Denna artikel fokuserar på hur hemtjänstpersonal förhåller sig till utmaningar och dilemman med omsorgstagare med alkoholproblem. Analysen visar hur personalen fokuserar på att spela en roll som omsorgsgivare och förmågan att ”spela teater” som några av förutsättningarna för arbetet. Goffmans dramaturgiska begreppsapparat respektive Hochschilds teorier om emotionellt lönearbete används för att tolka resultaten.

Older persons with alcohol problems have today become an all too common part of everyday elder care, but research in this area is still scarce. This article has a Swedish context with the aim of describing and analysing home care workers’ narratives about older people who can be characterised as heavy drinkers, i.e. people with severe alcohol problems who need considerable care for extended periods. Limited knowledge is available concerning this age group. This article therefore fills a knowledge gap about home care workers’ perspective about body work and the abject, and breaches the myth that older individuals should be able to drink as they prefer and/or notions of drinking alcohol as a last enjoyment in life. The care workers talked about how they got drawn into the daily lives of the care recipients and how they ended up in situations where they, on the one hand, removed the consequences of drinking, and on the other, felt that they sustained the drinking by cleaning out dirt and washing the care recipients’ bodies.

”We meet the involuntary” – social workers talk about older people with alcohol problems

Social workers working in addiction teams in the municipalities rarely have documented collaboration with elder care managers despite the fact that older people with alcohol problems have become more common within elder care, especially home care services. There are few studies of older people with alcohol problems, and knowledge on the subject is scarce. The aim of this study was to investigate how social workers within addiction treatment talk about older people with alcohol problems. Six group interviews and three individual interviews have taken place including a total of 18 social workers. The social workers came from seven different municipalities. Social workers usually meet older people with a long history of abuse and several institutional stays behind them. Many are reluctant to have further contact with social services. In the case of older persons with alcohol problems it is seldom considered appropriate to initiate treatment interventions. Older persons could however sometimes get a place at an abuse institution to get in better shape. In the interviews elder care is often looked upon as a way to get a better situation around an older person with alcohol problems. There are few treatment programmes aimed at older people with alcohol abuse problems. According to the social workers there is a lack of adequate institutional care and various social activities. Nor do older people with alcohol problems fit into activities organized by elder care. One conclusion is the need to develop different treatment interventions targeted at older people with alcohol problems as well as to develop cooperation between elder care and addiction teams.

Aim: The aim of this study was to investigate howcare managerswent about in theirwork with older people living at homeand having alcohol abuse problems. Method: Six focus group interviews and one interview with two participants were carried out. In total, 23 care managers from five different municipalities participated. Results: The care managers all stressed the fact that within home care, no addiction treatment was conducted. The role of home care was to provide good care helping older people in their everyday lives irrespective of their problems. The care managers had to push the limits for the available services to be able to help older people with alcohol abuse problems. The services offered are however strictly regulated in guidelines. Many older people with alcohol abuse problems were not interested in receiving home care, and they were seldom interested in having contact with the addiction unit. The self-determination of older people in need of home care is strongly stressed in legislation. If the older person did not want any help, there was not much the care managers could do. Conclusions: Since older people today drink more alcohol than earlier generations, there is a need for services and addiction treatment specifically directed at older people with alcohol abuse problems suitable for their needs.

AIM - Alcohol abuse and self-determination - a mapping of the conditions for home care work with older persons with alcohol problems in Sweden. The aim of this study was to investigate the conditions within home care services when working with older persons with alcohol abuse. DESIGN - A telephone survey has been carried out and middle managers for needs assessment officers and middle managers for home care staff have been interviewed. The managers in 25 municipalities in the Stockholm area took part in the study. RESULTS - It was common that care workers were in regular contact with older people with alcohol abuse. However, very few had any training regarding how to treat older people with alcohol abuse and there was no specialization within this field. A conflicting task was the question of buying alcohol to alcohol addicts. The self determination of older people was the guideline. The home care workers had little or no cooperation with misuse teams in the municipalities. The municipalities had no guidelines for the work with older people with alcohol abuse and the responsibility was pressed down to the lowest level in the organization. CONCLUSIONS - To a great extent, home care workers stand alone in the work with older people with alcohol problems.