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Seven care managers employed by a large municipality in Sweden were interviewed concerning their reasoning regarding end-of-life care for older people. Data were analyzed using a hermeneutic approach. The results showed that end-of-life care was considered to constitute a small part of the care managers’ work and was something they did not focus on in general when assessing care needs. Two different pathways to death – the natural and the medical – were identified. In the natural pathway, death was invisible and the care was more routine-oriented. In the medical pathway, death was visualised and the care more individualised. Neither of the pathways paid attention to communication or existential needs. Thus, there is a need for a palliative pathway to death based on the philosophy of palliative care, which could provide guidance for care managers and promote opportunities for older people to achieve a dignified dying and death.

The purpose of this study was to illuminate the meaning of elderly persons' moving to a nursng home, and how it can be understood. Older persons recently moved in three different nursing home wards was interviewed. In order to have a deeper understanding of their lived experiences this study used a phenomenological-hermeneutic approach. Moving to nursing home was depending on elder's failing health that leads to an extensive dependence of other persons. The elderly's ways of living changed in many ways and was about transition into a new life situation. Moving into a nursing home was complex and there were many factors that affected the new life situation and it differed from previous home. How life becomes after moving in to nursing home has in the present study to do with the individuals abilities to adjust her self to the new life situation. Caregivers' abilities of empathy, sensitiveness and patience could be crucial for the older people experiences of the new life siruation.