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This study explores policy makers’, health-care professionals’ and senior volunteers’ perceptions of senior volunteers. Two Norwegian government white papers regarding older adult care and welfare services, which were published over a period of 19 years, were selected for close examination. Furthermore, focus group interviews with a purposeful sample of five senior volunteers and 15 health-care professionals were conducted. The study explores the discursive formations of senior volunteers in the government white papers and how they are negotiated in the senior volunteers’ and the health-care professionals’ narratives. Two dominant discourses were presented in the white papers: a prevention discourse (in which volunteering was presented primarily as a means to prevent volunteers’ loneliness and need for care services) and a sustainability discourse (in which the volunteers were presented as instrumental in future sustainable care services). Both discourses echo a common overarching discourse about a capacity crisis due to the ageing population. The senior volunteers were positioned as partners and active agents in both their own narratives and the health-care professionals’ narratives. Their position as independent and as spokespersons for the less empowered were evident only in the senior volunteers’ own narratives. Only the health-care professionals referenced the prevention discourse and capacity issues. The senior volunteers presented themselves as competent, efficient political actors, and they resisted both the prevention and sustainability discourses. In the senior volunteers’ narratives, social and political participation were interrelated. The study demonstrates that new discursive landscapes must be created to capture the diversity among senior volunteers and their efforts. While senior volunteers must be meaningfully involved in decision making, planning and design, their positions as independent and active agents must also be ensured. Authentic partnerships between senior volunteers and public care services involve a balance between involvement and independence. [ABSTRACT FROM AUTHOR]

This article aims to contribute to the understanding of shared decision making as an important aspect of user involvement in mental health care from the perspectives of service users. A thematic analysis of interviews with 25 individual service users in three different community mental health centers in Norway identified different understandings of shared decision making. Shared decision making was identified as essential in four contexts: 1) during admission, 2) in individualized treatment, 3) in different treatment contexts, and 4) in user-professional relationships. We consider shared decision making to be intertwined with treatment from the service user perspective. [ABSTRACT FROM AUTHOR]

Background: Norwegian government white papers have stated that the Sami population is reluctant to seek help from healthcare services and has traditions of self-help and the use of local networks. Objective: In this article we explore healthcare professionals' discursive constructions of Sami persons with dementia and their families' reluctance to seek and accept help from healthcare services. Design: The article is based on an analysis of focus group interviews with healthcare professionals (n = 18) in four municipalities in Northern Norway with multiethnic populations. A narrative context analysis, which involved an examination of sequences of discourse, was employed. Results: Reluctance to seek and accept help among Sami service users and assumptions about self-support were recurring themes in the focus groups. The reluctance was attributed to macro contexts, such as socio-historical processes and cultural norms, and to micro contexts, such as individual and interpersonal factors including the healthcare professionals' cultural backgrounds and language competence. The healthcare professionals' positioning as insiders or outsiders (Sami or non-Sami) affected their attributions. Conclusions: Local healthcare professionals are at the front line for providing and assessing service users' needs for healthcare services. Consequently, their perceptions of service users' needs are pivotal for achieving equity in healthcare. The established opinion that Sami "take care of their own" and are reluctant to seek and accept help may lead to omissions or neglect. Healthcare professionals' awareness about how present encounters in healthcare settings are framed and shaped by the service users' previous and prevailing experiences of marginalisation and subordination is crucial to avoid omissions or neglect resulting from assumptions about cultural preferences. Discursively shaped boundaries and differences between groups may create the impression that the distance between the groups is too wide to traverse, which in turn may lead to further marginalisation of service users in healthcare encounters. [ABSTRACT FROM AUTHOR]

The point of departure for this article is narrative gerontology's conceptualization of life as storied and the assumption that identity development and meaning making do not cease at any age, but rather continue throughout life. We suggest that if identity construction is considered to be a lifelong project, narrative gerontology would benefit from applying analytical perspectives focused on the situated activity of narration. In this article, we apply a three-level positioning analysis to segments of interviews with two elderly Sami women concerning missed opportunities or roads not taken and, more specifically, to narrations about missed opportunities for education. We argue that such narrations should not necessarily be considered expressions of regret or processes of reconciliation but rather as pivotal in here-and-now identity constructions. Narrations about missed opportunities demonstrate that what narrators choose to insert into their life stories is chosen for a purpose and for an audience in a specific interpersonal and discursive context. We suggest that narrative gerontology would benefit from a broader focus on the diversity of sites of engagement in which older adults perform identity constructions. This shift implies moving beyond traditional studies of older adults' life stories and biographical narratives as related in the context of qualitative research interviews (of which the present study of Sami older adults' life stories is indeed an example). [ABSTRACT FROM AUTHOR]

The point of departure for this article is the commitment in Indigenous research to reflect Indigenous contexts and worldviews. Based on an analysis of a story from my research, I argue that Indigenous contexts (rather than being things-unto-themselves that pre-exist description) are complex constructions comprised of social structures, historical events, and cultural meta-narratives that are rendered relevant in local interview contexts by both the interviewees and the interviewers. Such contexts are relevant for the interviewers’ performances as insiders and outsiders in interview situations. I argue that as a consequence of applying a performance perspective to Indigenous research, one must accept that the complex question regarding insiderness and outsiderness cannot be finalized. Rather, the researcher’s identities are performed continuously in every interview situation. [ABSTRACT FROM PUBLISHER]

Abstract: The Sami are an indigenous people living in Norway, Sweden, Finland, and Russia. Historically, national states have made strong efforts to assimilate the Sami people into the majority populations, and the Sami have experienced stigmatization and discrimination. However, after World War II, there has been a revitalization process among the Sami that was pioneered by the Sami Movement and gradually adopted in broader spheres of Norwegian society. The lifespans of the current cohort of elderly Sami unfold throughout a historical period in which contrasting public narratives about the Sami have dominated. The purpose of this study was to explore the relationship between elderly Sami's individual life stories and contrasting public narratives about the Sami. Nineteen elderly Sami individuals in Norway were interviewed. This article is a dialogical narrative analysis of the life stories of four elderly Sami. The article illuminates how individual life stories are framed and shaped by public narratives and how identifying is an ongoing process also in late life. A dialogical relationship between individual life stories and public narratives implies that individual stories have the capacity to shape and revise dominant public narratives. To do so, the number of stories that are allowed to act must be increased. A commitment in dialogic narrative research on minority elderly is to make available individual stories from the margins of the public narratives to reduce narrative silences and to prevent the reproduction of established “truths”. [Copyright &y& Elsevier]

Introduction: The large number of people affected by dementia diseases poses major challenges for public health, healthcare services and healthcare service providers. The Western health policy of ageing in place rests on a triad collaboration among patients, healthcare service providers and family caregivers. Such collaborations presuppose involvement in and influence on a vague juridical landscape. Several researchers have stated the need for knowledge about decision-making processes regarding admission to nursing homes for persons with dementia. The research question of this study is as follows: How do family caregivers experience involvement in and influence on the nursing home decision-making process for persons with dementia? Theory/Methods: The data consist of twelve in-depth interviews with family caregivers to persons with dementia. By the use of positioning theory, we demonstrate how family caregivers strive to balance their assumed duty to take care of the person with their needs to take care of themselves. Results: The family caregivers involvement (or non-involvement) in the complex decision-making process is demonstrated through seven positions: 1) the self-condemning determiner, 2) the dominant, 3) the proponent, 4) the saluting, 5) the pending, 6) the prisoner, and 7) the stooge. Discussions: We discuss why expedient positions are more available for some individuals and the consequences that family caregivers' various positions have on the healthcare policy aim of collaboration, and moreover, of equal healthcare services. Conclusions: Health care policies regarding ageing in place rest on a third party: the family caregivers. This study contributes family caregivers' experiences of involvement in and influence on the nursing home decision-making process for persons with dementia. Knowledge of how family caregivers present themselves and others within positions is useful in understanding how decisions regarding admission to nursing homes are made, and further, in evaluating individuals' access to healthcare. This knowledge is important for Health care providers in order for them to provide tailored support and thus facilitate the involvement of family caregivers in nursing home decisionmaking processes for persons with dementia. Lessons learned: To pinpoint the legislated user involvement for persons with dementia and reduce the family caregivers' decisional burden, politicians and healthcare services must understand, acknowledge and emphasize family caregivers' own needs. If the Health care providers are aware of potential positions in interactions with family caregivers of persons with dementia, they may enable more expedient positions for themselves and family caregivers. More expedient positions may result in fewer conflicts and reduced decisional burden when demanding decisions as admission to nursing homes must be made. Limitations:The study design is an exploratory, qualitative design based on an interactional perspective, where 'reality' is context bound and thus the results reflect one of several possible interpretations. Suggestions for future research: Our model of family caregivers' positions can be useful for further development of decisional aid to reduce conflicts and negative effects of care for family caregivers in home-based care. [ABSTRACT FROM AUTHOR]

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'. • Narratives are openings to older adults' experiences of frailty • Experiences of frailty are framed and shaped by the past, present, and future • Narrative can maintain identity, a sense of belonging, and balance amid adversities • Care professionals can support older adults by engaging with their stories [ABSTRACT FROM AUTHOR]