InCareS Individuality of Care, Services and environment to support self-management and independent living of older people
The aim of this study is to identify and develop individually tailored care and services for older people to enhance their self-management and independent living.

Principal investigator
Professor Riitta Suhonen, PhD, RN, Director of Nursing (part-time)
University of Turku, Department of Nursing Science, +358-50-3042150, +358-2-3338417

This study includes six work packages:

  • Precursors for self-management and independent living
  • Older individuals in acute care
  • Nurse collaboration
  • Individualised care environment supporting self-management and independence
  • International Older People in Institutional Care
  • Implementation of individualised care

This study provides knowledge about the care environment of older people, home, acute and institutional care and individualisation of care and care environment for older people to support their self-management and independence. Expected are a broad view on quality of care and care environment and a realistic view of what is happening currently in the care settings for older people from different perspectives, nationally and internationally.

This information assists in developing tailored, individualised care and services maintaining self-management for older people, preventing “institutionalization”, improving health care and nursing care processes and promoting positive outcomes for both patients and staff harmonizing care pathways nationally and internationally from the older people’s point of view in different care contexts and enhance possibilities for workforce mobility in the Europe. The results can be applied to:

  • give a realistic view to general public about care settings of older people
  • the evaluation of care quality and health care quality improvement
  • the development of clinical nursing care and care environments both nationally and internationally
  • developing and advancing patient outcomes
  • nursing education
  • advancing scientific knowledge base in older people nursing science.

Individual and focus group interviews, questionnaire surveys, register information, photos and observation will be used for data collection. This study includes 11 different sub-data: 1800 older people (service users) and 1500 care providers from different care environments for older people will be recruited nationally and internationally. The international cross-cultural comparative study WP5 includes participants from Finland, Cyprus, Greece, Spain, Sweden and England, both older people (N=900) and their care providers (N=900) and investigates their perceptions of individualization and its outcomes in physical, social and symbolic environment.

Research group

​Principal investigator
Professor Riitta Suhonen, PhD, RN, Director of Nursing (part-time)
University of Turku, Department of Nursing Science, +358-50-3042150, +358-2-3338417

Research team members
Laura Viikari, MD, PhD, docent, Geriatrics, University of Turku and Turku City Hospital
Maija Hupli, PhD, post doc researcher, University of Turku, Department of Nursing Science
Minna Stolt, MNSc, PhD, Researcher, post doc researcher
Sini Eloranta PhD, Post doc researcher, clinical teacher

Pasi Liljeberg, PhD, adjunct professor, Dept of Information Technology (WP4).
Tomi Westerlund PhD, senior research fellow, Dept of Information Technology (WP4).


Doctoral candidates
Terhi Lemetti: Collaboration between hospital and primary health care nurses on older people nursing care – Developing and testing a theoretical model.

Kristiina Toivonen: Supporting spirituality as a part of symbolic environment of older adults with memory disorder in the nursing care

Johanna Ritvanen: person-centered transitional care of older patients with multiple illnesses – Effects to person-centeredness after changing nursing practice.

Kaisu Mäkelä, Teija Leino, Suvi Sundgren, Anniina Kaskinoro

Publications (2019-)

Miikkola M, Lantta T, Suhonen R & Stolt M. 2019. Challenges of foot self-care in older people: a qualitative focus-group study. Journal of Foot and Ankle Research. (accepted)

Lemetti T, Voutilainen P, Stolt M, Eloranta S & Suhonen R. 2019. Older patients’ experiences of nurse-to-nurse collaboration between hospital and primary healthcare in the care chain for older people nursing care. Scandinavian Journal of Caring Sciences 2019 Jan 10. doi: 10.1111/scs.12653

Suhonen R, Karppinen T, Rodrigues-Martin B & Stolt M. 2019. Nurse managers’ perceptions of care environment: supporting older people’s ability to function in nursing homes. Journal of Nursing Management 00, xx-xx. doi: 10.1111/jonm.12695.

Rodriguez-Martín B, Martín-Martín R & Suhonen R. 2019. Individualized Care Scale-patient: A Spanish validation study. Nursing Ethics. doi:10.1177/0969733018769351

Publications (-2018)

Salmi R, Tolvanen M, Suhonen R, Lahti S & Närhi T. 2018. Knowledge, perceived skills and activities of nursing staff to support oral home care among older domiciliary care clients. Scandinavian Journal of Caring Sciences 32(4), 1342-1347.DOI: 10.1111/scs.12579

Vesa NM, Stolt M, Koskenniemi J & Suhonen R. 2018. Läheisen rooli kuntoutumisprosessissa.        Gerontologia 32(3), 163-179.

Zhao FF, Suhonen R, Katajisto J & Leino-Kilpi H. 2018. The association of diabetes-related self-care activities with perceived stress, anxiety and fatigue: a cross-sectional study. Patient Adherence and Preference 2018:12:1677-1686. doi:

Koskenniemi J, Leino-Kilpi H, Puukka P, Stolt M & Suhonen R. 2018. Being respected by nurses: measuring older patients’ perceptions. International Journal of Older People Nursing 2018 Sep;13(3):e12197. doi: 10.1111/opn.12197

Toivonen K, Charalambous A & Suhonen R. 2018. Supporting spirituality in the care of older people living with dementia: a hermeneutic phenomenological inquiry into nurses’ experiences. Scandinavian Journal of Caring Sciences 32(2), 880-888. doi: 10.1111/scs.12519

Suhonen R, Charalambous A, Berg A, Katajisto J, Lemonidou C, Patiraki E, Sjövall K, Stolt M & Radwin L. 2018. Hospitalized cancer patients’ perceptions of individualized nursing care in four European countries. European Journal of Cancer Care 27, e12525. doi: 10.11.1111/ecc.12525

Suhonen R, Stolt M, Berg A, Katajisto J, Lemonidou C, Patiraki E, Sjövall K, Charalambous A. 2018. Cancer patients’ perceptions of quality of care attributes – associations with age, perceived health status, gender and education. Journal of Clinical Nursing 27(1-2), 306-316. doi: 10.1111/jocn.13902.DOI: 10.1111/jocn.13902

Lemetti T, Voutilainen P, Stolt M, Eloranta S, Suhonen R. 2017. An enquiry into nurse-to-nurse collaboration within the older people care chain as part of integrated care: a qualitative study. International Journal of Integrated Care 17(1):5, 1-11.

Ylönen M, Viljamaa J, Isoaho H, Junttila K, Leino-Kilpi H & Suhonen R. 2017. Internet -based learning program to increase nurses’ knowledge level about venous leg ulcer care in home healthcare. Journal of Clinical Nursing 26(21-22), 3646-3657. doi: 10.1111/jocn.13736

Adam C, Patiraki E, Lemonidou C,Radwin L, Charalambous A, Charalambous M, Berg A, Sjövall K, Katajisto J, Stolt M & Suhonen R. 2017. Quality of nursing care as perceived by cancer patients: A cross-sectional survey in four European countries. Journal of B.U.ON: The Official Journal of Balkan Union of Oncology 22(3), 777-782.

Stolt M, Charalambous A, Radwin L, Adam C, Katajisto J, Lemonidou C, Patiraki E, Sjövall K, Suhonen R. 2016. Measuring Trust in Nurses – Psychometric properties of the Trust in Nurses Scale in four countries. European Journal of Oncology Nursing 25(1), 46-54. doi: 10.1016/j.ejon.2016.09.006

Suhonen R, Charalambous A, Berg A, Katajisto J, Lemonidou C, Patiraki E, Sjövall K & Stolt M. 2016. Syöpää sairastavien potilaiden arvioima hoidon laatu – iäkkäiden ja työikäisten potilaiden vertailu kansainvälisessä aineistossa. Hoitotiede 28(4), 335-347.

Charalambous A, Radwin L, Berg A, Sjövall K, Patiraki E, Lemonidou C, Katajisto J, Suhonen R. 2016. An international study of hospitalized cancer patients’ health status, nursing care quality, perceived individuality in care and trust in nurses: A path analysis. International Journal of Nursing Studies 61(1), 176-186.

Giebel C, Sutcliffe C, Verbeek H, Zabalegui A, Soto-Martin M, Hallberg IR, Saks K, Renom-Guiteras A, Suhonen R, & Challis D. 2016. Depressive symptomatology and associated factors in dementia in Europe: home care versus long-term care. International Psychogeriatrics 28(4), 621-630. doi:10.1017/S1041610215002100

Rodriguez-Martín B, Stolt M, Katajisto J & Suhonen R. 2016. Nurses’ characteristics and organizational factors associated with their assessments of individualized care in care institutions for older people. Scandinavian Journal of Caring Sciences 30(2), 250-259. doi: 10.1111/ scs. 12235

Tuominen L, Leino-Kilpi H & Suhonen R. 2016. Older people’s experiences of their own free will in and its actualisation, promoters and barriers in nursing homes. Nursing Ethics 23(1), 22-35. 10.1177/0969733014557119

Ahlqvist A, Nyfors H & Suhonen R. 2016. Factors associated with older people’s independent living from the point of view of health and functional capacity: A register-based study.  Nursing Open 3 (2), 79-89. doi: 10.1002/nop2.39

Lemetti T, Stolt M, Rickard N & Suhonen R. 2015. Collaboration between hospital and primary health care nurses in adult care: a literature review. International Nursing Review 62(2), 248-66.

Toivonen K, Stolt M & Suhonen R. 2015. Nursing support of the spiritual needs of older adults living with Dementia. A narrative literature review. Holistic Nursing Practice 29 (5), 303-312.

Earlier studies (2017-)

Kontulainen-Mäntymäki Merja​Yksilöllinen hoito psykiatrisessa hoitotyössä – Asiakkaan näkökulma.
Individualised care in psychiatric care – Clients’ perspective.
​Sundgren Suvi​Geronteknologian käyttöön liittyvät eettiset kysymykset ikääntyneiden koti-hoidossa.
Ethical issues related to the use of gerontechnology in the care of community-dwelling older people
​Kaskinoro AnniinaKotona asuvien ikääntyneiden kokemuksia hoitotyössä tapahtuvasta kohtaamisesta päivystyksen toimintaympäristössä.
Experiences of nurse-patient encounters in the emergency care by home-dwelling older people
​Antila, Satu​Laitoksissa asuvien iäkkäiden yksilöllinen suun hoito – suuhygienistin näkökulma
​Leino, TeijaSydämen vajaatoiminnan itsehoito ikääntyneillä ja kognitiivisen toimintakyvyn yhteys itsehoitoon
​Mäkelä, Kaisu-LeenaSydämen vajaatoimintaa sairastavien ikääntyneiden terveydenlukutaito ja sen mittaaminen
Assessment and measurement of health literacy among elderly with congestive heart failure (CHF)
​Määttänen, Tiina“Asiakkaan palvelutarpeen arviointi kotihoidossa” – käsiteanalyysi hybridisen mallin mukaan
“Client’s Service Needs Assessment in Home Care” – a concept analysis with the hybrid model
​​Virtanen, Hanna-Kaisa​Kansalaisten näkemykset omaishoidon kehittämisestä sekä ikääntyneiden kotona asumisen tukemiseksi tehtävistä toimista
The views of citizens about how to develop informal care and how to support elderly people living at home

Earlier studies (2014-2016)

​Grönvall, AnuTerveysneuvontaan osallistuneiden 70-vuotiaiden elämänlaadun muutos vuoden seuranta-aikana
Changes in quality of life among 70-year-olds participating in health care guidance over a one-year follow-up period​
​Hanhilampi, NinaMuistipotilaan tarkoituksenmukaisen hoitopaikan määrittäminen Balance of Care -menetelmällä
Determining the appropriate place of care with Balance of Care approach for people with dementia
​Henriksson, RiittaKotona asuvien 70-vuotiaiden terveyden ja toimintakyvyn kehityssuunnat
Trends in Health and Functioning in 70-Year-Olds
​Kostamo, SannaPsykososiaalisten haittojen ja mielialan yhteys ikäkuuloon – potilaan näkökulma
Connection between age-related hearing loss, psychosocial problems and mood – Patient’s perspective
​Tattari, MerviKotona asuvien ikääntyvien kokemukset fyysisen toimintakykynsä säilyttämisestä
How older people living at home experience maintaining their physical functioning
​Vesa, Niina-MarikaLäheisen rooli ja tuen tarve iäkkään kotiutuessa arviointi- ja kuntoutusosastolta
The role of next of kin and the need for support when the elderly is discharged from rehabilitation department to home​



​Karppinen, TiinaIkääntyneen toimintakykyä tukeva hoitoympäristö osastonhoitajien näkökulmasta
Care environment supporting older residents’ ability to function from nurse managers’ perspective
​Lepistö, MinnaKotona asuvan muistipotilaan läheisen sosiaali- ja terveyspalvelujen käyttö
The use of social and healthcare services by informal caregiver of people with memory disorder living at home
​Lintula, Anni​Kotihoidossa olevien muistipotilaiden sosiaali- ja terveyspalveluiden käyttö
The social and health services used by people with memory disorders in home care
​Salminen, MarjoKotona toteutettu sijaishoito aikuisen omaishoitajan ja aikuisen omaishoidettavan kokemana
Experiences of respite care at home by an adult caregiver and an adult care recipient
Toivonen, Kristiina​Potilaana ihminen – hermeneuttis-fenomenologinen tutkimus hengellisyydestä ikääntyneiden muistisairaiden hoitotyössä
Human as a patient – A hermeneutic phenomenological inquiry into the spirituality in the nursing care of older adults with dementia

Earlier studies (-2014)

– 2014

​Astola-Pöllanen, RiiaToimintakyky ja yksilöllinen hoito – ympärivuorokautisessa hoidossa olevan iäkkään näkökulma
Function ability and individualized care – the older peoples’ point of views in long-term care
​Kenttälä, Sanna​Kokemuksia muistipoliklinikan toiminnasta – Alzheimerin tautia sairastavan potilaan omaisen näkökulma
Experiences of the Work of a Memory Polyclinic – A Point of View of a Relative of a Patient with Alzheimer’s
​Lemetti, Terhi​Sairaanhoitajien välinen yhteistyö ikääntyvän potilaan hoidossa – Erikoissairaanhoidon ja perusterveydenhuollon sairaanhoitajien näkökulma
Collaboration between nurses on older people nursing care – Hospital and primary health care nurses’ point of views
​Miikkola, Maija​Jalkojen omahoito ja sen toteuttamiseen liittyvät tekijät – Ikääntyneiden näkökulma
Foot Self-care and Factors Associating It – The View of Older People
​Paimensalo-Karell, Irmeli​Hiljainen tieto pääomaksi ikääntyneiden hoitotyössä – hoitohenkilöstön kokemuksia
Tacit knowledge for capital equity in the elderly care described by Nursing Staff
​Pihlaja, Sari​Iäkkään kokemus kuntouttavasta lyhytaikaishoidosta ja sen merkityksestä toimintakykyyn ja elämänlaatuun
Older people’s experiences of rehabilitative short-term care and its meaning to functional ability and quality of life
​Ahlqvist, Anette​Kotona asuvien ikääntyneiden itsenäinen selviytyminen mitä 75-vuotiaiden ennaltaehkäisevät terveystarkastukset paljastavat
Independently living elderly’s coping in everyday life what do preventive health care examinations reveal

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