Omsorgstagaren i fokus? Om delaktighet och självbestämmande på äldreboenden

The thesis concerns participation for people with dementia living in nursing homes. The work includes four studies. The first study is based on an analysis of 7 procurement documents (specifying the requirements of three municipalities for private actors who will operate). Procurement documents emphasize the requirement for staff to work for the resident's participation, while there is little in the documents about how staff should be supported. The second study is a scoping review, which showed that the involvement of residents with dementia in nursing homes was limited, and the attitudes of staff/managers to the care recipients' opportunities for participation were significant. The articles in the scooping review have been graded according to a ladder model of involvement to determine whether the person with dementia was involved in the research and their daily life. The third study contains six group interviews with staff. Staff were aware of their demands to work for the residents' participation, and they experienced moral distress when they could not live up to these demands. Staff sometimes act with moral agency according to their moral compass but against the institution's rules. This agency could be either active or passive. The fourth study contains individual interviews with 16 relatives. Furthermore, two co-researchers are also involved. Relatives highlighted the situations that did not favor the residents' participation, and these situations sometimes violated human rights (as we interpreted relatives' narratives). However, some relatives expressed that their loved ones could not participate. The residents were not seen as people with essential knowledge in the daily work at nursing homes; consequently, we can frame that as epistemic injustices. Furthermore, defining dementia as a disability could further strengthen the rights of people with dementia.