policy enactment frameworks into dementia homecare, and by illustrating how participatory approaches can strengthen bottom-up translation mechanisms within complex public care systems.