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Online representations of nursing-home life in Sweden: perspectives from staff on content, purpose and audience
- Authors:
- CARLSTEDT Elisabeth, JONSON Hakan
- Journal article citation:
- Ageing and Society, 40(12), 2020, pp.2754-2770.
- Publisher:
- Cambridge University Press
The article is based on a study of how social media and other types of online representations of nursing homes are described by staff. The study proceeds from a qualitative thematic analysis of 14 interviews with nursing-home representatives. The article addresses a key finding that was apparent in the interviews: the online representations’ form and content were adjusted to fit the demands of residents’ relatives. Given the peripheral role attributed to relatives in official Swedish eldercare policies, the motives for the online representations are systematically examined. Two motives are found to be central: marketing and assurance. Residents’ relatives, specified as adult children, were perceived pre-admission as customers in charge of the process of choice and placement; post-admission, relatives requested proof that social activities were provided for their parents. The article discusses how online representations strategically construct a version of ‘reality’ by adjusting to relatives’ unrealistic expectations, only showing residents as involved in social activities. Finally, the need to examine the actual role of relatives in Swedish eldercare is discussed. (Edited publisher abstract)
Shaping nursing home mealtimes
- Authors:
- HARNETT Tove, JONSON Hakan
- Journal article citation:
- Ageing and Society, 37(4), 2017, pp.823-844.
- Publisher:
- Cambridge University Press
A number of studies stress the importance of positive mealtime experiences for nursing home residents. However, the components that comprise an ideal nursing home meal remain unclear, reflecting the ambiguity of whether nursing homes should be framed as institutions, domestic settings or a type of hotel. In this study, nursing home meals were viewed as situations that the involved parties could continuously modify and ‘work on’. The aim was to analyse how the staff and residents shaped mealtimes by initiating frames and acting according to established social scripts. The study was based on semi-structured interviews with staff and residents and on ethnographic data, consisting of 100 hours of observations at two nursing home settings in Sweden. The analysis revealed how staff and residents interactively shaped meals using institutional, private or restaurant frames. There were three important findings: (a) an institutional meal frame was dominant; (b) there were substantial difficulties in introducing private frames and established private scripts for meals, since such meal versions are personal and not easy to transport into collective settings; (c) successful creation of private or home-like meal situations illustrates an often overlooked skill in care work. Making meals as ‘care-free’ as possible can be viewed as a way to operationalise the goal of providing a non-institutional environment in nursing homes. (Publisher abstract)
Is it racism? Skepticism and resistance towards ethnic minority care workers among older care recipients
- Author:
- JONSON Hakan
- Journal article citation:
- Journal of Gerontological Social Work, 49(4), 2007, pp.79-96.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Sweden has evolved into a multi-cultural society, and a significant proportion of those employed in the care of older people are born both outside Sweden and outside the European Union. For older native Swedes the receipt of care may involve their first extended encounters with people from ethnic minorities, and some react badly. This paper is based on interviews with 12 representatives of caring organisations, and three ethnic minority care workers. The former described hostility and resistance as rare, attributing it primarily to language difficulties or a temporary fear of the unknown. They adopted a pragmatic or pathologising approach that enabled them to collude with apparent racism: for example, complying with the demands of a client not to be cared for by an ethnic minority worker, in order to protect the worker; or rationalising hostile behaviour as ‘not really racism’ because of the client’s age or mental state. The latter view was also expressed by the three care workers, who nonetheless described a more widespread and severe problem of racism. The paper concludes by looking at how racism in elder care settings can be challenged while simultaneously taking into account the vulnerability of clients. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Ethnically profiled nursing home care in Sweden - from culture to lifestyle
- Authors:
- JONSON Hakan, HARNETT Tove, NILSSON Magnus
- Journal article citation:
- European Journal of Social Work, 21(2), 2018, pp.235-246.
- Publisher:
- Taylor and Francis
The paper investigates presentations of ethnically profiled nursing homes in Sweden, and in particular what categories these nursing homes target and what problems they are suggested to solve. The findings relate to the construction of older immigrants and to shifting ideas on responsibilities of the Swedish welfare state. Data consisted of 68 articles from newspapers and journals between the period of 1995 and 2015 that were analysed using qualitative methods. Guided by a social constructionist approach focusing on claims-making, two comprehensive ‘problem frames’ were identified: the language and culture frame and the choice of lifestyle frame. The main finding of the paper was that, since about 2007, descriptions of ethnically profiled nursing homes have come to be included in a broader category of profiled nursing homes such as ‘all inclusive’ and ‘hotel-concept’, within a system that focuses on choice based on special needs, lifestyle and interest. The paper concludes that, although this way of framing ethnically profiled nursing homes works against the construction of older immigrants as a problematic category, there is a risk that the emphasis on choice of lifestyle conceals or justifies inequalities based on social class. (Publisher abstract)
Framing scandalous nursing home care: what is the problem?
- Author:
- JONSON Hakan
- Journal article citation:
- Ageing and Society, 36(2), 2016, pp.400-419.
- Publisher:
- Cambridge University Press
The aim of this article is to investigate different ways in which nursing home scandals in Sweden have been framed, to discuss the relations between these existing frameworks, and to identify ways of describing the problem that are absent in the current debates. Data for the study consisted of media articles, television documentaries and internet debates, expert reports and court hearings, and interviews with representatives of organisations dealing with the issue of mistreatment in care services for older people. An analytical tool developed within social movement research was used to identify three ‘debates’ on such mistreatment in Sweden, where competing ways of framing the problem have been used: (a) a debate where staff are cast as either perpetrators or victims, (b) a debate on privatisation and profit as the motive for neglect of care recipients, and (c) a debate on deserving and non-deserving recipients of socially provided care centred around populist claims. The analysis highlights a need to introduce an alternative frame for interpretation where mistreatment in care for older people is regarded as involving scandalous cases of ageism. This anti-ageism frame would provide older people with a lead role in the drama – not just as victims but as stakeholders in relation to the problem. (Publisher abstract)
That’s not my Robert!: identity maintenance and other warrants in family members’ claims about mistreatment in old-age care
- Authors:
- HARNETT Tove, JONSON Hakan
- Journal article citation:
- Ageing and Society, 30(4), May 2010, pp.627-647.
- Publisher:
- Cambridge University Press
This report details the interactions between staff of residential care homes for older people, and twenty one relatives of care recipients recruited from a Swedish association for relatives of care recipients. The qualitative evaluations of those family members of the care their loved ones received were collected by interview and are described. The definition of mistreatment depends on context and often varies from professional to professional, as well as between professional caregivers and family carers, which only emphasises the importance of caregivers remembering the individual identities of each of their patients. Four warrants about mistreatment were identified, physical harm (or failure to meet physical needs), psychological harm (or displaying bad manners), social care deficiencies (or failure to meet basic, social needs) and identity subversion, with the latter including lack of respect for personality and habits/routines being focused upon in this study. Family members backed arguments about a care recipient’s persona being violated using unique knowledge of the care recipients’ appearance, daily routines and preferred activities. Some examples of relatives, acting as moral and physical guardians, in their attempts to protect the dignity/identity of loved ones, their fears of abuse, and actual cases of conflict with and retribution by care staff are listed. Insights from these case studies may help inform future guidance on how to lessen conflicts between formal care providers and relatives.