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The Swedish Social Services Act (SFS 2001:453) stipulates since 1982 that the municipal Social Committee should become well acquainted with the living conditions in the municipality. They should also participate in urban planning, and in cooperation with other public bodies, organizations, associations and individuals promote good living environments in the municipality. The development, planning and design of good living environments for older people is an endeavour of great complexity that demands collaboration between many actors. Housing and care for older people is an important area in which social servicesand urban planning could benefit from collaboration. Planning for older people has recently been indicated as urgent and necessary, especially in the light of changed demography in which the proportion of older people is increasing. A built environment that accommodates older people’s everyday needs embraces issues such as age-friendliness, care, socio-spatial inequality, inclusion, and innovation. This research program, CollAge, investigates cross-sectoral collaboration in Swedish municipalities between social eldercare, urban planning and Senior Citizens’ Councils as regards housing and care. With diverse qualitative methodologies the multidisciplinary team of scholars in social work, architecture and urban planning  explore how eldercare interventions and services are managed and understood in municipal urban planning and development, and how older people’s preferences can contribute to improved quality of care in social services and housing provision.  The ultimate aim of the programme is to develop a methodological tool – CollAge – to support, facilitate and structure collaboration between the three actors.

Samhället sätter stora förhoppningar till att digitaliseringen ska utveckla hemtjänsten, men kunskap saknas om konsekvenserna för brukare, omsorgspersonal och chefer. Det finns många frågor att besvara. 

The increasing size of the elderly population has been described as a major challenge for Western eldercare. In light of such demographic changes, welfare technology has been presented as a solution. It has been claimed, in both international and Swedish government policy, that digital technologies can improve how care is given and received. However, there is limited knowledge about what happens to articulations of care when national goals filter down to municipal local level where the actual care is practised. The aim of this article is to analyse how care and welfare technology are described in municipal strategy documents, and to discuss potential consequences of such articulations for everyday eldercare. A critical policy analysis, building on theories about articulation, was conducted on a selection of 19 policy documents (N = 19) from 18 municipalities. The key analytical results show that care tends to be articulated as an organizational matter and that care is transferred into the future of older people’s lives, through self-care and prevention. Interdependence, frailty and alternatives when welfare technology fails to create independence, are not brought up in the documents. Overall, such rearticulations of care indicate a more disembodied eldercare in the future.

Welfare technology (WT) has been identified as a potential solution for challenges within eldercare, with policymakers emphasising its capacity to reduce reliance on care staff. Policy discussions surrounding WT also highlight other anticipated benefits, such as mitigating loneliness, facilitating increased social interaction between caregivers and care recipients, and promoting greater independence for the latter. These expectations are permeated by a techno-optimism. Needing care means being vulnerable, and care builds on relationship and interdependence. How older adults think about WT and its consequences for social aspects of care is important for a successful implementation. The individual perspective is relatively unknown. This study aims to investigate how potential users perceive WT and its consequences for feelings of loneliness, opportunities for social interaction in care settings, and levels of independence. To accomplish this, a questionnaire was administered to approximately 5000 individuals between the ages of 65 and 90 residing in Västerbotten. The findings suggest that the techno-optimism visible at the national level is not widely shared by older adults. A majority expressed skepticism regarding the potential of WT to positively influence social aspects of care, and most of the respondents believe that WT will contribute to increased feelings of loneliness. Furthermore, a majority did not perceive a need for various technologies in eldercare and expressed a preference for care provided by human caregivers rather than technology-based alternatives. These attitudes where not effected by age. The group of 65-year-olds that have grown up with technology and are more digital were as skeptical towards WT as the older age groups. We interpret these results to indicate that the inherent relational nature of care can make it unsuitable for direct replacement with technology. An increased expected frailty and vulnerability that follows from needing to receive care may mean that technology is an inappropriate solution.

Summary: An interview study was conducted with persons receiving home care services and personal assistance in Sweden (13 individuals, 25 interviews) with the aim to analyze their experiences of managing personal and intimate care. The analytical approach was guided by phenomenologically informed research and Erving Goffman's theoretical work on self-presentation and social life as it differs in frontstage and backstage settings.

Findings: A reflected approach to the complex challenges associated with becoming and being a person in need of personal and intimate care was revealed. This involved continuous adaptations and attuning to organizational and relational conditions of formal home care. Being a recipient of personal and intimate care does not mean being passive. It entails relating to and sustaining the care relation, where even choosing to accept suboptimal conditions is an act of agency. The recipients’ private homes were hybridized, transformed both into a waiting room, with the recipient on standby and into a workplace. The homes thus partly lost their character as a backstage realm where one could avoid the gaze of others. This also led to a hybridization of the personal sphere, in the form of marginal scope for true privacy, necessitating strategies for protecting one's own space.

Applications: It is important both to acknowledge the intrusive nature of personal and intimate care, which results in extensive hybridization of the home and personal sphere and to recognize care recipients’ agency in the relationship that care establishes.

Sweden, as a welfare state, has a long tradition of providing formal home care and support to their citizens in their own homes, either through home care services or personal assistance. A large percentage of frail elderly and persons with disability who receive formal home care require personal and intimate care, such as help with eating, showering, getting dressed and personal hygiene. Managing intimacy and safeguarding the care recipient’s integrity pose particular challenges for staff. The aim of this qualitative interview study is to describe and analyse care workers’ (CWs) and personal assistants’ (PAs) strategies for managing situations and challenges related to provision of personal and intimate care in the context of formal home care. Semi-structured interviews with eleven CWs and nine PAs were conducted. Our analysis reveals a complex repertoire of relational and communicative strategies, within an overall approach - which we labelled 'empathetic attuning'—of relating to the current situation and task at hand whilst safeguarding integrity. These strategies were intertwined with dimensions of time. The possibility to accomplish satisfactory personal and intimate care rests on structural and organisational conditions that promote sustainable working conditions, where relations characterised by continuity, integrity and respect can be realised.

This article aims to explore how community home care of older people is provided and organized at night. In times of welfare decline, organizational changes, and an increasing aged population, questions arise about home care and support for older people. In Sweden as in many other western countries 'ageing in place' is a guiding principle in care provision for older people, which put increasing pressure on home care services. Still, night-time care represents a research gap within health and social care research, nationally and internationally. This telephone interview survey examines 41 operations managers' perceptions of organization and care provision and how they account for the goals and work of home care at night-time in a selection of 37 Swedish municipalities. The analysis was inspired by thematic content analysis where three central themes were categorized: organizational context of night-time care, working conditions, and challenges of night-time care. Our results reveal that organizational context varied depending on the demography and size of the municipality. The work situation was characterizeded by constantly unforeseen events to manage. Multiple challenges were identified on societal and political levels, as were limited resources and recruitment problems. In conclusion, our analysis has identified unpredictability as a core feature of night-time care work. The complexity of the provision of night-time care was not recognized as important for the municipal organization. To provide high quality care at night in ordinary housing, there is a need to both focus on organizational aspects and to have sufficient resources and time. 

Sweden has a long tradition of providing social care and support to its citizens in their own homes through formal home care, delivered either by home care services or personal assistance. A majority of people given support by formal home care need assistance with personal and intimate care. The focus of this interview study was on exploring care recipients’, care workers’, personal assistants’ and care unit managers’ perceptions and experiences of intimate and personal care in the context of formal home care in Sweden. In total, 57 interviews were conducted with 42 persons. Three themes emerged in the analysis: Personal Hygiene, Personal Sphere, and The Contextual Variability of Intimacy. Interviewees described intimate care as being inseparable from a person’s service needs as a whole. Highlighted was how caring for and washing intimate body parts, intrusion into recipients’ personal spheres, and the need to preserve integrity vary depending on situational, temporal and relational aspects. To safeguard the care recipient’s influence, integrity and dignity in the reception/provision of care work, home care services and personal assistance, it is important to raise awareness of the variation in perceptions of intimate and personal care in education and inhouse training.

I Sverige får ett stort antal sköra äldre och personer med funktionsnedsättning omsorg i hemmet, i form av hemtjänst och/eller personlig assistans. För majoriteten av omsorgsmottagare utgör personlig och intim omsorg både ett centralt och vardagligt inslag i verksamheterna. Fokus för denna intervjustudie var att undersöka omsorgsmottagares, omsorgspersonals och enhetschefers uppfattning om och erfarenheter av personlig och intim omsorg i hemtjänst och personlig assistans. Totalt genomfördes 57 intervjuer med 42 personer. Tre övergripande teman framkom i analysen; personlig hygien, personlig sfär och kontextuell variation av intimitet. Intervjupersonerna beskriver personlig och intim omsorg som något som inte går att separera från behovet av omsorg som helhet. Analysen visar hur intim omsorg och överträdelser av omsorgsmottagarens personliga sfär, samt behovet av att trygga omsorgsmottagarens integritet, varierar beroende på situationella, temporala och relationella aspekter. För att säkra omsorgstagares inflytande, integritet och värdighet i samband med omsorgsarbete, är det viktigt att i utbildning och inskolning skapa en ökad medvetenhet om olikheter och variationer i uppfattningar av vad som räknas som personligt och intimt i hemtjänst och personlig assistans.

Up to date, we know little about how home care services is organized and performed at nighttime. There are no official statistics of night time care or the number of older people havingassistance at night. This paper aims to report from a survey with operation managers and theiraccounts of organization and provision of care at night.The material consisted of a sample of 37 of Sweden’s 290 municipalities, covering for urbanas well as rural areas, smaller and larger municipalities as well as bigger cities. Individualtelephone interviews were conducted with 41 operation managers responsible for night timecare. Standardised and open ended questions were raised to capture strategies of night timehome care organization and provision. The material was analysed quantitatively andqualitatively.The results revealed similarities as well as differences in organization where smallermunicipalities often had to find special solutions. The care workers had to manage emergencyalarm from the older persons as well as scheduled care work at night. The care work includeda lot of car driving and insecurity at night, such as bad weather and violence in the streets.Safety and dignity were raised by the managers as important values in provision of care, bothfor the elderly and staff.There were several challenges in demographic development and local politics, but also inrecruitment problems and staff’s working conditions. To organize for ageing in place, homecare needs to be user friendly for vulnerable persons, also at night time.