Accounts of professional and institutional tension in the context of Swedish elderly care (original) (raw)
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The desire for control: Negotiating the arrangement of help for older people in Sweden
Journal of Aging Studies, 2010
The interface between formal (public) and informal help for older people is unclear and subject to change in many welfare states. Our aim in this study was to contribute to increased understanding of the experiences of older people, their next of kin, and the care managers from the municipalities in the process of negotiating help in the everyday lives of older people who can no longer manage on their own. We took a qualitative approach, using qualitative interviews as the main data collection method. The results revealed that the different actors had contrary interests that made it difficult for all parties to be content with the outcome of the negotiations. The everyday lives of dependent older people and their next of kin are strongly affected by the conditions of formal eldercare.
Choice, needs or equality? Discursive struggles about defining home care for older people in Sweden
Ageing and Society, 2021
Focusing on Swedish home care for older people, this article explores the discursive (re) production of home care as an institution. Equality and universal service provision have been described as defining features of the Nordic care regime. At the same time, Nordic research has highlighted a shift in social care policy, from a focus on universalism and egalitarian ideals towards a focus on freedom of choice, diversity and individualised services. This article takes as a starting point that home care for older people is formed by different and potentially conflicting ideas. We understand home care as a contested formation and define institutional change in terms of ongoing discursive struggles. The analysis draws on qualitative semi-structured interviews with key informants, including politicians, local authority officials and representatives of interest organisations. Informants were engaged in policy making, implementation or advocacy related to care for older people. We examine the meanings attached to home care for older people and the analysis reveals three different discourses-on choice, needs and equality. By comparing and contrasting discourses, we reveal silences, conflicts and tensions, and highlight the politics involved in (re)creating home care as an institution.
Journal of multidisciplinary healthcare, 2022
Knowledge of older person's experiences of important values in home care service can facilitate the development and delivery of high-quality services supporting their well-being, dignity and participation in the care provided. To date, few studies have explored older person's values and experiences of home care services. Purpose: This study aimed to explore values that older person holds regarding home care services and their experiences of how these values manifest in home care service delivery. Participants and Methods: The study has a qualitative exploratory design. Semi-structured interviews were conducted with 16 older persons aged 74-90 who received home care service. Data were analysed using qualitative content analysis. Results: Two themes (each with sub-themes) of values relating to the experience of home care service from the perspective of the 16 older persons were identified: to be supported as an autonomous person and to be supported as a relational being. The participants experience that these two values were only partly manifested in the home care services they received. They also noted that their wellbeing was negatively affected when staff failed to implement these values. The fundamental values identified in study related to the older person feeling safe, being autonomous, maintaining control and independence, and having relationships. The values constitute help to guide practice from the perspective of older persons who receive home care services. Conclusion: The identified values are primarily interpersonal-level values. However, such values are also of importance for home care service organisations when promoting delivery of person-centred care. Taking such a position implies adopting a relation-oriented rather than a task-oriented approach in providing home care services for older persons.
Professional Development in Social Work: Elderly Care in Sweden and Denmark
SOCIAL WELFARE: INTERDISCIPLINARY APPROACH, 2016
The purpose of this article is to highlight and give reflections on elderly care in two welfare states, Sweden and Denmark, on the basis of the question, how can elderly care be understood from a transnational perspective? The empirical data consists of a project, and the analysis is based on ecological model. The main conclusion is that by focusing on societal and professional knowledge sharing from a regional perspective, we can develop our understanding of the driving forces behind access to knowledge, professional identity maintenance and the professional position of the elderly individual.
Eldercare in Sweden: An overview
2017
espanolEste articulo ofrece una vision general de las politicas y practicas relacionadas con la ayuda y el apoyo a las personas mayores dependientes en Suecia. El modelo sueco de cuidado de personas mayores dependientes se situa dentro del regimen Nordico de cuidado universal y se describen las caracteristicas clave de este regimen de Estado de bienestar. El articulo presenta los antecedentes historicos y describe como los servicios de ayuda a domicilio se convirtieron en un servicio universal. Asimismo, describe las politicas actuales y las caracteristicas de la organizacion y la prestacion de servicios de cuidado de personas mayores dependientes. Se identifican tres tendencias, la disminucion de los servicios, la re-familiarizacion y la privatizacion (a traves de la deduccion fiscal para los servicios domesticos), y se analizan en terminos de los retos que plantean para el universalismo. El articulo tambien examina los dilemas y las consecuencias relacionados con la mercantilizaci...
International Journal of Social Welfare, 2011
This article aims to contribute to comparative welfare state research by analysing the everyday work life of long-term care facility workers in Canada and Sweden. The study's empirical base was a survey of fixed and open-ended questions; this article presents results from a subset of respondents (Care Aides and Assistant Nurses) working in facilities in three Canadian provinces (n=557) and across Sweden (n=292). The workers' experiences were linked to the broader economic and organisational contexts of residential care in the two jurisdictions. We found a high degree of country-specific differentiation of work organisation: Canada follows a model of highly differentiated task-oriented work, whereas Sweden represents an integrated relational care work model. Reflecting differences in the vertical division of labour, the Canadian Care Aides had more demanding working conditions than their Swedish colleagues. The consequences of these models for care workers, for elderly people and for their families are discussed.
Journal of Health Social Care in the Community, 1996
The aim of this study was to investigate from the perspective of formal carers the care given to people aged 65 and over, who are cared for in their own homes by informal care. Thirty-three district nurses (DNs) and 20 home service assistants in a municipality with 13500 inhabitants (over 65 years old), were interviewed about the location of care recipients and 398 care recipients were located. Most of them were over 80 years old and had more than one disease (62%), mostly related to the circulatory system (27%). Dependence in three or more of the Katz ADL categories was seen in 30%, reduced mobility in 67%, reduced memory in 34% to a degree that restricted their everyday life and 34% of them could seldom or never be alone. Care had been given for three years or more for 57% of these people. The monitoring of the disabilities and reduced functional health status differed significantly between the diagnostic groups. Home help service was associated with the care recipients' ADL index but not with their need for continuous monitoring. The DNs' care did not relate to any of the variables. In conclusion, diagnoses, the care recipients ability to be alone and functional health status are important variables to include when assessing the demands for home care and when planning supplementary care for home care recipients and their informal caregivers.
Journal of Social Service Research, 2018
In Sweden, a policy shift towards more individualized eldercare, with an emphasis on consumer choice, has taken place. The aim of this study was to analyze the processes and practices of individualized eldercare, focusing on preconditions for older peoples' choice and control. Data consist of qualitative interviews with users of home care services (n-12) and staff (n-12) and participant observations (n-7) of meetings between staff and older people. The choice and control available to older users emerged as decisions about 'what' care and services, 'who' should provide the care and services, and 'how' the care and services should be performed. Three approaches to enable older people choice and control over their home care services were revealed: test and revise, services elaborated in close collaboration between users, care managers and home care staff; choices in the moment, users could choose services at each occasion; and quality improvement through competition, competing providers develop attractive services. The findings could guide policy makers in combining the strengths of these approaches to enable older people in need of support to become co-producers in designing, managing, as well as consuming, care and services. Future quantitative research is needed to achieve generalizable knowledge about the strengths and weaknesses of different ways to organize eldercare services.