title: Top-level managers' and politicians' worries about future care for older people with complex and acute illnesses: a Nordic study.
abstract: BACKGROUND
  The growing aging population, with its associated complex needs and illnesses, will in the future become an even more important challenge for the Nordic countries.
  
  
  OBJECTIVE
  The aim of the study was to describe and explore the perceptions and views of top-level managers and politicians in regard to an optimal future care for older people during the next decade.
  
  
  METHODS
  The study has a qualitative, descriptive design.
  
  
  METHODS
  Top-level managers (n = 11) and politicians (n = 8) were interviewed in Sweden, Finland, Denmark and Norway in 2009. The data material was analysed through manifest and latent content analyses.
  
  
  RESULTS
  Future care should substantially focus on the individual needs and dignity of older people. The respondents also recommended a preventive perspective on future care. They anticipate that older people's needs will be complex, requiring nursing competence on an advanced level within home care and nursing homes, and point to the importance of leadership abilities and workplace image. Limited resources and the use of health technology will be dominant issues, entailing the need for open-mindedness to reorganise future care. The latent theme expressed was 'A creative willingness to act - but with an underlying worry about the future'.
  
  
  CONCLUSIONS
  The findings reveal a multifaceted scenario of optimal future care; older people will have significant, acute and complex needs but resources will be limited. In the near future, medical treatment and nursing care for older people at advanced and specialised levels within primary health care will be needed.
  
  
  CONCLUSIONS
  To meet demands, a clear need exists for the advanced clinical competence of nurses. There is also a clear need to reorganise health care services for older people, develop the leadership abilities of nurse managers and make workplaces more attractive.
authors.affiliation: School of Health and Medical Sciences, Örebro University, Örebro, Sweden. elisabeth.finnbakk@ldh.no
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Finnbakk
authors.forename: Kirsti
authors.initials: K
authors.lastname: Skovdahl
authors.forename: Ellen Störe
authors.initials: ES
authors.lastname: Blix
authors.forename: Lisbeth
authors.initials: L
authors.lastname: Fagerström
mesh_terms: D000208:Acute Disease / Q000628:therapy; D000288:Administrative Personnel / Q000523:psychology*; D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000628:therapy; D003159:Community-Institutional Relations; D003718:Denmark; D005260:Female; D005387:Finland; D006295:Health Resources; D006301:Health Services Needs and Demand; D006299:Health Services for the Aged / Q000592:standards* / Q000639:trends; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009664:Norway; D009732:Nursing Care; D010348:Patient Care Team; D011057:Politics; D011157:Population Dynamics; D011785:Quality Assurance, Health Care / Q000592:standards*; D013548:Sweden