Care of the elderly

Health care consumption and care of people with severe health conditions - Research with Ingalill Rahm Hallberg as the principal investigator

The focus of the research with Ingalill Rahm Hallberg as the Principal investigator (PI), is made up of different areas all under the umbrella of Aging, care of the elderly, health care consumption and care of people living with severe health conditions; the one area is on the elderly in particular the oldest old, their health, quality of life, health complaints as well as their health care consumption, informal care and social service and care quality. The focus is also on living with severe diseases, cancer and intensive care. Currently the group consists of one professor and three senior researchers and 6 doctoral students. The PI is concentrating her resources on promoting young researchers in particular the years after finishing the PhD. The research is multi- and interdisciplinary, mainly in collaboration with physicians but also with researchers from social sciences, health economy and human sciences.

Collaboration with other departments and faculties within the university and with research groups at other universities and internationally (UK, Netherlands, Iceland, USA and China) is extensive. The PI is often invited to give lectures at other places, to the public and to contribute to national authorities within their area of competence. The standing of the research group internationally is high and also in a national perspective. The Pi is frequently invited and used for national commissions related to the research areas as well as other commissions and for review purposes in the Nordic countries as well as internationally and she is the president of the "European Academy of Nurse Science" which had hold a Marie Curie grant to carry out a European summer school for doctoral nurse students in Europe. In 2010 a grant from the European Science Foundation was obtained from 2011. The strengths of the research is its international publication record, its recognition nationally, in the Nordic countries as well as internationally. The strengths are also the high number of doctoral students that have already earned their PhD. In the years 2003-2007, it was in total 20 that completed their thesis and from the start of the research group it is 31 of which 26 have been supervised by the Pi as main supervisor or as the co-supervisor. Altogether more than 100 publications in peer reviewed scientific journals (2003-10) have been published involving the PI and some of the researchers or doctoral students in the group. The strength is in the clear focus on clinical issues, their breadth with regard to methods, the move between designs from surveys to experimental designs and the longstanding record of providing research seminars and arranging method courses of relevance for the research program. The international evaluation RQ08 regarded the research of the group as very good/excellent.

The most promising research areas it that of quality of life, health complaints, informal and formal care that was started in 2001 and have attracted large grants (about 2.5 million SEK), and produced 8 theses and doctoral students obtaining their PhD and some 35-40 peer reviewed international publications in scientific journals. Also the research areas focusing health care and social service has been unique with 3 thesis completed and doctoral students obtaining their PhD, several publications has been published or submitted and some more ongoing analysis and PhD studies are going on. The result of these studies are unique in that they are integrating care and social service provided to the elderly by the municipalities as well as by the county councils. Grants for these studies have been obtained from national funding bodies as well by "The Ministry of Health and Welfare" amounting to more than 2 million SEK yearly. This research has lead to a new research area with the purpose to improve the chain of care for the most vulnerable elderly with high health care consumption. This RCT study testing the effects of Case Manager and integrated care has so far obtained 6.4 million SEK for the years 2007 to 2010. The study is ongoing and has start producing publications. One junior researcher (holding a PhD) and three doctoral students has been recruited and are working in the study.

From 2010 an EU funded study started of which the PI is one of WP leaders. The study is about care and service to people with a dementia disease and their informal caregivers and aiming at developing a model of best practice. It includes 8 European countries and consists of 6 WP. The funding is for 3,5 years and amount altogether of 3 miljon Euros.

The broad research program with regard to the elderly and their care and social service, monitoring and controlling health complaints as well as health care consumption including informal caregiving continues. Also the emerging research trend towards health care problems, health care provision and care quality in relation to those with multiple health problems and diseases continues and is important due to the increasing number of older people in such situations These studies continue to move from understanding various phenomena, intervening using RCT design like in the case management studyand developing and using multi-method designs since care of the elderly is one of the biggest challenges to the western world as well as to the eastern countries. The method development, statistics as well as design is an important part of the research due to the lack for knowledge of how to carry out strong intervention studies in natural environment is sparse.