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National Board of Health and Welfare claims that the quality of elderly care services differ considerably between municipalities in Sweden. This study aims to analyze to what extent these variations can be accounted for by the older person’s municipality affiliation (i.e. receiving elderly care in a certain municipality).

Addressing this issue, national survey data from 78,538 older respondents receiving elderly care services in Sweden were analyzed using multilevel modeling (MLM).

The results showed that municipality affiliation only marginally explained the variance in satisfaction with care, i.e. its variations were larger within than between municipalities. Instead, user-oriented care accounted for the variation in satisfaction with care. Specifically, the way the care workers behave toward the older person proved to be much more crucial for satisfaction with care than municipality affiliation. Moreover, random effects analyses revealed that the effects of user-oriented care on satisfaction with care varied across municipalities. Care setting (i.e. home care or nursing home) only marginally accounted for its variance.

Developing care quality should start and primarily be discussed at the interpersonal care level, and not, as is customary, at the municipality level.

The present research is the first in its kind to quantitatively investigate the sources of variation in perceived quality of Swedish elderly care using MLM.

The purpose of this paper is to describe how first-line managers (FLMs) in home care (HC) reason about the opportunities and obstacles to lead the work according to the individual’s needs and goals.

In this participatory appreciative action reflection project, eight managers within one Swedish municipality were interviewed. The data were analysed using a thematic analysis.

The results showed a polarization between two different systems that FLMs struggle to balance when attempting to lead HC that adapts to the needs and goals of individuals. One system was represented by the possibilities of a humane system, with human capital in the form of the individual, older persons and the co-workers in HC. The second system was represented by obstacles in the form of the economic needs of the organization in which the individual receiving HC often felt forgotten. In this system, the organization’s needs and goals governed, with FLMs needing to adapt to the cost-effectiveness principle and keep a balanced budget. The managers had to balance an ethical conflict of values between the human value and needs-solidarity principles, with that of the cost-effectiveness principle.

The FLMs lack the opportunity to lead HC according to the needs and goals of the individuals receiving HC. There is a need for consensus and a value-based leadership model based on ethical principles such as the principles of human value and needs-solidarity to lead the HC according to the individual’s needs and goals.

User-oriented care, defined as individualized assisting behaviors, is the dominant approach within elderly care today. Yet, there is little known about its conceptual structure. This paper proposes that user-oriented care has a bi-partite structure which may be decomposed into the two dimensions of task and relation.

Care workers were “shadowed” (i.e. observed) at their work (n=391 rated interactions). User-oriented care was assessed along ten process quality indicators targeting the acts of caregiving (i.e. task focus, relation focus, involvement, time-use, body language, autonomy, respect, warmth, encouragement, and information) in two elderly care settings, i.e. home care and nursing home. Observations added up to 45 hours.

Principal component analyses confirmed the proposed two-factor structure of user-oriented care. Specifically, the user-oriented care indicators loaded on two distinct factors, i.e. task and relation. The underlying structure of user-oriented care revealed to be invariant across the two settings. However, the results revealed interesting structural differences in terms of explained variance and the magnitude of factor loadings in the home care and nursing home settings. Differences also emerged specifically pertaining to the indicators of autonomy and time-use. These findings suggest that user-oriented behavior may to some extent denote different acts of caregiving and what may be called task- and relation-orientation may be loaded with different meanings in these two care settings.

This is the first study investigating user-oriented behavior in the context of elderly care using a quantitative observational approach. The authors propose that the observed differences between the two care settings are primarily not due to better elderly care work in home care, but due to some inherent differences between these two contexts of care (e.g. better health and living at home).

This article analyses community care services (CCS) in terms of availability, awareness, accessibility, and acceptance (the Four A’s approach), untangles the deep-seated factors underlying the CCS and provides some short-term, medium-term, and long-term recommendations.

A literature review was conducted, including relevant government reports, consultation papers, Legislative Council papers and articles from academic journals from 1980 to the present.

The Four A’s approach shows that applicants to both centre-based services and home-based services endure lengthy waiting times because of the limited number of CCS. Furthermore, the awareness of day respite services is approximately 50 percent, which lags behind other CCS. Accessibility is contingent on a cross-district day respite service system and a lack of consistency between the quota and the proportion of older adults in the districts. Finally, the level of service provided by CCS is unsatisfactory due to inflexible service provision. Reviewing the brief history of long-term care services (LTC) reveals the deep-seated factors at the core of their heavy reliance on the subvention model, in contrast to the adoption of the ‘mixed economy of care’ by residential care services (RCS). An imbalance in budget allocation to RCS and CCS is also revealed.

Although the principle of ‘ageing in place’ was introduced in 1977, the institutionalisation rate (6.8 percent) of older adults remains unexpectedly high in Hong Kong, even surpassing its Asian counterparts, whereas the usage rate of CCS hovers around 0.8 percent. Thus, how to implement policy concerning LTC services for older adults must be re-evaluated.

Malaysia is considered to be a relatively young country as compared to other older countries such as Japan, China and Australia in terms of the ageing population. However, until 2035, Malaysia will be in the ageing group countries as 15% of the entire population will be above 60 years of age. This situation is quite alarming as more and more ageing care centres will be required to fulfill the ongoing demands of the ageing population. The elderly care centres in Malaysia are categorised as public (sponsored by the government), private, and charity based that comes under religious centres. Currently, there are about 365 registered elderly care centres working in the main states of Malaysia, including Sabah and Sarawak, two states of the East Malaysia. Due to the importance of ageing population issues, the present study is conducted to explore the demographics facet of Malaysian’s elderly care centres. The main reason behind that lies on the fact that many of these centres are still labelled as being not well equipped and lacking behind in trained staff, equipment and also suffering from severe financial constraints but some still capable of working on a sustainability basis.

Qualitative Research Strategy has been adopted, and 28 centres throughout Malaysia are included in this study. About 18 Operators from different centres and 15 caregivers were interviewed to get the holistic view of ageing care and facilities in their respective centres.

The results highlight that the majority of centres are not receiving any financial help from the government, and few centres are doing small business such as supplying consumable medical and non-medical items and providing renting and rehabilitation centres facilities to sustain. The caregivers are facing issues such as excess workload, less salary, peer conflicts and non-cooperative centre leadership.

The present study may help to provide useful information to the policymakers, which enables them to formulate the strategies for ageing care centres in Malaysia. As this study provides insight of components that have an impact on the overall wellbeing of elderly care centres, hence, it could help the care services providers to act as a rising star for Malaysian’s social life comfort.

The purpose of this paper is to describe how migration affects the care of older people in Italy.

The paper is based on anthropological fieldwork by one of the authors. This consisted of in-depth interviews with 20 “badanti” (migrant caregivers), with relatives of older people and with social workers in the city of Verona, Italy. It further included extensive study of secondary materials on the topic of migrant care of older people.

Badanti, Italian families and older people find themselves locked in an uneasy contract: badanti because they are exploited and often unable to find better, formal employment; Italian families because they are aware that they fail to render their moral duty to their aged parents and grandparents; and older people because they feel neglected and maltreated by their children. Yet the three parties also rely on each other to make the best of a precarious situation. The relationship between badanti and Italian elderly highlights the contradictions within Italian politics on care and migration. This case study shows how migrants help Italian families to hold on to the tradition of family care for ageing parents.

The small sample of badanti and families provides a detailed and profound insight of the complexity of elder care in Italy but does not allow generalisation for developments in the country as a whole.

Policy makers should take notice of the indispensability of informal migrant care in present day Italy.

The originality of the paper lies in the in-depth conversations with badanti and in the way in which elderly care is contextualised in the Italian tradition of care and present day politics.

Due to the increasing population and diverse lifestyles of aging people in Thailand, close examination of their needs and health care problems is required. Availability and accessibility of food affects the health and well-being of aging people in the community; therefore, to enhance their quality of life, community nurses and health care personnel must understand the variety of foods in their diet, in order to provide suitable and culturally acceptable nutrition for the elderly. The purpose of this paper is to explore the diversity of foods eaten by older people and the social, economic, environmental, and cultural contexts in which they live in the Northern region of Thailand. This is a part of a larger research project of community food management systems for the care of older people.

Critical ethnographic research was employed during the study. The data were collected from 41 primary elderly informants and family members. The researcher collected data by conducting individual in-depth interviews, observation of activities, and focus group discussions. The text data were analyzed by content analysis.

Information gathered from this research reveal nine categories of food which older people are associated with and which include: favorite foods; food provided by others; foodstuffs which should be eaten due to chronic diseases (recommended by doctor); foods to be avoided; snacks; food eaten with others (eating when socializing); food for festivals and cultural traditions; food offered for making merit; and food donated to others.

Utilization of health data, specifically regarding individual dietary diversity, can guide community nurses and health care personnel to provide and promote health that will suit individuals and their families. Community nurses and health care personnel should be aware of the variety of older persons’ diets and the importance of being able to manage and sustain their own nutritional needs. Appropriate nutrition, which is one of the social determinants of health, could improve the quality of the well-being of aging members in the community.

The aim of this paper is to argue for the values of familial caring and relationships in addition to the provision of social media technology during the COVID-19 pandemic in Hong Kong.

The discussion of this paper has adopted an inter-disciplinary approach by integrating health care system and psychological analysis, based on cultural philosophical argument through the hermeneutic approach of classical texts and critical analysis.

The COVID-19 pandemic has exposed the dilemma between the public health measures for COVID-19 and sustaining elderly social psychological health through familial connection. From a Confucian perspective, the practice of filial piety (xiao, 孝), which demands taking care of parents, is essential for one’s moral formation, and for one’s becoming a virtuous (ren, 仁) person. The necessity of taking care of elderly parents by adult children is not something that can be explained in terms of consequentialism. Indeed, the rising trend of instrumental rationality seems to weaken rather than strengthen the sense of filial obligation. In the face of the COVID-19 pandemic which tends to separate connections between family members, the author argues that we should emphasize the values of familial caring and relationship because it enhances the elderly’s characteristic of resilience.

This paper shows that while social media technology has mitigated the negative effect of social distancing, such online relationships should never replace the bodily connections between the elderly and their family members from a Confucian perspective.