Personalbrist har lett till att utrikesfödda kvinnor och män framhålls som en viktig rekryteringsbas inom äldreomsorgen. Därmed har frågor om språkkunskaper blivit alltmer uppmärksammade.

Syftet med denna studie var att fokusera på hur hemtjänstchefer resonerar kring utmaningar när personal som redan arbetar i hemtjänsten, eller vid rekrytering, har brister i det svenska språket. Studien är baserad på semistrukturerade intervjuer med 15 hemtjänstchefer verksamma i både offentliga och privata verksamheter i Stockholmsområdet.

Resultaten visar att cheferna hade ansvar att själva ­hantera ett spektrum av dilemman rörande språkbrister. De utvecklade strategier för att säkra kvaliteten på omsorgen. Det var vanligt att ge en person i uppdrag att kon­trollera och justera dokumentation. Cheferna konstruerade även språktester och fokuserade på informella ­värden, och därmed mindre på formella språkkunskaper. Genom handlingsutrymmet har cheferna förhandlat fram minimi­krav för språkkunskaper, för att kunna anställa och behålla personal, samtidigt som de riskerar en försämrad verksamhe

Although international research has shown an increase in precarious work in recent decades, few of these studies have been devoted to paid care work. This article joins feminist research on care work with work–life balance-oriented research on precarious work to study the work situation of Swedish homecare workers. The results show a high prevalence of multidimensional precariousness among the care workers and reveal how several indicators of job precariousness are associated with physical and mental strain, poor work–life balance, and intentions to quit the job, including time pressure, lack of job control and limited possibilities to develop and use skills, as well as to create and keep relations with users.

Nordic countries are known for their service-based welfare states, which include basic health and social care for all older adults who have been formally assessed and found to need additional services. Facing fiscal constraints in the mid-1990s, these countries endeavoured to create more cost-effective care services that incorporated the doctrines of new public management (NPM). Overlapping NPM, steps have been taken to better integrate services and utilise the care capacity of a broader institutional and environmental set of actors. In this study, we draw attention to this call for collaborative and participatory modes of governance beyond NPM. We explore whether and how Nordic eldercare policies fit in to the framework and logic of new public governance (NPG). The data consist of 62 key government documents from five Nordic countries, representing the central features of eldercare policies over the past 10 years. Our content analysis is based on three conceptual lenses associated with NPG: service integration, service co-production and cross-sectoral co-creation. The analysis shows that several policy issues are framed by the logic of NPG in all countries. Further research is needed to assess how these NPG measures are implemented and interacting with institutional arrangements of other public governance paradigms. 

Background/objectives: Call-bells are often taken-for-granted systems to heighten safety. In joint discussions among residential care home (RCH) residents, their family members, and staff, issues related to call-bell use in everyday life and work were repeatedly raised. In this article, we explore these experience-based perspectives, addressing several key questions important for call-bell use and communication.

Research design/methods: We inductively analyzed a series of individual interviews and group discussions with 44 individuals at two units of the same Swedish RCH, conducted as part of a participatory action research project to strengthen supportive end-of-life environments.

Results: While the call-bell was a central part of RCH communication, we found: fragmented understanding about how the call bell functioned among all participants; many residents lacked the physical and cognitive competencies demanded for call-bell use; tensions between use of the call-bell for social/existential communication versus purely discrete tasks; and that a call-bell system assuming room-bound residents exacerbated issues related to varied response times, lack of feedback mechanisms, and pressured work situations.

Discussion and implications: Investigation of the call-bell system provides an empirical example of how complex relationships among stakeholders are played out in concrete situations. Tensions between different logics of care, and between clock and embodied time become evident.

Care workers have valuable knowledge to contribute to the improvement of their work environments. Yet incorporating their perspectives into organizational decision-making within long-term care facilities (LTCFs) has been an ongoing challenge. In this article we investigate a promising practice that brought workers and management together in weekly and bimonthly facilitated reflection meetings to identify and resolve problems. Drawing on observations as well as individual and group interviews, we sought to understand whether and how this intervention worked from the perspective of participants. Our study found that one of the main achievements was creating a safe space for workers to speak honestly. They felt heard and treated with respect. In this context, they were willing to surface concerns, failures, and problems for collective deliberation and action. The inclusion of a range of occupational groups ensured that the solutions developed were sensitive to context, including organizational and occupational realities. While the outcomes of the process were impressive, this paper highlights the relational work that created trust, respect, and a spirit of collaboration. We suggest that such facilitated reflection processes may serve as an important strategy to improve the organization of work in LTCFs, one that is particularly well-suited to the dynamic and relational nature of care.

Since the 1980s, research on care has stressed that the organisational conditions of work are crucial for workers’ and care receivers’ experiences of care quality. Working conditions in eldercare have been challenged by New Public Management (NPM) reforms, which emphasise standardised managerial control functions. Based on interviews conducted in two Swedish residential care homes we analyse how auditing, person-centred care and competence are implemented in everyday work. The dimensions studied are described with ambivalence: Both positive and negative aspects are linked to three dimensions of work. But, to foster a practice where logic of caring get more space in relation to the rationality of marketisation, there is need for organisational changes that promotes development where the aim of documentation is transparent in everyday work. Further, to achieve person-centred care, workers require conditions enabling them to respond to the person’s needs and not only what is written in care plans. The results show tensions between formal education and experience-based skills that contributed to make the relational and emotional aspects of care invisible and unrecognised. These struggles highlight tensions between two organisational logics—rationality of caring and marketisation—where one, rationality of caring, is devalued by the organisation but not in the everyday work. 

This chapter describes the organizational and social policy changes of the eldercare sector in Sweden. It also describes data sources and methods used; gives the context for eldercare services in the Swedish welfare state; and summarizes three decades of organizational trends in Swedish eldercare. The chapter analyzes how these changes have affected the everyday lives of care workers and to some extent the users and their families. Both home-based and residential care has gone through major organizational changes, and in both forms of care the organizational reforms have been implemented with hardly any consideration of the consequences for staff. Both national statistics on work-related injuries and the NORDCARE survey present a picture of worsening working conditions for the staff in eldercare, a trend that can be related to declining resources and organizational changes. The chapter concludes by discussing the women-friendly potential of the Swedish welfare state for care workers in light of the recent changes in eldercare services.