To contribute to the development of effective support for early career researchers during and after doctoral education, the aim of this study was to examine the experiences of the early career transition after affiliation with an interdisciplinary graduate school, using the Swedish National Graduate School on Ageing and Health (SWEAH) as an example. Through qualitative interviews with 18 alumni, the findings reveal that the graduate school had fostered interdisciplinary research skills among early career researchers, and they felt well-prepared for the next career stage. However, they expressed a need for continuous career support and personal guidance while still feeling confident and open-minded. Interdisciplinary graduate schools can play a crucial role in nurturing the next generation of early career researchers, providing them with the skills and identities needed for impactful research and collaboration in a complex, interconnected world. We suggest that academic careers should be understood in an entangled or interlinked way from the very beginning of the academic journey, and introduce a new conceptual coinage of “career ecologies”. This implies that doctoral students and early career researchers should be encouraged, empowered, energized, and invited to activate and make use of their societal voice, influence, and value, right from the early formative doctoral years. Moreover, strategic support is vital to maintain an interdisciplinary spirit and facilitate informed career choices.

The aim is to describe the development of a novel interdisciplinary graduate school, using the Swedish National Graduate School for Competitive Science on Ageing and Health (SWEAH) as a case example. We explore doctoral students’ perceptions of being part of SWEAH and provide implications for practice. Written self-reports reflecting 78 students’ experiences and perceptions were analyzed using thematic analysis. The findings reveal that affiliation with SWEAH is highly valued. The students emphasized the tailored courses and learning activities and reported that it was instrumental in deepening their knowledge and broadening their research perspectives. The findings demonstrate how students navigate between disciplinary and interdisciplinary contexts and become enculturated with intellectual mindset and understanding of the importance of network building. The graduate school adds an interdisciplinary layer of learning, influenced by peers and researchers, and demonstrates the importance of community building within interdisciplinary environments and how it can be achieved. 

Introduction: Studies of older women’s life transitions is rare but gains relevance as the aging population, with older women as the majority, expands.

Purpose: To explore the meaning of a good life for older widows with extensive home care needs.

Materials and methods: Semi-structured interviews were carried out with eleven women, aged 80 and over (82–95 years, mean 90) residing at home with extensive care needs (≥4 daily sessions, averaging 2.5–6 hours, mean 3). Data were analysed by reflexive thematic analysis.

Results: The theme “This Day in My Home, the frame of my life” reflects the women’s experience of a good life. A good day imbued them with hope, trust and security, carrying them forward with the assurance that night would usher in a new day. However, there were moments when life was merely about navigating daily challenges. During such days, the women felt trapped in time, unsafe and lonely.

Conclusion: A day at home may seem static, yet it mirrors life’s dynamism, evolving with shifting circumstances. Older widows navigate challenges while maintaining their sense of self, independence, and connection to home. These findings have implications for aged care, recognizing the multifaceted aspects of life and the centrality of home.

Lipedema is a chronic, progressive disease that almost exclusively affects women and often misdiagnosed as obesity or primary lymphedema. Research concerning lipedema is sparse, and there is a lack of studies focusing on women’s experiences of living with the illness. We interviewed fourteen women with lipedema with the aim of describing their experiences of living with lipedema. Our results show that women felt controlled by their body, and were fat-shamed and viewed by others as a person who lacked character. They received unsupportive advice on how to manage from healthcare, and blamed themselves while striving to take responsibility.

Persons with dementia face several challenges in daily life and the consequences of the disease can be a threat to live a dignified life. Martha Nussbaum has developed the concept of dignified life for people with dementia and suggests the capability approach focusing on what people are able to do and to be in certain agreed-upon areas. Particularly, affiliation and practical reasoning are crucial to preserve a dignified life. For people with dementia the consequences of the disease may affect their opportunities to achieve these vital human capabilities. Digital resources have been shown to have potential to support people in their everyday life and provide them with the means necessary to participate in all aspects of life. In this study, our purpose is to describe digital resources aimed at supporting opportunities for affiliation and practical reasoning among people with dementia. Specifically, we wanted to give an overview of the existing digital resources used to support affiliation and practical reasoning and how such resources affect opportunities for people with dementia. A framework for scoping reviews was used and literature searches were conducted in PubMed and Scopus. The results, by providing a deep analysis of digital resources for affiliation and practical reasoning, highlight the need for a clearer direction towards the very core of vital aspects in a dignified life. Hence, there is a need for a framework that can guide attention towards crucial aspects for supporting a dignified life when developing and evaluating digital resources. 

The ability of nursing staff to assess and evaluate behavioral and psychological symptoms of dementia (BPSD) to determine when intervention is needed is essential. In order to assist with the assessment process, the current use of the Neuropsychiatric Inventory Nursing Home version (NPI-NH) is internationally accepted. Even though the NPI-NH is thoroughly validated and has several advantages, there are also various challenges when implementing this system in practice. Thus, the aim of this study was to explore clinical reasoning employed by assistant nurses when utilizing the NPI-NH as a tool to assess frequency and severity of BPSD in individuals with advanced dementia.

Twenty structured assessment sessions in which assistant nurses used the NPI-NH were audio recorded and analyzed with a discourse analysis focusing on the activities in the communication.

Four categories were identified to convey assistant nurses' clinical reasoning when assessing and evaluating BPSD using the NPI-NH: considering deteriorations in ability and awareness, incorporating individual and contextual factors, overcoming variations in behaviors and ambiguous formulations in the instrument, and sense-making interactions with colleagues.

The NPI-NH served as a supportive frame and structure for the clinical reasoning performed during the assessment. The clinical reasoning employed by assistant nurses became a way to reach a consensual and broader understanding of the individual with dementia, with the support of NPI-NH as an important framework.

Aims and objectives

To explore how Martha Nussbaum's approach to human capabilities can apply to dignity in the lives of people with advanced dementia living in nursing homes.

Background

Challenges experienced when supporting people with advanced dementia who express problematic behaviours include understanding their needs and ensuring a dignified life for them.

Design and methods

Data were gathered using an ethnographic approach based on participatory observation. Nussbaum's capability approach was then used as a framework for the analysis. Four women diagnosed with advanced dementia who also expressed problematic behaviours were recruited from a nursing home in Northern Sweden. The data collection was performed during 2015.

Findings

Individuals with advanced dementia had difficulties in participating in the planning of their lives and achieving the human capability of practical reasoning. They were also at risk of being placed outside the social group, thus hindering them from attaining the human capability of affiliation. A dignified life for individuals with advanced dementia requires nursing staff to be present and to provide adapted support to ensure that the individual can actually pursue human capabilities.

Conclusion

Creating opportunities for the human capabilities of practical reasoning and affiliation is essential as they permeate all other human capabilities. For these individuals, it was crucial not only to create opportunities for human capabilities but also to attend to their expressions and needs and to guide and steer them towards a dignified life.

Implications for Practice

The normative structure of the capability approach described by Nussbaum can ensure that nursing staffs move beyond fulfilling patients’ basic needs to consider other capabilities vital for a dignified life.

Understanding people with dementia whose verbal ability has been impaired is a complex and challenging task, even for professional nursing staff. The aim of this PhD thesis was to explore structures that may promote the understanding of people with advanced dementia living in nursing homes. It focusses specifically on (I) the clinical reasoning employed by assistant nurses when utilizing the NPI-NH (Neuropsychiatric Inventory Nursing Home version) as a tool to assess frequency and severity of BPSD (behavioural and psychological symptoms in dementia, i.e. problematic behaviours) in people with advanced dementia, (II) whether a sensor measuring electrodermal activity (EDA) can improve the identification of agitation in individuals with dementia, (III) how an EDA sensor impacts assistant nurses’ structured assessments of problematic behaviours amongst people with dementia and their choices of care interventions, and (IV) how Martha Nussbaum’s approach to human capabilities can apply to dignity in the lives of people with advanced dementia living in nursing homes. Study I used a method of discourse analysis that focussed on clinical reasoning utilized by assistant nurses when assessing problematic behaviours. In study II, a nonexperimental and correlational observation of the relationship between a sensor measuring EDA and assistant nurses’ structured observations of agitation in people with advanced dementia was applied. Study III used both quantitative and qualitative approaches; data were collected during structured assessments of problematic behaviours conducted by assistant nurses, as well as by focus group interviews with assistant nurses. Study IV took an ethnographic approach with participatory observations that were analyzed with a recursive analysis using a theoretical framework for the conditions necessary for a dignified human life. The structure of the NPI-NH provided a supportive framework that encouraged assistant nurses to discuss and broaden their understanding of the person with dementia (I). The EDA sensor provided continuous information regardless of staff presence and the potential to identify EDA prior to observing these behaviours (II, III), which supported the understanding of the person and when to introduce timely interventions to prevent the onset of problematic behaviours (III). The structure of Nussbaum’s approach to human capabilities illuminated that people with advanced dementia were at risk of living a life in which their opportunities for human capabilities were limited, and hence, the possibility to live a dignified life (IV). An overview of the findings in this thesis indicates that the studied structures were used to piece together fragments of information to create a comprehensive understanding of the needs of the person with dementia. For the structures to support the understanding of the person with dementia, it was crucial that nursing staff were present, attentive and engaged in each person’s situation in order for them to figure out how to piece together and integrate the structures into the overall understanding of the person and, based on that, formulate caring actions in daily life that are meaningful from the perspective of the person with advanced dementia.