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  • 1.
    Giertz, Lottie
    Linnaeus University, Faculty of Social Sciences, Department of Social Work.
    Brukardelaktighet i social barnavård: En metodprövning av ”brukarråd” för familjehemsplacerade barn2014Report (Other academic)
  • 2.
    Giertz, Lottie
    Linnaeus University, Faculty of Social Sciences, Department of Social Work.
    En studie av inflytande och självbestämmande med personlig assistans2018In: Forskning om personlig assistans - en antologi / [ed] Altermark, Knutsson & Svensson Chowdhury, Stockholm: KFO Personlig assistans , 2018, 1, p. 97-104Chapter in book (Other academic)
  • 3.
    Giertz, Lottie
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Social Work.
    Erkännande, makt och möten: En studie av inflytande och självbestämmande med LSS2012Doctoral thesis, monograph (Other academic)
    Abstract [en]

    The dissertation is about people with serious functional impairments who receive support pursuant to the Swedish LSS – the Act Concerning Support and Service for Persons with Certain Functional Impairments. LSS gives compensatory support, so that a person can enjoy the right to live a life like anyone else. The user’s right to influence and self-determination is emphasized in the Act.

    The overall aim of the dissertation is to describe and analyse conditions, possibilities, and limitations to influence and self-determination for people receiving LSS support. The investigation includes two interview studies. One is a study of influence and self-determination in everyday life with personal assistance. The other study focuses on people receiving some form of LSS service in combination with having a limited guardian.

    The thesis shows that LSS can be understood on a general level as a judicial recognition of the group’s right to support for citizenship on individual terms. In many cases LSS service give the user influence and self-determination in everyday life. The interaction between the user and the supporting persons are crucial. If it involves mutual recognition of equality and recognition of difference – the right to be compensated for restricted abilities – then the user can act autonomously. The study deals with power and recognition as essential aspects. The analysis shows that recognition and power together contribute to an understanding of the complex situation that users of LSS measures have in their day-to-day lives. The intention behind the care is to ensure the user’s best interest. Relations and encounters around the user are affected by pastoral power with a caring purpose where support and control are interwoven. Mis-directed recognition is perceived as an infringement of integrity. The dilemma is that care that aims for something good without recognition reduces the user to an object and disrespect. The studies reveal a tension between the ideal of influence and self-determination as ”subject of rights” and the user’s everyday life. Personal assistance can be designed to contribute to achieving the intentions. Among many people receiving LSS support and having a legal guardian, the personal influence and self-determination are not distinct and guardianship is unclear. Relations are characterized by dilemmas concerning the preferential right of interpretation. The individuals are seen as “objects of care” by others. Influence and self-determination depend on a fundamental recognition of the user as subject with a need for individually adapted care. This means the right to be and act as a “subject of care”. Recognition, relations and power are keys to influence and self-determination in LSS.

  • 4.
    Giertz, Lottie
    Linnaeus University, Faculty of Social Sciences, Department of Social Work. Växjö Kommun.
    Gode män och förvaltare till vuxna huvudmän i Växjö kommun  ÅR 20142015Report (Other academic)
  • 5.
    Giertz, Lottie
    Linnaeus University, Faculty of Social Sciences, Department of Social Work.
    Guardianship for Adults with Intellectual Disabilities: Accountant, Advocate or ‘Family’ Member?2018In: Scandinavian Journal of Disability Research, ISSN 1501-7419, E-ISSN 1745-3011, Vol. 20, no 1, p. 256-265Article in journal (Refereed)
    Abstract [en]

    The overarching aim of this study is to explore guardianship in terms of its impact on daily lives of adults with intellectual disabilities in Sweden. Based on qualitative interviews, the article focuses on the expected and actual role of limited guardians for people with intellectual disabilities in the context of Swedish laws. Our findings show that the legal definition of limited guardianship is unclear, and that this lack of clarity among other dilemmas creates conflict among clients, guardians, relatives, professionals and care workers. The guardian may be expected to act as an accountant, a legal advocate, or even a surrogate family member. The result is consistent with previous research in other countries on the consequences of guardianship. The current legislation on limited guardianship is in need of amendment in order to avoid legal uncertainty and ambiguity among clients and their support network.

  • 6.
    Giertz, Lottie
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Ideal och vardag: Inflytande och självbestämmande med personlig assistans2008Licentiate thesis, monograph (Other academic)
    Abstract [en]

    Personal assistance was introduced in 1994 as part of “LSS”, Act concerning Support and Service for Persons with Certain Functional Impairments. The intention of this assistance is to enable people with severe and extensive impairments to live a “normal life”. In this law text the importance of the user’s influence on how to form the assistance is emphasized; the user also has the opportunity to choose which organization should carry out his/her achievement. The user is encouraged to act independently and autonomously.

    The main purpose of the present investigation is to shed light on how the user’s influence in the process of gaining assistance and independence in everyday life is perceived and described. The study is based on different forms of qualitative interviews with users, legal representatives, assistance employers, handling officers and personal assistants.

    The results show that many users need support from others in the process of applying for assistance. Obstacles in the user’s influence are mainly the impairment itself; a failing body, feebleness and other difficulties. Other impediments are lack of knowledge of one’s rights, legislation and the organization of the assistance.

    Self-determination in everyday assistance is facilitated by the support being given by a few familiar persons in the household. The level of self-determination depends mainly on the relationship between the user and the personal assistant. Users develop different strategies such as adapting the content of the day to the assistant who works that particular day or to employ family members as assistants. For other users it can be difficult to find functioning strategies for self-determination and they imply that the assistants take over the home. The home is being turned into a workplace and the user’s independence in decision-making is questioned and threatened.

    Many people with severe disabilities have a legal representative. In the inquiry the interviewed representatives are also relatives of the user – often parents. In the application process for assistance the results show that user influence is facilitated when there is a third party who can speak for the user. In daily life however self-determination in the user’s assistance becomes complicated – it becomes difficult for assistants and assistance employers to interpret the difference between the will of the user and the will of the relative/representative.

    The Act concerning Support and Service for Persons with Certain Functional Impairments becomes a paradox when the individual user lacks chances to live up to an active and responsible role which is assumed in the text of the law. The frailest persons lacking representatives run the risk of heavier vulnerability. Then the right to independence and self-determination in their own lives is reserved for the users who have a strong voice of their own or a strong willpower from their legal representatives who are able to claim their rights to influence and self-determination.

  • 7.
    Giertz, Lottie
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Social Work.
    Vardag på egna villkor med personlig assistans2011In: Förhållningssätt och möten: Arbetsmetoder i social omsorg / [ed] Thomas Strandberg, Lund: Studentlitteratur AB, 2011, 1, p. 221-238Chapter in book (Other academic)
  • 8.
    Giertz, Lottie
    et al.
    Linnaeus University, Faculty of Social Sciences, Department of Social Work.
    Melin Emilsson, Ulla
    Linnaeus University, Faculty of Social Sciences, Department of Social Work.
    Albertsson, Marie
    Ställföreträdarskap och livet med demens: En studie om självbestämmande, samtycke och företrädarskap2018Report (Other (popular science, discussion, etc.))
  • 9.
    Giertz, Lottie
    et al.
    Linnaeus University, Faculty of Social Sciences, Department of Social Work.
    Melin Emilsson, Ulla
    Linnaeus University, Faculty of Social Sciences, Department of Social Work. Lund University, Sweden.
    Vingare, Emme-Li
    Linnaeus University, Faculty of Social Sciences, Department of Social Work.
    Family caregivers and decision-making for older people with dementia2019In: Journal of Social Welfare and Family Law, ISSN 0964-9069, E-ISSN 1469-9621, Vol. 41, no 3, p. 321-338Article in journal (Refereed)
    Abstract [en]

    This article addresses the dilemmas concerning legislation, individual autonomy and the reality of everyday life for people coping with dementia. We describe and analyse decision-making in relation to older people with dementia in Sweden, within the area of social work regulated by the Social Services Act and the Parental Act. Swedish legislation is based on the individual's autonomy and capacity to consent to services without anyone having legal authority to decide on behalf of the individual. Based on data from interviews with family caregivers living at home, decision-making through family caregivers is discussed and formal guardianship is also considered. Swedish legislation leaves individuals with dementia and family caregivers in a vacuum between self-determination and full autonomy with the ideal of citizenship emphasised and recognised in the Social Services Act on the one hand, and on the other, a strong need for support in everyday life and with decision-making.

  • 10.
    Giertz, Lottie
    et al.
    Linnaeus University, Faculty of Social Sciences, Department of Social Work.
    Thörnblad, Mary
    Unterstützung und Hilfen für Menschen mit Behinderungen in Schweden: Gesetze, Trends und Arbeitsmethoden2013In: Die Person als Organon in der Sozialen Arbeit: Erzieherpersönlichkeit und qualifiziertes Handeln / [ed] Kathrin Blaha, Christine Meyer, Herbert Colla, Stefan Müller-Teusler, Wiesbaden: Springer, 2013, 1, p. 293-311Chapter in book (Other academic)
    Abstract [de]

    Soziale Arbeit vollzieht sich nicht nur lokal, sondern hat zunehmend auch internationale Dimensionen – sei es in dem Anwerben von Fachkräften aus anliegenden Grenzgebieten oder in dem Vergleich von Gesetzen und Konzepten. Insbesondere in den Hilfen für Menschen mit Behinderungen liegt in Schweden im europäischen Vergleich eine Selbstverständlichkeit zugrunde, an die andere Länder (so auch Deutschland) bei weitem noch nicht heranreichen. Das betrifft nicht nur die Assistenzdienste, sondern auch die Akzeptanz in der Bevölkerung und die sich daraus ergebenden „inklusiven“ Aspekte. Daher haben wir den nachfolgenden Text von zwei schwedischen Kolleginnen in dieses Buch mit aufgenommen, um eine Möglichkeit des Vergleiches zu haben.

  • 11.
    Lethin, Connie
    et al.
    Lund University.
    Giertz, Lottie
    Linnaeus University, Faculty of Social Sciences, Department of Social Work.
    Vingare, Emme-Li
    Linnaeus University, Faculty of Social Sciences, Department of Social Work.
    Hallberg, Ingalill Rahm
    Lund University.
    Dementia care and service systems - a mapping system tested in nine Swedish municipalities2018In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 18, article id 778Article in journal (Refereed)
    Abstract [en]

    BackgroundIn dementia care, it is crucial that the chain of care is adapted to the needs of people with dementia and their informal caregivers throughout the course of the disease. Assessing the existing dementia care system with regard to facilities, availability and utilization may provide useful information for ensuring that the professional dementia care and service system meets the needs of patients and their families from disease onset to end of life.MethodsThe aim of this study was to further develop and test a mapping system, and adapt it to a local context. In addition, the aim was to assess availability and utilization of care activities as well as professional providers' educational level in nine municipalities under the categories of Screening, the diagnostic procedures, and treatment; Outpatient care facilities; Institutional care and Palliative care. This cross-sectional study was conducted in April through May 2015. Data was derived from the health care and social service systems in nine rural and urban municipalities in two counties in Sweden. The mapping system covered seven categories with altogether 56 types of health care and social service activities.ResultsThe mapping system was found to be reliable with minor adaptations to the context mainly in terms of activities. Availability of care activities was common with low utilization regarding Screening, the diagnostic procedures, and treatment; Outpatient care facilities; Institutional care and Palliative care and dementia trained staff was rare. Availability and utilization of care activities and professionals' educational level was higher concerning screening, the diagnostic procedures and treatment compared with outpatient care facilities, institutional care and palliative care.ConclusionsThe mapping system enables policy makers and professionals to assess and develop health care and social service systems, to be offered proactively and on equal terms to people with dementia and their informal caregivers throughout the course of the disease. The educational level of professionals providing care and services may reveal where, in the chain of care, dementia-specific education for professionals, needs to be developed.

  • 12.
    Lethin, Connie
    et al.
    Lund University, Sweden.
    Hallberg, Ingalill Rahm
    Lund University, Sweden.
    Vingare, Emme-Li
    Linnaeus University, Faculty of Social Sciences, Department of Social Work.
    Giertz, Lottie
    Linnaeus University, Faculty of Social Sciences, Department of Social Work.
    Persons with Dementia Living at Home or in Nursing Homes in Nine Swedish Urban or Rural Municipalities2019In: Healthcare, E-ISSN 2227-9032, Vol. 7, no 2, p. 1-13, article id 80Article in journal (Refereed)
    Abstract [en]

    The methodology from the RightTimePlaceCare study of dementia care was tested locally in terms of relevance, acceptability and attrition. Comparing persons with dementia (PwDs) receiving home care (HC) with PwDs living in nursing homes (NHs), in urban versus rural areas, regarding their health conditions and informal caregiver burden was also done. Standardized measurements regarding sociodemographic, and physical and mental health was used. Questions related to legal guardianship were added. Interviews were conducted with PwDs and their caregivers in HC (n = 88) and in NHs (n = 58). Bivariate and multivariate logistic regression analysis was used. The attrition rate was higher in HC. In the bivariate regression model, for HC and NH, living at home was significantly associated with more severe neuropsychiatric symptoms (p <= 0.001) and being cared by a spouse (p = 0.008). In NH, the informal caregivers were significantly younger (p = 0.003) and living in rural areas (p = 0.007) and more often in paid work (p <= 0.001). In the multivariate regression model, informal caregivers were significantly younger (p = 0.007) when caring for a PwD in an NH and caregiver burden was significantly higher in HC and in urban areas (p = 0.043). Legal guardianship was very low. Professionals should acknowledge that PwDs in HC have more behavioural problems and caregivers in urban areas report higher caregiver burden.

  • 13.
    Vingare, Emme-Li
    et al.
    Linnaeus University, Faculty of Social Sciences, Department of Social Work.
    Giertz, Lottie
    Linnaeus University, Faculty of Social Sciences, Department of Social Work.
    Melin Emilsson, Ulla
    Linnaeus University, Faculty of Social Sciences, Department of Social Work.
    Do national guidelines have any impact?: a comparison of nine Swedish municipalities and the Dementia care2018In: Nordic Social Work Research, ISSN 2156-857X, E-ISSN 2156-8588, p. 1-15Article in journal (Refereed)
    Abstract [en]

    Living with dementia, care and social care systems The aim of this article is to find out what impact national guidelines have on municipality dementia care. Furthermore, the aim is to compare organization of social care to the local adaptation of nationally invoked values. This article is connected to Living with dementia, care and social care systems , an interdisciplinary project between Health Sciences at Lund University and Social Sciences at Linnaeus University. The national guidelines for care and services to people with dementia recommend specialized units, and professional specialization in dementia care. Based on values of self-determination, integrity, accessibility, equity, rights and safety, they are meant to guide the dementia care in the community. In this article the organization of care is compared to how nationally invoked values are discussed in local policy documents in nine municipalities. These two aspects of dementia care are central to the national guidelines. The organization of care was explored by a mapping study of 19 municipality services. Type of organization was determined based on when, throughout the progression of the disease, services were made available, the existence of specialized dementia care units, and level of professional specialization. Information about values in local policies was examined by utilizing policy as discourse analysis of local policy documents. Four types of relationships between organization and value implementation were found. Eight out of nine municipalities failed to adapt to both aspects of the national guidelines.

1 - 13 of 13
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