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Samén, A., Lindberg, J. & Andersson, K. (2024). Disembodied care: Articulations of care in municipal policy regarding welfare technologies in eldercare. Nordic Journal of Social Research, 15(1), 1-14
Open this publication in new window or tab >>Disembodied care: Articulations of care in municipal policy regarding welfare technologies in eldercare
2024 (English)In: Nordic Journal of Social Research, E-ISSN 1892-2783, Vol. 15, no 1, p. 1-14Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Universitetsforlaget, 2024
Keywords
eldercare provision, welfare technology, articulations of care, policy analysis, disembodied care
National Category
Social Work
Research subject
Sociology
Identifiers
urn:nbn:se:umu:diva-220799 (URN)10.18261/njsr.15.1.1 (DOI)
Available from: 2024-02-12 Created: 2024-02-12 Last updated: 2024-02-13Bibliographically approved
Lövgren, V., Kalman, H., Andersson, K. & Ahnlund, P. (2023). Care recipients’ management of and approaches to receiving personal and intimate care. Journal of Social Work, 23(6), 1118-1134
Open this publication in new window or tab >>Care recipients’ management of and approaches to receiving personal and intimate care
2023 (English)In: Journal of Social Work, ISSN 1468-0173, E-ISSN 1741-296X, Vol. 23, no 6, p. 1118-1134Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Sage Publications, 2023
Keywords
disability, empowerment, qualitative research, social inclusion, social service, Social work
National Category
Social Work
Identifiers
urn:nbn:se:umu:diva-214546 (URN)10.1177/14680173231197920 (DOI)001060696900001 ()2-s2.0-85170279215 (Scopus ID)
Funder
The Kamprad Family Foundation, 20180140
Available from: 2023-09-25 Created: 2023-09-25 Last updated: 2024-02-02Bibliographically approved
Andersson, K., Lövgren, V., Ahnlund, P. & Kalman, H. (2023). Empathetic attuning: 'How would i feel if i had to expose myself all the time?'—strategies for managing personal and intimate care in swedish formal home care. British Journal of Social Work, 53(2), 921-938
Open this publication in new window or tab >>Empathetic attuning: 'How would i feel if i had to expose myself all the time?'—strategies for managing personal and intimate care in swedish formal home care
2023 (English)In: British Journal of Social Work, ISSN 0045-3102, E-ISSN 1468-263X, Vol. 53, no 2, p. 921-938Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Oxford University Press, 2023
Keywords
care workers and personal assistants, empathetic attuning, formal home care, personal and intimate care, relational and communicative strategies
National Category
Social Work Nursing
Research subject
Sociology
Identifiers
urn:nbn:se:umu:diva-199277 (URN)10.1093/bjsw/bcac164 (DOI)000851543300001 ()2-s2.0-85148574686 (Scopus ID)
Funder
The Kamprad Family Foundation, 20180140
Available from: 2022-09-11 Created: 2022-09-11 Last updated: 2023-09-28Bibliographically approved
Andersson, K. & Sjölund, M. (2023). Nighttime home care in Sweden: "a constant struggle to manage unforeseen events": operations managers’ perceptions of organization and provision of care for older people. Health & Social Care in the Community, 2023, Article ID 4101574.
Open this publication in new window or tab >>Nighttime home care in Sweden: "a constant struggle to manage unforeseen events": operations managers’ perceptions of organization and provision of care for older people
2023 (English)In: Health & Social Care in the Community, ISSN 0966-0410, E-ISSN 1365-2524, Vol. 2023, article id 4101574Article in journal (Refereed) Published
Abstract [en]

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. 

Place, publisher, year, edition, pages
Hindawi Publishing Corporation, 2023
National Category
Social Work
Identifiers
urn:nbn:se:umu:diva-212806 (URN)10.1155/2023/4101574 (DOI)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2015-00820
Available from: 2023-08-11 Created: 2023-08-11 Last updated: 2023-09-04Bibliographically approved
Ahnlund, P., Lövgren, V., Andersson, K. & Kalman, H. (2023). Perceptions of intimacy and integrity in formal home care: [Föreställningar om intimitet och integritet i hemtjänst och personlig assistans]. European Journal of Social Work, 26(5), 828-839
Open this publication in new window or tab >>Perceptions of intimacy and integrity in formal home care: [Föreställningar om intimitet och integritet i hemtjänst och personlig assistans]
2023 (English)In: European Journal of Social Work, ISSN 1369-1457, E-ISSN 1468-2664, Vol. 26, no 5, p. 828-839Article in journal (Refereed) Published
Abstract [en]

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.

Abstract [sv]

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.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2023
Keywords
Intimate and personal care, formal home care, home care services, personal assistance, integrity and dignity, Intim och personlig omsorg, formell hemtjänst, personlig assistans, integritet och värdighet
National Category
Social Work
Identifiers
urn:nbn:se:umu:diva-199052 (URN)10.1080/13691457.2022.2113862 (DOI)000844098800001 ()2-s2.0-85136604104 (Scopus ID)
Funder
The Kamprad Family Foundation
Available from: 2022-09-01 Created: 2022-09-01 Last updated: 2023-09-04Bibliographically approved
Andersson, K. (2023). Riktlinjer för biståndshandläggning: mellan individuella behov och standardiserade insatser (1ed.). In: Magdalena Elmersjö; Sara Hultqvist; Stina Johansson (Ed.), Socialt arbete i äldreomsorg: professionell handläggning i teori och praktik (pp. 37-53). Malmö: Gleerups Utbildning AB
Open this publication in new window or tab >>Riktlinjer för biståndshandläggning: mellan individuella behov och standardiserade insatser
2023 (Swedish)In: Socialt arbete i äldreomsorg: professionell handläggning i teori och praktik / [ed] Magdalena Elmersjö; Sara Hultqvist; Stina Johansson, Malmö: Gleerups Utbildning AB, 2023, 1, p. 37-53Chapter in book (Other academic)
Place, publisher, year, edition, pages
Malmö: Gleerups Utbildning AB, 2023 Edition: 1
National Category
Social Work
Identifiers
urn:nbn:se:umu:diva-208246 (URN)9789151109428 (ISBN)
Available from: 2023-05-12 Created: 2023-05-12 Last updated: 2023-06-16Bibliographically approved
Andersson, K. & Sjölund, M. (2022). Challenges in Swedish elderly home care services at night-time. In: ESA, 6th midterm conference of the research network on ageing in Europe (RN01) of the european sociological association. Ageing in europé: towards more inclusive societies, research and policy. Paper presented at 6th Midterm Conference of the Research Network on Ageing in Europe (RN01) of the European Sociological Association, University of Vienna, Austria, 13-15 July, 2022. (pp. 44-44). Vienna: Universität Wien, European Sociological Association, European centre for social welfare policy and research
Open this publication in new window or tab >>Challenges in Swedish elderly home care services at night-time
2022 (English)In: ESA, 6th midterm conference of the research network on ageing in Europe (RN01) of the european sociological association. Ageing in europé: towards more inclusive societies, research and policy, Vienna: Universität Wien, European Sociological Association, European centre for social welfare policy and research , 2022, p. 44-44Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

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.

Place, publisher, year, edition, pages
Vienna: Universität Wien, European Sociological Association, European centre for social welfare policy and research, 2022
National Category
Social Work
Research subject
Sociology
Identifiers
urn:nbn:se:umu:diva-218162 (URN)
Conference
6th Midterm Conference of the Research Network on Ageing in Europe (RN01) of the European Sociological Association, University of Vienna, Austria, 13-15 July, 2022.
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2015-00820
Available from: 2023-12-17 Created: 2023-12-17 Last updated: 2023-12-18Bibliographically approved
Andersson, K. & Sjölund, M. (2022). Swedish eldercare within home care services at night-time: perceptions and expressions of 'good care' from the perspective of care workers and care unit managers. Nordic Social Work Research, 12(5), 640-653
Open this publication in new window or tab >>Swedish eldercare within home care services at night-time: perceptions and expressions of 'good care' from the perspective of care workers and care unit managers
2022 (English)In: Nordic Social Work Research, ISSN 2156-857X, E-ISSN 2156-8588, Vol. 12, no 5, p. 640-653Article in journal (Refereed) Published
Abstract [en]

This article aims to explore and analyse how good and dignified care is perceived and expressed at night-time within elder home care services, in which night-time care represents a knowledge gap. Dignity has become a legislated value in Swedish eldercare, aiming to increase the quality of care and to clarify the ethical values of everyday care practice. The data presented here come from a qualitative case study with in-depth interviews with six care unit managers and 14 care workers in four municipalities. The analysis of the interviewees’ perceptions and expressions of good care were informed by Nodding’s concepts: responsiveness, receptivity, and relatedness. The results showed that there was a relative unawareness of the new goals of the dignity policy and there was no specific guidance regarding dignity during night-time care. The care unit managers’ perspective was mainly administrative and related to the policy level and the staff’s ability to care. The care workers’ view of good and dignified care included aspects of ideal characteristics and user-centredness with a focus on older people’s individual needs. However, good care was conditioned by time. The dignity policy, as described in national documents, was perceived by the interviewees as vague and with unreachable goals constructed on the structural level. In social care practice, however, expressions of good and dignified care were already found in care ethics, regardless of the dignity policy. By bringing relationality to the dignity discourse on the structural policy level, recognition of care may be emphasized.

Place, publisher, year, edition, pages
Routledge, 2022
Keywords
Night-Time elder home care services, the Swedish dignity policy, good and dignified care, care unit managers, care workers
National Category
Social Work
Research subject
Sociology
Identifiers
urn:nbn:se:umu:diva-177611 (URN)10.1080/2156857X.2020.1858330 (DOI)001026169800004 ()2-s2.0-85145508995 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2015-00820
Available from: 2020-12-15 Created: 2020-12-15 Last updated: 2023-09-04Bibliographically approved
Andersson, K. & Johansson, S. (2021). Assessing individual needs in Swedish elderly home care services: care managers’ argumentation in relation to the needs of migrant customers. Nordic Social Work Research, 11(4), 293-305
Open this publication in new window or tab >>Assessing individual needs in Swedish elderly home care services: care managers’ argumentation in relation to the needs of migrant customers
2021 (English)In: Nordic Social Work Research, ISSN 2156-857X, E-ISSN 2156-8588, Vol. 11, no 4, p. 293-305Article in journal (Refereed) Published
Abstract [en]

The aim of the article is to analyse and problematize care managers’ argumentation of individual needs when assessing migrant customers within Swedish public elderly home care services. According to legislation, need for assistance should always be assessed individually. In recent decades of service decline, standardization of needs has been part of the distribution of elderly care services. Simultaneously, the stratum of older people has become more diverse, which means that a wider spectrum of needs is presented to the care managers. Ten interviews with care managers were analysed with a focus on their arguments regarding the care needs of elderly people with migrant backgrounds seeking assistance. The theoretical conceptions of the two perspectives of care and services were used to analyse the understanding of care managers’ arguments. Our analysis shows that the service perspective with assistance and support that are standardized for Swedes is poorly suited to people born outside Sweden and socialized into other expectations of family and society. The meaning of individual needs was imprecise and contradictory when confronted with diverse cultural codes. When general standards were used in the arguments by referring to regulations and local guidelines, immigrants’ individual needs were not prioritized. Our analysis suggests that the tension between national standards, local guidelines and individual needs has to be discussed further, where theoretical tools related to care and services may be useful in guiding care managers’ professional arguments of individual needs and cultural sensitivity in the needs assessment.

Place, publisher, year, edition, pages
Routledge, 2021
Keywords
Individual needs, care managers, needs assessment, elderly home care services, migrant customers
National Category
Social Work
Research subject
Sociology
Identifiers
urn:nbn:se:umu:diva-165539 (URN)10.1080/2156857X.2019.1694056 (DOI)2-s2.0-85114316814 (Scopus ID)
Funder
Swedish Research Council, 2007-9620-53427-13
Available from: 2019-11-26 Created: 2019-11-26 Last updated: 2023-03-24Bibliographically approved
Holmström, E. & Andersson, K. (2021). Erfarenheter av krishanatering i biståndshandläggningsmöten med äldre personer under covid-19 pandemin: En kvalitativ intervjustudie. Socialvetenskaplig tidskrift, 28(4), 455-475
Open this publication in new window or tab >>Erfarenheter av krishanatering i biståndshandläggningsmöten med äldre personer under covid-19 pandemin: En kvalitativ intervjustudie
2021 (Swedish)In: Socialvetenskaplig tidskrift, ISSN 1104-1420, E-ISSN 2003-5624, Vol. 28, no 4, p. 455-475Article in journal (Refereed) Published
Place, publisher, year, edition, pages
Förbundet för forskning i socialt arbete (FORSA), 2021
National Category
Other Social Sciences Social Work
Identifiers
urn:nbn:se:umu:diva-196169 (URN)10.3384/SVT.2021.28.4.4369 (DOI)
Available from: 2022-06-09 Created: 2022-06-09 Last updated: 2022-06-27Bibliographically approved
Projects
Dignity 24 hours a day in Swedish elderly care? A survey and analysis of work and organisation in home care servises at night-time [2015-00820_Forte]; Umeå University; Publications
Andersson, K. & Sjölund, M. (2022). Challenges in Swedish elderly home care services at night-time. In: ESA, 6th midterm conference of the research network on ageing in Europe (RN01) of the european sociological association. Ageing in europé: towards more inclusive societies, research and policy. Paper presented at 6th Midterm Conference of the Research Network on Ageing in Europe (RN01) of the European Sociological Association, University of Vienna, Austria, 13-15 July, 2022. (pp. 44-44). Vienna: Universität Wien, European Sociological Association, European centre for social welfare policy and researchAndersson, K. & Sjölund, M. (2022). Swedish eldercare within home care services at night-time: perceptions and expressions of 'good care' from the perspective of care workers and care unit managers. Nordic Social Work Research, 12(5), 640-653Andersson, K. & Sjölund, M. (2021). Kartläggning av nattlig omsorg inom hemtjänst: Organisering, arbetssituation och målbeskrivningar. Umeå: Umeå universitetSjölund, M. & Andersson, K. (2018). Conditions for safety visits in nighttime elderly home care services: strategies and differences. In: : . Paper presented at The 24th Nordic Congress of Gerontology; Lessons of a lifetime, Oslo, Norge, May 2-4, 2018. Andersson, K. & Sjölund, M. (2018). Dignity at night in swedish elderly home care services: perspectives and challenges. In: : . Paper presented at The 24th Nordic Congress of Gerontology; Lessons of a lifetime, Oslo, Norway, May 2-4, 2018.
Research communication aimed at nursing and caring staff in the field of elderly and disability care and their managers [KOM18-1359:1_RJ]; Umeå University
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-1456-1207

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