Professor at Department of health and care sciences, UiT The arctic university of Norway. Professor II at Western Norway university of applied sciences. RN, MSc, PhD. Main research interests are gerontology, indigenous older adults, equity in health and health care, and narrative inquiry.
Narrative inquiry is often represented by using fragments of field texts. Drawing on a 4-year stu... more Narrative inquiry is often represented by using fragments of field texts. Drawing on a 4-year study alongside refugee families from Syria, we show the importance of acknowledging the multiple and nested contexts within which field texts are situated. We illustrate how each moment is reflective of being in the midst—of social, institutional, and cultural narratives, formula stories, multiple relationships, domestic details, and silences. Attending to living in the midst allows us to contemplate perplexities amid a plurality of experiences that are embedded and understood as part of living within unfolding lives and relationships.
Drawing on the metaphor of “care convoys,” this study explores the experiences and strategies of ... more Drawing on the metaphor of “care convoys,” this study explores the experiences and strategies of family caregivers of older adults with dementia in rural areas of Northern Norway. The study is part of a broader project that investigates how these older adults and their caregivers use or do not use municipal health and care services. We conducted qualitative in-depth interviews with 11 family caregivers in rural municipalities. The thematic analysis of the interview data yielded three main themes: Delaying the transition to long-term care amid evolving needs, facilitating knowledge transition, and navigating divergent expectations about involvement. In addition, a fourth theme, caregiving in the rural Arctic, was identified as cross-cutting, reflecting the unique rural Arctic context that was a backdrop across all themes. In navigating the caregiving journey, family caregivers assume various roles within care convoys. They may act as solitary vessels, as an integral part of a larger care convoy, or as the main ship guiding the convoy. At times, family caregivers serve as vessels called upon by the convoy when needed. Difficulties in assembling an adequate or robust care convoy were exacerbated by the context of the Artic North, which represents treacherous waters for the convoy to navigate, primarily due to two factors: first, many of the smaller ships (other family members) were not present or had to travel great distances to join the convoy and second, the lengthy journeys (long travel distances), and particularly in the winter time, made the convoys susceptible to loosing ships along the way.
This article compares community services provided to older adults living in Bergen, Norway, and T... more This article compares community services provided to older adults living in Bergen, Norway, and Toronto, Canada. We investigate the gaps that are left unattended in the respective jurisdictions and consequently maintained by the organizations. Our findings reveal the importance of community organizations in positively influencing the initial transition from independence to needing more supports. Our findings show differences between the jurisdictions in the experiences of care gaps for diverse groups of providers and clients, while the overall importance of community organizations for older adults is shared in both jurisdictions, particularly by filling gaps between the formal and informal care systems.
In this study, we drew on Barbara Adam's (1998) timescape perspective and applied a times... more In this study, we drew on Barbara Adam's (1998) timescape perspective and applied a timescape lens to our analysis of how nine older adults who live alone, receive home care and are considered by home care professionals to be frail, experience living (in) time. Over a period of eight months, we conducted three interviews with each of the nine participants. We analysed the data using reflexive thematic analysis and drew on timescapes to further interpret our preliminary analysis. Our results show that situated everyday time, place across time, and large-scale time interact in the framing and shaping of older adults' everyday lives. Older adults' embodied experiences of being of advanced age, living alone and receiving home care influenced their timescapes. We propose that paying attention to older adults' timescapes can enable home care professionals and other supporters to consider older adults' health, well-being, vulnerabilities and strengths from a broader perspective than the ‘here and now’ and thereby enhance the provision of person-centred care.
Although older people who live alone might be in a vulnerable situation, they have often managed ... more Although older people who live alone might be in a vulnerable situation, they have often managed their everyday life for a long time, frequently with health challenges. In this article, we explore how nine older persons who live alone, who receive home care and are identified by home care professionals as being frail, manage their everyday lives by inquiring into their stories about living alone and receiving home care. We conducted three qualitative interviews with each of the nine participants over a period of eight months and analysed the data using thematic analysis and a narrative positioning analysis. Using the concept of resilience as our analytic lens, we identified three thematic threads: continuity, adaptation and resistance. In the narrative positioning analysis of three participants' stories, we identified that the participants used the processes of continuity, adaptation and resistance strategically and interchangeably. The study thus provides insight into how older people who live alone and use home care services narrate their balancing of strengths and vulnerabilities, and engage in the construction and maintenance of a sense of self through positioning in relation to master narratives. Older people's narrations are nuanced and complex, and this study indicates that encouraging storytelling and engaging with older people's narrations might support how older people enact resilience and thus their management of everyday life when living alone and ageing in place.
This article is based on experiences with the Dreamcatchers, a project involving people living wi... more This article is based on experiences with the Dreamcatchers, a project involving people living with substance addiction, and their significant others, in which the participants composed and explored narratives through creative, collaborative processes. In the article, we think with a narrative composed by one of the participants in the project to learn from her experiences. Our thinking is inspired by narrative inquiry as a way of thinking about experience. We understand the playful and imaginative narrative processes within the Dreamcatchers project as composing sustainable stories to live by. The Dreamcatchers project demonstrates the necessity of involving people living with substance addiction in naming the problem and in the search for possible and sustainable solutions or improvements.
International Journal of Integrated Care, Aug 8, 2019
Larsen, L et al 2019 Family caregivers' involvement in Decisionmaking processes regarding admissi... more Larsen, L et al 2019 Family caregivers' involvement in Decisionmaking processes regarding admission to nursing homes for
The Shaping of Professional Identities: Revisiting Critical Event Narrative Inquiry, 2024
I am a narrative inquirer still in the making. My journey of being and becoming a narrative inqui... more I am a narrative inquirer still in the making. My journey of being and becoming a narrative inquirer, so far, has involved a series of personal and professional turns. In this chapter I draw on two painful experiences of shortcoming and the apparent paradox that every time we perform a turn, we are looking backwards in order to move forward.Turning points are openings to learning and to surprise. For me, narrative inquiry involves a commitment to navigate unknown waters, and a willingness to inquire into the unknown and sometimes silenced in my own and others’ lives. Dwelling with my own shortcomings, such as my experiences alongside Risten and Maria, is crucial in my process of being and becoming a narrative inquirer.
People who suffer from advanced cancer may experience a loss of ability to participate in everyda... more People who suffer from advanced cancer may experience a loss of ability to participate in everyday life and meaningful activities, challenging their sense of identity and social relations. Social support in patient-to-patient interactions and the sharing of experiences with people in similar situations may help alleviate distress. This article is based on an ethnographic field study carried out in relation to three residential narrative courses, which included 36 persons with advanced cancer. In this study, we aimed to explore whether the courses were perceived as significant by the participants and, if so, in what ways. The field work included 185 hr of observations, six focus group interviews and nine individual interviews. The data were analyzed using an abductive thematic approach. Our findings indicate that the residential courses were generally experienced as meaningful and that in particular the setting, the community, and gaining hope were experienced as significant.
Narrative methods have been shown to help people with cancer to create meaning, find hope and res... more Narrative methods have been shown to help people with cancer to create meaning, find hope and restore a sense of coherence in life. Likewise, the combination of rehabilitation and palliative care for people with life-threatening illness is receiving increasing interest and is generally perceived as beneficial for patients. Four narrative courses combining rehabilitation and palliative care approaches for people who have or have had cancer were carried out in Denmark between 2021 and 2022. An ethnographic field study revealed that some of the course participants experienced harm during the courses and therefore chose to withdraw. Findings show that a rehabilitation approach dominated in the courses and that the participants’ experiences of harm occurred in a complex interplay between the participants, the professionals and the specific narrative exercises. While some participants’ stories were recognised as legitimate and meaningful and were continuously supported and encouraged, other participants’ stories of suffering were suppressed.
In this study, we drew on Barbara Adam's (1998) timescape perspective and applied a timescape len... more In this study, we drew on Barbara Adam's (1998) timescape perspective and applied a timescape lens to our analysis of how nine older adults who live alone, receive home care and are considered by home care professionals to be frail, experience living (in) time. Over a period of eight months, we conducted three interviews with each of the nine participants. We analysed the data using reflexive thematic analysis and drew on timescapes to further interpret our preliminary analysis. Our results show that situated everyday time, place across time, and large-scale time interact in the framing and shaping of older adults' everyday lives. Older adults' embodied experiences of being of advanced age, living alone and receiving home care influenced their timescapes. We propose that paying attention to older adults' timescapes can enable home care professionals and other supporters to consider older adults' health, well-being, vulnerabilities and strengths from a broader perspective than the ‘here and now’ and thereby enhance the provision of person-centred care.
This article is based on experiences with the Dreamcatchers, a project involving people living wi... more This article is based on experiences with the Dreamcatchers, a project involving people living with substance addiction, and their significant others, in which the participants composed and explored narratives through creative, collaborative processes. In the article, we think with a narrative composed by one of the participants in the project to learn from her experiences. Our thinking is inspired by narrative inquiry as a way of thinking about experience. We understand the playful and imaginative narrative processes within the Dreamcatchers project as composing sustainable stories to live by. The Dreamcatchers project demonstrates the necessity of involving people living with substance addiction in naming the problem and in the search for possible and sustainable solutions or improvements.
Decisions regarding pro re nata medications might be challenging due to the complex nature of the... more Decisions regarding pro re nata medications might be challenging due to the complex nature of the practice. The aim of this study was to expand our understanding of the experiences of older people living in sheltered housings with regard to shared decision-making concerning pro re nata medications. In this study, we conducted in-depth interviews with residents living in Norwegian sheltered housings. The analysis was inductive, based on a narrative positioning analysis. Twelve residents were interviewed, and three narratives representing participants’ variation are presented. People take different positions in shared decision-making of pro re nata medication, and they position themselves variously at different levels and situations. Prevailing master narratives affect the residents’ positions in shared decision-making. Contrasts in older adults’ experiences indicate that shared decision-making is not straightforward and is highly reliant on the context. Seemingly, they wish to be inv...
Objective Two-thirds of the economic resources in Norwegian hospitals are used on 10% of the pati... more Objective Two-thirds of the economic resources in Norwegian hospitals are used on 10% of the patients. Most of these high-cost patients are older adults, which experience more unplanned hospital admissions, longer hospital stays and higher readmission rates than other patients. This study aims to examine the individual and clinical characteristics of older patients with unplanned admissions to Norwegian somatic hospitals and how these characteristics differ between high-cost and low-cost older patients.
Design Observational cross-sectional study.
Setting Norwegian somatic hospitals.
Participants National registry data of older Norwegian patients (≥65 years) with ≥1 unplanned contact with somatic hospitals in 2019 (n=2 11 738).
Primary outcome measure High-cost older patients were defined as those within the 10% of the highest diagnosis-related group weights in 2019 (n=21 179). We compared high-cost to low-cost older patients using bivariate analyses and logistic regression analysis.
Results Men were more likely to be high-cost older patients than women (OR=1.25, 95% CI 1.21 to 1.29) and the oldest (90+ years) compared with the youngest older adults (65–69 years) were less likely to cause high costs (OR=0.47, 95% CI 0.43 to 0.51). Those with the highest level of education were less likely to cause high costs than those with primary school degrees (OR=0.74, 95% CI 0.69 to 0.80). Main diagnosis group (OR=3.50, 95% CI 3.37 to 3.63) and dying (OR=4.13, 95% CI 3.96 to 4.30) were the clinical characteristics most strongly associated with the likelihood of being a high-cost older patient.
Conclusion Several of the observed patient characteristics in this study may warrant further investigation as they might contribute to high healthcare costs. For example, MDGs, reflecting comprehensive healthcare needs and lower education, which is associated with poorer health status, increase the likelihood of being high-cost older patients. Our results indicate that Norwegian hospitals function according to the intentions of those having the highest needs receiving most services.
The upper secondary school dropout rate is a challenge in many western countries, and measures ha... more The upper secondary school dropout rate is a challenge in many western countries, and measures have been taken to prevent dropout. The dropout rate in Norway is stable but is the highest among the northernmost counties. The aim of this study is to explore the strategies employed by upper secondary school teachers and their collaborators to prevent dropout from upper secondary school among Sami youth in northern Norway. This study is based on three focus group interviews with teachers, advisers, nurses, and counsellors in the Sami areas of northern Norway. The thematic analysis identified two main strategies, namely tracking the student and giving the student time. A transparent environments, cultural competence, and interdisciplinary collaboration were identified as prerequisites for successfully implementing the two strategies to prevent dropout from upper secondary school.
In this article, we develop, through drawing forward fragments of our experiences, a concept of r... more In this article, we develop, through drawing forward fragments of our experiences, a concept of reciprocity as always situated within the relational ontology of narrative inquiry. Reciprocity is most commonly understood within a transactional sense, an exchange of goods. We show important aspects of reciprocity in narrative inquiry, including the importance of intentionally creating and responding to spaces where reciprocity occurs and can be sustained over time and place, and the potential reciprocity holds to change who we, and those with whom we work, are. As we reconsider the ways in which reciprocity is not understood as a transaction in a relational methodology, new questions about the entanglement of reciprocity and recognition emerge. We understand that recognition does not necessarily have to be reciprocal, but recognition is necessary to compose a space where reciprocity can live in our ordinary interactions with others.
In this article, we develop, through drawing forward fragments of our experiences, a concept of r... more In this article, we develop, through drawing forward fragments of our experiences, a concept of reciprocity as always situated within the relational ontology of narrative inquiry. Reciprocity is most commonly understood within a transactional sense, an exchange of goods. We show important aspects of reciprocity in narrative inquiry, including the importance of intentionally creating and responding to spaces where reciprocity occurs and can be sustained over time and place, and the potential reciprocity holds to change who we, and those with whom we work, are. As we reconsider the ways in which reciprocity is not understood as a transaction in a relational methodology, new questions about the entanglement of reciprocity and recognition emerge. We understand that recognition does not necessarily have to be reciprocal, but recognition is necessary to compose a space where reciprocity can live in our ordinary interactions with others.
By inquiring into older adults' narrations about their lives in the present, past, and fu... more By inquiring into older adults' narrations about their lives in the present, past, and future, this study aims to learn more about home-dwelling older adults' lived experiences of being and becoming “frail”. This article is based on a dialogical narrative analysis of interviews with three home-dwelling older adults identified as frail by the home care services. We conducted a series of three interviews with each participant over a period of eight months. Our results demonstrate that while some older adults experience frailty as inevitable and irreversible, others experience it as a transition. Some narrated frailty as a comprehensive experience, while others' narratives were more situational and transitional. Being able to live at home was crucial and moving to a nursing home was associated with the risk of becoming frailer and the loss of valued relations to family and their home. Experiences of frailty were framed and shaped by the past, present, and future. Faith, fate, and previous capacities to overcome adversities were crucial in the older adults' narrations. Older adults' stories provide an opening to diverse and changing experiences of living with frailty. By telling stories about the past, present, and future, older adults can maintain identity, a sense of belonging, and balance in the midst of adversities. By engaging with older adults' stories, health and care professionals can support the older adult in the ongoing process of being and becoming ‘a frail older adult’.
Background and Objectives: In the 21st century, the future of the Norwegian welfare state is broa... more Background and Objectives: In the 21st century, the future of the Norwegian welfare state is broadly debated. In Norway, as in other countries, concerns regarding the sustainability and affordability of the welfare state in light of the projected population development have been voiced in public and academic discourse, and not least in governmental statements and documents. Because we consider texts, such as government white papers, as both products and producers of discursively based understandings of the social world, a close examination of policy documents can provide insight into the predominant understanding of a distinct phenomenon in a specific society at a particular point in time. Research Design and Methods: The article is based on a critical discourse analysis of 3 recent Norwegian government policy documents addressing the older adult population. Results: We demonstrate that prominent ideas from the widely contested successful aging paradigm are embedded and forwarded in current Norwegian policies, where ideas about successful and healthy aging produced and reproduced in the documents frame and shape expectations toward older adults. Discussion and Implications: We argue that the ideas and ideals of successful aging and neoliberalism in parallel pave the way for changes in the historically generous and comprehensive Norwegian social democratic welfare state. For decision makers, the rhetoric of successful aging that emphasizes activity, productivity, self-reliance, and freedom of choice is undoubtedly more convenient to communicate to the public than explicit arguments for the necessity of downscaling public services.
Narrative inquiry is often represented by using fragments of field texts. Drawing on a 4-year stu... more Narrative inquiry is often represented by using fragments of field texts. Drawing on a 4-year study alongside refugee families from Syria, we show the importance of acknowledging the multiple and nested contexts within which field texts are situated. We illustrate how each moment is reflective of being in the midst—of social, institutional, and cultural narratives, formula stories, multiple relationships, domestic details, and silences. Attending to living in the midst allows us to contemplate perplexities amid a plurality of experiences that are embedded and understood as part of living within unfolding lives and relationships.
Drawing on the metaphor of “care convoys,” this study explores the experiences and strategies of ... more Drawing on the metaphor of “care convoys,” this study explores the experiences and strategies of family caregivers of older adults with dementia in rural areas of Northern Norway. The study is part of a broader project that investigates how these older adults and their caregivers use or do not use municipal health and care services. We conducted qualitative in-depth interviews with 11 family caregivers in rural municipalities. The thematic analysis of the interview data yielded three main themes: Delaying the transition to long-term care amid evolving needs, facilitating knowledge transition, and navigating divergent expectations about involvement. In addition, a fourth theme, caregiving in the rural Arctic, was identified as cross-cutting, reflecting the unique rural Arctic context that was a backdrop across all themes. In navigating the caregiving journey, family caregivers assume various roles within care convoys. They may act as solitary vessels, as an integral part of a larger care convoy, or as the main ship guiding the convoy. At times, family caregivers serve as vessels called upon by the convoy when needed. Difficulties in assembling an adequate or robust care convoy were exacerbated by the context of the Artic North, which represents treacherous waters for the convoy to navigate, primarily due to two factors: first, many of the smaller ships (other family members) were not present or had to travel great distances to join the convoy and second, the lengthy journeys (long travel distances), and particularly in the winter time, made the convoys susceptible to loosing ships along the way.
This article compares community services provided to older adults living in Bergen, Norway, and T... more This article compares community services provided to older adults living in Bergen, Norway, and Toronto, Canada. We investigate the gaps that are left unattended in the respective jurisdictions and consequently maintained by the organizations. Our findings reveal the importance of community organizations in positively influencing the initial transition from independence to needing more supports. Our findings show differences between the jurisdictions in the experiences of care gaps for diverse groups of providers and clients, while the overall importance of community organizations for older adults is shared in both jurisdictions, particularly by filling gaps between the formal and informal care systems.
In this study, we drew on Barbara Adam's (1998) timescape perspective and applied a times... more In this study, we drew on Barbara Adam's (1998) timescape perspective and applied a timescape lens to our analysis of how nine older adults who live alone, receive home care and are considered by home care professionals to be frail, experience living (in) time. Over a period of eight months, we conducted three interviews with each of the nine participants. We analysed the data using reflexive thematic analysis and drew on timescapes to further interpret our preliminary analysis. Our results show that situated everyday time, place across time, and large-scale time interact in the framing and shaping of older adults' everyday lives. Older adults' embodied experiences of being of advanced age, living alone and receiving home care influenced their timescapes. We propose that paying attention to older adults' timescapes can enable home care professionals and other supporters to consider older adults' health, well-being, vulnerabilities and strengths from a broader perspective than the ‘here and now’ and thereby enhance the provision of person-centred care.
Although older people who live alone might be in a vulnerable situation, they have often managed ... more Although older people who live alone might be in a vulnerable situation, they have often managed their everyday life for a long time, frequently with health challenges. In this article, we explore how nine older persons who live alone, who receive home care and are identified by home care professionals as being frail, manage their everyday lives by inquiring into their stories about living alone and receiving home care. We conducted three qualitative interviews with each of the nine participants over a period of eight months and analysed the data using thematic analysis and a narrative positioning analysis. Using the concept of resilience as our analytic lens, we identified three thematic threads: continuity, adaptation and resistance. In the narrative positioning analysis of three participants' stories, we identified that the participants used the processes of continuity, adaptation and resistance strategically and interchangeably. The study thus provides insight into how older people who live alone and use home care services narrate their balancing of strengths and vulnerabilities, and engage in the construction and maintenance of a sense of self through positioning in relation to master narratives. Older people's narrations are nuanced and complex, and this study indicates that encouraging storytelling and engaging with older people's narrations might support how older people enact resilience and thus their management of everyday life when living alone and ageing in place.
This article is based on experiences with the Dreamcatchers, a project involving people living wi... more This article is based on experiences with the Dreamcatchers, a project involving people living with substance addiction, and their significant others, in which the participants composed and explored narratives through creative, collaborative processes. In the article, we think with a narrative composed by one of the participants in the project to learn from her experiences. Our thinking is inspired by narrative inquiry as a way of thinking about experience. We understand the playful and imaginative narrative processes within the Dreamcatchers project as composing sustainable stories to live by. The Dreamcatchers project demonstrates the necessity of involving people living with substance addiction in naming the problem and in the search for possible and sustainable solutions or improvements.
International Journal of Integrated Care, Aug 8, 2019
Larsen, L et al 2019 Family caregivers' involvement in Decisionmaking processes regarding admissi... more Larsen, L et al 2019 Family caregivers' involvement in Decisionmaking processes regarding admission to nursing homes for
The Shaping of Professional Identities: Revisiting Critical Event Narrative Inquiry, 2024
I am a narrative inquirer still in the making. My journey of being and becoming a narrative inqui... more I am a narrative inquirer still in the making. My journey of being and becoming a narrative inquirer, so far, has involved a series of personal and professional turns. In this chapter I draw on two painful experiences of shortcoming and the apparent paradox that every time we perform a turn, we are looking backwards in order to move forward.Turning points are openings to learning and to surprise. For me, narrative inquiry involves a commitment to navigate unknown waters, and a willingness to inquire into the unknown and sometimes silenced in my own and others’ lives. Dwelling with my own shortcomings, such as my experiences alongside Risten and Maria, is crucial in my process of being and becoming a narrative inquirer.
People who suffer from advanced cancer may experience a loss of ability to participate in everyda... more People who suffer from advanced cancer may experience a loss of ability to participate in everyday life and meaningful activities, challenging their sense of identity and social relations. Social support in patient-to-patient interactions and the sharing of experiences with people in similar situations may help alleviate distress. This article is based on an ethnographic field study carried out in relation to three residential narrative courses, which included 36 persons with advanced cancer. In this study, we aimed to explore whether the courses were perceived as significant by the participants and, if so, in what ways. The field work included 185 hr of observations, six focus group interviews and nine individual interviews. The data were analyzed using an abductive thematic approach. Our findings indicate that the residential courses were generally experienced as meaningful and that in particular the setting, the community, and gaining hope were experienced as significant.
Narrative methods have been shown to help people with cancer to create meaning, find hope and res... more Narrative methods have been shown to help people with cancer to create meaning, find hope and restore a sense of coherence in life. Likewise, the combination of rehabilitation and palliative care for people with life-threatening illness is receiving increasing interest and is generally perceived as beneficial for patients. Four narrative courses combining rehabilitation and palliative care approaches for people who have or have had cancer were carried out in Denmark between 2021 and 2022. An ethnographic field study revealed that some of the course participants experienced harm during the courses and therefore chose to withdraw. Findings show that a rehabilitation approach dominated in the courses and that the participants’ experiences of harm occurred in a complex interplay between the participants, the professionals and the specific narrative exercises. While some participants’ stories were recognised as legitimate and meaningful and were continuously supported and encouraged, other participants’ stories of suffering were suppressed.
In this study, we drew on Barbara Adam's (1998) timescape perspective and applied a timescape len... more In this study, we drew on Barbara Adam's (1998) timescape perspective and applied a timescape lens to our analysis of how nine older adults who live alone, receive home care and are considered by home care professionals to be frail, experience living (in) time. Over a period of eight months, we conducted three interviews with each of the nine participants. We analysed the data using reflexive thematic analysis and drew on timescapes to further interpret our preliminary analysis. Our results show that situated everyday time, place across time, and large-scale time interact in the framing and shaping of older adults' everyday lives. Older adults' embodied experiences of being of advanced age, living alone and receiving home care influenced their timescapes. We propose that paying attention to older adults' timescapes can enable home care professionals and other supporters to consider older adults' health, well-being, vulnerabilities and strengths from a broader perspective than the ‘here and now’ and thereby enhance the provision of person-centred care.
This article is based on experiences with the Dreamcatchers, a project involving people living wi... more This article is based on experiences with the Dreamcatchers, a project involving people living with substance addiction, and their significant others, in which the participants composed and explored narratives through creative, collaborative processes. In the article, we think with a narrative composed by one of the participants in the project to learn from her experiences. Our thinking is inspired by narrative inquiry as a way of thinking about experience. We understand the playful and imaginative narrative processes within the Dreamcatchers project as composing sustainable stories to live by. The Dreamcatchers project demonstrates the necessity of involving people living with substance addiction in naming the problem and in the search for possible and sustainable solutions or improvements.
Decisions regarding pro re nata medications might be challenging due to the complex nature of the... more Decisions regarding pro re nata medications might be challenging due to the complex nature of the practice. The aim of this study was to expand our understanding of the experiences of older people living in sheltered housings with regard to shared decision-making concerning pro re nata medications. In this study, we conducted in-depth interviews with residents living in Norwegian sheltered housings. The analysis was inductive, based on a narrative positioning analysis. Twelve residents were interviewed, and three narratives representing participants’ variation are presented. People take different positions in shared decision-making of pro re nata medication, and they position themselves variously at different levels and situations. Prevailing master narratives affect the residents’ positions in shared decision-making. Contrasts in older adults’ experiences indicate that shared decision-making is not straightforward and is highly reliant on the context. Seemingly, they wish to be inv...
Objective Two-thirds of the economic resources in Norwegian hospitals are used on 10% of the pati... more Objective Two-thirds of the economic resources in Norwegian hospitals are used on 10% of the patients. Most of these high-cost patients are older adults, which experience more unplanned hospital admissions, longer hospital stays and higher readmission rates than other patients. This study aims to examine the individual and clinical characteristics of older patients with unplanned admissions to Norwegian somatic hospitals and how these characteristics differ between high-cost and low-cost older patients.
Design Observational cross-sectional study.
Setting Norwegian somatic hospitals.
Participants National registry data of older Norwegian patients (≥65 years) with ≥1 unplanned contact with somatic hospitals in 2019 (n=2 11 738).
Primary outcome measure High-cost older patients were defined as those within the 10% of the highest diagnosis-related group weights in 2019 (n=21 179). We compared high-cost to low-cost older patients using bivariate analyses and logistic regression analysis.
Results Men were more likely to be high-cost older patients than women (OR=1.25, 95% CI 1.21 to 1.29) and the oldest (90+ years) compared with the youngest older adults (65–69 years) were less likely to cause high costs (OR=0.47, 95% CI 0.43 to 0.51). Those with the highest level of education were less likely to cause high costs than those with primary school degrees (OR=0.74, 95% CI 0.69 to 0.80). Main diagnosis group (OR=3.50, 95% CI 3.37 to 3.63) and dying (OR=4.13, 95% CI 3.96 to 4.30) were the clinical characteristics most strongly associated with the likelihood of being a high-cost older patient.
Conclusion Several of the observed patient characteristics in this study may warrant further investigation as they might contribute to high healthcare costs. For example, MDGs, reflecting comprehensive healthcare needs and lower education, which is associated with poorer health status, increase the likelihood of being high-cost older patients. Our results indicate that Norwegian hospitals function according to the intentions of those having the highest needs receiving most services.
The upper secondary school dropout rate is a challenge in many western countries, and measures ha... more The upper secondary school dropout rate is a challenge in many western countries, and measures have been taken to prevent dropout. The dropout rate in Norway is stable but is the highest among the northernmost counties. The aim of this study is to explore the strategies employed by upper secondary school teachers and their collaborators to prevent dropout from upper secondary school among Sami youth in northern Norway. This study is based on three focus group interviews with teachers, advisers, nurses, and counsellors in the Sami areas of northern Norway. The thematic analysis identified two main strategies, namely tracking the student and giving the student time. A transparent environments, cultural competence, and interdisciplinary collaboration were identified as prerequisites for successfully implementing the two strategies to prevent dropout from upper secondary school.
In this article, we develop, through drawing forward fragments of our experiences, a concept of r... more In this article, we develop, through drawing forward fragments of our experiences, a concept of reciprocity as always situated within the relational ontology of narrative inquiry. Reciprocity is most commonly understood within a transactional sense, an exchange of goods. We show important aspects of reciprocity in narrative inquiry, including the importance of intentionally creating and responding to spaces where reciprocity occurs and can be sustained over time and place, and the potential reciprocity holds to change who we, and those with whom we work, are. As we reconsider the ways in which reciprocity is not understood as a transaction in a relational methodology, new questions about the entanglement of reciprocity and recognition emerge. We understand that recognition does not necessarily have to be reciprocal, but recognition is necessary to compose a space where reciprocity can live in our ordinary interactions with others.
In this article, we develop, through drawing forward fragments of our experiences, a concept of r... more In this article, we develop, through drawing forward fragments of our experiences, a concept of reciprocity as always situated within the relational ontology of narrative inquiry. Reciprocity is most commonly understood within a transactional sense, an exchange of goods. We show important aspects of reciprocity in narrative inquiry, including the importance of intentionally creating and responding to spaces where reciprocity occurs and can be sustained over time and place, and the potential reciprocity holds to change who we, and those with whom we work, are. As we reconsider the ways in which reciprocity is not understood as a transaction in a relational methodology, new questions about the entanglement of reciprocity and recognition emerge. We understand that recognition does not necessarily have to be reciprocal, but recognition is necessary to compose a space where reciprocity can live in our ordinary interactions with others.
By inquiring into older adults' narrations about their lives in the present, past, and fu... more By inquiring into older adults' narrations about their lives in the present, past, and future, this study aims to learn more about home-dwelling older adults' lived experiences of being and becoming “frail”. This article is based on a dialogical narrative analysis of interviews with three home-dwelling older adults identified as frail by the home care services. We conducted a series of three interviews with each participant over a period of eight months. Our results demonstrate that while some older adults experience frailty as inevitable and irreversible, others experience it as a transition. Some narrated frailty as a comprehensive experience, while others' narratives were more situational and transitional. Being able to live at home was crucial and moving to a nursing home was associated with the risk of becoming frailer and the loss of valued relations to family and their home. Experiences of frailty were framed and shaped by the past, present, and future. Faith, fate, and previous capacities to overcome adversities were crucial in the older adults' narrations. Older adults' stories provide an opening to diverse and changing experiences of living with frailty. By telling stories about the past, present, and future, older adults can maintain identity, a sense of belonging, and balance in the midst of adversities. By engaging with older adults' stories, health and care professionals can support the older adult in the ongoing process of being and becoming ‘a frail older adult’.
Background and Objectives: In the 21st century, the future of the Norwegian welfare state is broa... more Background and Objectives: In the 21st century, the future of the Norwegian welfare state is broadly debated. In Norway, as in other countries, concerns regarding the sustainability and affordability of the welfare state in light of the projected population development have been voiced in public and academic discourse, and not least in governmental statements and documents. Because we consider texts, such as government white papers, as both products and producers of discursively based understandings of the social world, a close examination of policy documents can provide insight into the predominant understanding of a distinct phenomenon in a specific society at a particular point in time. Research Design and Methods: The article is based on a critical discourse analysis of 3 recent Norwegian government policy documents addressing the older adult population. Results: We demonstrate that prominent ideas from the widely contested successful aging paradigm are embedded and forwarded in current Norwegian policies, where ideas about successful and healthy aging produced and reproduced in the documents frame and shape expectations toward older adults. Discussion and Implications: We argue that the ideas and ideals of successful aging and neoliberalism in parallel pave the way for changes in the historically generous and comprehensive Norwegian social democratic welfare state. For decision makers, the rhetoric of successful aging that emphasizes activity, productivity, self-reliance, and freedom of choice is undoubtedly more convenient to communicate to the public than explicit arguments for the necessity of downscaling public services.
Denne boken tar opp sentrale tema knyttet til narrativ forskning. Boken retter seg mot studenter,... more Denne boken tar opp sentrale tema knyttet til narrativ forskning. Boken retter seg mot studenter, praktikere og forskere som lytter til, forteller, eller på andre måter arbeider med fortellinger. Boken springer ut av et nordisk narrativt miljø med bakgrunn i helsevitenskap, samfunnsvitenskap, familieterapi, litteraturvitenskap og pedagogikk. Den tverrfaglige tilnærmingen til fortellinger gir et rikt og mangfoldig innblikk i et stort vitenskapelig felt som er i stadig utvikling. I boken presenteres et komplekst og kreativt forskningsmiljø hvor variasjonene viser faglig styrke og genuin interesse for fortellinger og deres muligheter.
Interview with The Norwegian National Centre for Ageing and Health (Ageing and Health). In this i... more Interview with The Norwegian National Centre for Ageing and Health (Ageing and Health). In this interview I present my thoughts and research on informal care for older adults and persons living with dementia. https://vimeo.com/685872934
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Papers by Bodil Hansen Blix
own shortcomings, such as my experiences alongside Risten and Maria, is crucial in my process of being and becoming a narrative inquirer.
Design Observational cross-sectional study.
Setting Norwegian somatic hospitals.
Participants National registry data of older Norwegian patients (≥65 years) with ≥1 unplanned contact with somatic hospitals in 2019 (n=2 11 738).
Primary outcome measure High-cost older patients were defined as those within the 10% of the highest diagnosis-related group weights in 2019 (n=21 179). We compared high-cost to low-cost older patients using bivariate analyses and logistic regression analysis.
Results Men were more likely to be high-cost older patients than women (OR=1.25, 95% CI 1.21 to 1.29) and the oldest (90+ years) compared with the youngest older adults (65–69 years) were less likely to cause high costs (OR=0.47, 95% CI 0.43 to 0.51). Those with the highest level of education were less likely to cause high costs than those with primary school degrees (OR=0.74, 95% CI 0.69 to 0.80). Main diagnosis group (OR=3.50, 95% CI 3.37 to 3.63) and dying (OR=4.13, 95% CI 3.96 to 4.30) were the clinical characteristics most strongly associated with the likelihood of being a high-cost older patient.
Conclusion Several of the observed patient characteristics in this study may warrant further investigation as they might contribute to high healthcare costs. For example, MDGs, reflecting comprehensive healthcare needs and lower education, which is associated with poorer health status, increase the likelihood of being high-cost older patients. Our results indicate that Norwegian hospitals function according to the intentions of those having the highest needs receiving most services.
own shortcomings, such as my experiences alongside Risten and Maria, is crucial in my process of being and becoming a narrative inquirer.
Design Observational cross-sectional study.
Setting Norwegian somatic hospitals.
Participants National registry data of older Norwegian patients (≥65 years) with ≥1 unplanned contact with somatic hospitals in 2019 (n=2 11 738).
Primary outcome measure High-cost older patients were defined as those within the 10% of the highest diagnosis-related group weights in 2019 (n=21 179). We compared high-cost to low-cost older patients using bivariate analyses and logistic regression analysis.
Results Men were more likely to be high-cost older patients than women (OR=1.25, 95% CI 1.21 to 1.29) and the oldest (90+ years) compared with the youngest older adults (65–69 years) were less likely to cause high costs (OR=0.47, 95% CI 0.43 to 0.51). Those with the highest level of education were less likely to cause high costs than those with primary school degrees (OR=0.74, 95% CI 0.69 to 0.80). Main diagnosis group (OR=3.50, 95% CI 3.37 to 3.63) and dying (OR=4.13, 95% CI 3.96 to 4.30) were the clinical characteristics most strongly associated with the likelihood of being a high-cost older patient.
Conclusion Several of the observed patient characteristics in this study may warrant further investigation as they might contribute to high healthcare costs. For example, MDGs, reflecting comprehensive healthcare needs and lower education, which is associated with poorer health status, increase the likelihood of being high-cost older patients. Our results indicate that Norwegian hospitals function according to the intentions of those having the highest needs receiving most services.