Tid, rum och självbestämmande : Möjligheter och hinder i vardagen för äldre personer med intellektuell funktionsnedsättning på gruppboende

People with intellectual disability are living longer, which creates new demands for the support and care of this target group. Participation and autonomy at all ages, regardless of functional capacity, are cited in legislation and among the key objectives of disability policy. As a group, older people with intellectual disability have previously been almost invisible in both policy documents and research. Information regarding this group is thus limited, and more systematic knowledge is needed about older people with intellectual disability, their daily lives, and especially their opportunities for autonomy. The purpose of this thesis is to learn more about the role of influence and autonomy in everyday life from the perspective of older people with intellectual disability living in group homes. This will be achieved by studying situations in which opportunities and obstacles arise for these residents to exercise their autonomy in daily life, and identifying and analysing how autonomy is expressed in the meeting between residents and staff. The study applies an ethnographic approach, using methods including field studies with observations and videotaped meetings between residents and staff. The sample consists of residents aged 65 and over and staff at three group homes for people with intellectual disability. One resident at each group home is followed in greater depth. The analysis uses the time-geographic concepts of project, activity and restrictions in order to clarify where and when different projects are carried out, as well as who has the power to determine what is to be carried out. Interaction analysis is used to analyse the videotaped meetings between residents and staff. The analysis is based on Goffman’s interaction order and interaction rituals, theories about turntaking, both verbal and non-verbal, and theories about power and counter-power. In accordance with Goffman’s framework concept, the starting point is the concrete framework that reflects spatiality, which in turn becomes a way to place the more abstract framework of the situation into a specific context. Two major projects were identified: Sleep and Rest and Meals. The analysis reveals projects that are governed by the resident’s own preferences (individual projects) and projects that are governed to a greater degree by the staff’s objectives and opportunities (institutional projects). Some guidance also derives from municipal decisions and guidelines (organizational projects). Many projects were carried out based on staff decisions and objectives, but in actual practice many projects failed to get off the ground. Some projects were at risk of failure until something happened or someone intervened and thereby rescued the project so that it could be implemented. The interactional analysis perspective shows how autonomy is constructed in the meeting. Autonomy is situation-bound, and shifts more on the basis of context than in relation to specific individuals. The study includes decision situations mainly between autonomy and its opposite, paternalism, which are viewed as extremes on a continuum. However, certain factors lead to stronger autonomy in certain situations. When a resident can define the situation, they also have greater power to determine the outcome. In situations characterized by paternalism, the staff have a preferential right of interpretation and the power to decide, both on the basis of their knowledge and because of the asymmetrical interdependence that characterizes the resident-professional relationship. Such situations are also governed by the rules and procedures of the group home to a greater degree than those situations in which the resident exercises autonomy. The thesis discusses strategies that could increase the residents’ opportunities for autonomy. Greater communication skills among staff can be viewed as a step on the path toward greater autonomy for the residents. Staff have the potential to eliminate obstacles, to strengthen inadequate skills or create new ones by providing choices and assistive devices, and to exercise an affirmative approach.

Förbättring av tillgänglighet i tillgänglighetsanpassade naturreservat

More than half a million people in Sweden are affected by some sort of disability. During recreational activities in nature areas, these people might encounter difficulties such as inadequate accessibility. The Swedish society requires that all citizens should have the same possibilities. The purpose of this thesis is to improve the accessibility for people with disabilities. The aim is to examine occurring flaws in accessible nature reserves and suggest possible improvements.The questions that will be answered are as follows:• What flaws do accessible nature reserves have, and how do they affect the visitors?• What improvements can be made in nature reserves to increase accessibility?To answer the questions, a case study was done, where five different nature areas were visited. During the case study, various flaws in the accessibility were observed and analysed. Prior to the case study, requirements and scientific research regarding accessibility was studied. Using this, suggestions for improving the accessibility were made. . Most of the improvements that could be made in the studied nature reserves were presumed to be applicable in other nature reserves in Sweden.With the case study in mind, the accessibility was considered in need of various improvements. The accessibility was studied from three out of four of the Swedish disability association’s categories; physical, communicative, and informative accessibility. The flaws that were encountered in the studied areas were due to incorrect design, or insufficient maintenance. Most of the flaws could be corrected in simple ways, but the flaws that were due to incorrect design or planning would require more work. After the case study it was discovered that supposedly “accessible” trails, according to different websites, had varying levels of accessibility. An accessible recreational area will benefit all types of visitors, not only people with disabilities. It will be more convenient and enables visits with strollers. An area cannot be made accessible for all types of visitors, but can be made accessible for as many visitors as possible.