Open dialogues at wards are encouraged regarding what practices contribute to a positive ethical climate.

The aim of this qualitative interview study was to delineate the meaning of preparing, cooking, and serving meals among retired single living and cohabiting women. Sixty-three women living in two Swedish cities and their rural surroundings participated. The findings showed that the profound meaning was to do something for others. The whole procedure of preparing a meal could be seen as preparing a gift. Four phases were identified: finding out what to serve, cooking with fresh ingredients, presenting the gift in a beautiful manner, and enjoying the gift in commensality. Cohabiting women went on cooking with duty and joy as they had done before retirement as long as their power was maintained. For widows, especially those who had recently lost their spouse, the whole meaning of cooking and eating was lost, and among these women there is a risk of poor nutritional intake. Traditionally, women have been responsible for preparing, cooking, and serving food in private homes (Fieldhouse, 1995; Warde, 1997). Especially among the older generation, women have had this duty (Fjellström, 1990). Among those working in private homes this is obvious, but even among those with paid employment in the public sphere the labor at home involves providing food for the rest of the family (Ekström, 1990; Menell, Murcott, & van Otterloo, 1992). One reason may be that cooking is closely connected to the feminine identity and rationality and carries positive potentials. This prospect may be related to the meaning of the food and its character of being both substance and symbol (Fürst, 1997; Lupton, 1996).

The aim of the research reported in this paper was to study older Swedish women's experiences of managing food shopping and cooking as part of an independent life in different family situations. The research approach was qualitative, using informal ethnographic interviews and thematic analysis. Twenty-three single-living and 18 cohabiting Swedish women, aged 64–67, 74–77 and 84–87, participated. They valued being active through continuing with familiar routines whereby they could live independently. They gained physical exercise and social contacts when they went shopping. Well-known foods and traditional dishes were preferred as they enabled them to proceed from familiar routines. Economical thinking related to money and their own work guided their choice of food. Lack of strength made some, particularly the older informants and those living alone, dependent on local shops, and they simplified their cooking, while others had more freedom of choice when they shopped together with their husbands. The implications of the research for services which help older women, particularly those who live alone or who have been recently bereaved, are discussed.

Meals in geriatric institutions are often served in a dining room. The elderly patients--endowed with their socialized table manners and diet habits--who enter this milieu are affected by diseases and handicaps, reducing their ability to eat. In the present study individual patients' meals in geriatric care institutions were studied with respect both to nursing staffs' intentions and assessments of patients, as well as to those patients' experiences and the amount of influence they expected to have. The research approach was ethnographic. Eighteen newly admitted, mentally orientated patients and their primary enrolled nurses were allocated. The results indicated that the idea of both the nurses and the elderly patients was to reach a meal situation that was as natural and independent as possible. Compared with the elderly patients, the nursing staff had broader standards for acceptable table manners, and carried out collective dining of all 18. The elderly patients strove to behave in accordance with their standards and suffered because of their own limited eating competence and the experience of other patients' problems. The elderly patients avoided expressing their needs, and some enrolled nurses thought they were prying if they asked questions about such issues. These different, culturally dependent, perceptions resulted in care that was not congruent with the needs of the elderly patients.

Staff members must pay attention to residents' need to talk with people. For many older people, talking is perhaps the most important 'activity' at care homes. Nurses must safeguard residents' self-determination. When residents are in control of their lives, they may become satisfied with time.

Food-related health promotion must pay more attention to women living alone. Women who have lost their partners, may be at risk for poor nutritional intake as they often simplified the entire meal situation, while cohabiting women perceived food and cooking as a central task in their lives. One responsibility for nurses working in the community is to recognize and assess older women's deficient eating habits, assess them and plan eating together with the woman to prevent poor nutritional intake. Relatives and community staff could also be involved in this work.

The purpose was to improve the understanding of factors are perceived by elderly people as important for their life satisfaction, during and after rehabilitation. Fifteen persons aged 80-94 years were interviewed while in hospital and on two follow-up occasions after discharge. Assessment of motor function using the General Motor Function assessment scale was used for descriptive purposes. Three themes emerged as important for life satisfaction: activity, independence and adaptation. Activity and independence were considered significant for life satisfaction. Basic activity preferences were related to care of one's own body and to social contacts. Control and influence over help and services were regarded as important. Different strategies for adaptation to the consequences of disease were used: reorganisation, interaction with caregivers, mental adaptation and mental activities (used as pastime and escape). Those with declined motor functions limited their activity preferences. A key finding was that pleasant past memories were actively recalled in an effort to achieve current life satisfaction. This adaptation strategy created a sense of life satisfaction, however with a potential risk for concealing dissatisfaction with conditions that might otherwise be correctable. Strategies for improving life satisfaction among old people in rehabilitation are suggested.

This qualitative study aims to explore the cultural meaning of accomplishing food-related work by older women, when disease has diminished their abilities and threatens to make them dependent. Seventy-two women with stroke, rheumatoid arthritis, and Parkinson's disease, as well as women without those diseases, were interviewed. All were living at home. Results showed that older women valued independence and feared dependence when declining ability threatened performance of food-related work. They also had strong beliefs about living a "normal life," managing by oneself as long as possible, and becoming their own masters again. To remain independent, participants used three kinds of strategies: Public Health Service Support, self-managing, and adaptation. Their beliefs about dependence included not becoming a burden, retaining self-determination, and maintaining order in life. Implications for nursing include supporting independent cooking, developing care plans with the care recipient, and demonstrating respect for the women's self-determination.