The purpose of this qualitative study was to explore the lived experience of fall risk from a lifeworld perspective in elderly women with previous fragility fractures. Thirteen elderly women with a high risk of fall and fracture, aged 76-86, living in their own homes in rural areas, were recruited from a voluntary fracture prevention programme. All women had a history of fragility fractures and were interviewed in their homes from spring to autumn 2004. A phenomenological reflective lifeworld approach was chosen to analyse in-depth interview data. The study was conducted within an interdisciplinary research group inspired by dialogical research. Elderly women's life space has been narrowed due to advanced age, physical injury or by efforts to prevent new injuries leading to changes in self-perception. However, the women seek strategies to challenge limitations and insecurity, and strive to retain mobility and daily life routines. The four major constituents of the phenomenon 'elderly women's experiences of fall risk' emerged in this study: a changing body, living with precaution, ambiguous dependency and influence and need for understanding. Employing the women's thoughts and resources in trust-based dialogues with caregivers may strengthen their concord and the prospects to continue an active life. Elderly women seek strategies to challenge limitations and feelings of insecurity, and strive to maintain mobility and daily life routines. A trust-based care respecting the preferences of the women seemed to stimulate behavioural change in maintaining an active life.

Background People with intellectual disabilities in staffed group homes often need lifelong support and dependency on others. Thereby, special demands are placed on staff and service managers to ensure opportunities for participation in everyday life. This study aims to explore how service managers promote participation in Swedish group homes for adults with intellectual disabilities. Method A qualitative research design involving individual interviews with 14 service managers was used to gain an understanding of how the participation of adults with intellectual disabilities can be promoted in Swedish group homes. Results The results comprise two main themes; Creating preconditions for participation and Barriers for promotion of participation. Conclusions Service managers experienced that promoting service user participation in group homes was an important part of their responsibility. The findings indicate that structural strategies such as coaching, supervision and reflection are important and should be further developed.

People with intellectual disabilities are dependent in many ways on the support of others if they are to have access to social life, services and support in society. In order to participate in various activities, they need intellectual and social support. This means that participation for them, depends in several ways on other people´s willingness to facilitate and promote participation. This imposes high demands on those professionals providing formal support for them. Hence, the overall aim of this thesis was to explore and describe from four perspectives the experiences of everyday life and participation for people with intellectual disabilities. The thesis contains four qualitatively oriented studies, which have evolved over time. Studies I-II, including participant observations and interviews, and were conducted in group homes with staff and adults with intellectual disabilities. Furthermore, it emerged that adults with intellectual disabilities experienced different limitations in their everyday life, which indicates a lack of opportunity for participation (Study II). From the findings of these two studies, it became clear that participation is a central focus and that leadership is of particular significance for how participation is implemented; therefore, interviews were conducted with service managers (Study III). Lastly, within the framework of this thesis, the aim was directed at focus groups with significant others as the fourth perspective to provide a broad framing of what participation can mean for people with intellectual disabilities. Despite the fact that the disability policy has contributed to improvements for this target group, there are currently extensive shortcomings. This study has revealed deficiencies such as the lack of working methods to help staff facilitate participation (Study I); the lack of care worker´ continuity and the existence of many routines and rules in the group homes (Study II); more overarchingly, the financial situation was not adequate to promote participation (Studies III and IV). Consequently, there were also strengths and opportunities for a good everyday IV. Berlin Hallrup L., Kumlien C., Carlson E. (2019) Participation in Everyday Life for People with Intellectual Disabilities in Sweden. The Experiences of Significant Others'. Manuscript submitted to the Journal of Applied Research in Intellectual Disabilities.

The results of this study contribute to better insight and deeper knowledge of the lived experiences of adults with intellectual disabilities, enabling the staff and management to further enhance the well-being for residents. In addition, the findings provide feedback to staff, managers and researchers working in the intellectual disabilities field.

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