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The marketisation of care: rationales and consequences in Nordic and liberal care regimes
- Authors:
- BRENNAN Deborah, et al
- Journal article citation:
- Journal of European Social Policy, 22(4), 2012, pp.377-391.
- Publisher:
- Sage
The use of markets and market mechanisms to deliver care is one of the most significant and contentious ways in which welfare states have been transformed. This article examines debates and policies concerning the marketisation of eldercare and childcare in Sweden, England and Australia. It shows how market discourses and practices intersect with, reinforce or challenge traditions and existing policies and examines whether care markets deliver user empowerment and greater efficiency. Markets for eldercare and childcare have developed in uneven and context specific ways with varying consequences. Both politics and policy history help to shape market outcomes.
Helpful citizens and caring families: patterns of informal help and caregiving in Sweden in a 17-year perspective
- Authors:
- JEGERMALM Magnus, GRASSMAN Eva Jeppsson
- Journal article citation:
- International Journal of Social Welfare, 21(4), October 2012, pp.422-432.
- Publisher:
- Wiley
This article reports on an analysis of informal help and caregiving in Sweden with a focus on patterns of change over 17 years. In particular, it examines whether there has been a change in the extent of caregiving, the type of caregivers, and the relationship between the caregivers and the recipients of help. The discussion is based on results from a national survey repeated 4 times between 1992 and 2009. The survey asked whether the respondent regularly helped someone with whom they did not live (relatives, neighbours, co-workers or friends) with activities such as housework, transport, or gardening. In order to discuss how the trends can be understood in the Swedish context, the findings are analysed using 2 interpretative perspectives: the welfare state and impact of recent changes; and civil society and its possible and changing role. The findings indicate that in the 1990s the figures were stable, but from the late 1990s to 2009, there was a dramatic increase in the extent of informal help giving. Concerning types of helpers, the patterns implied involvement not only from family members, but also from other types of helpers.
To feel safe in everyday life at home: a study of older adults after home modifications
- Authors:
- PETERSSON Ingela, LILJA Margareta, BORELL Lena
- Journal article citation:
- Ageing and Society, 32(5), July 2012, pp.791-811.
- Publisher:
- Cambridge University Press
This qualitative study investigated contributory factors of safety in everyday life for eight older adults who received modification services. Three main categories emerged from interviews: prerequisites that enable a feeling of safety; strategies that enable safety in everyday life; and use of and reliance on technology impacts on safety. The results suggested that to feel safe in everyday life was based on three prerequisites: feeling healthy; having someone to rely on; and feeling at home. These prerequisites further impacted on the participants' strategies for handling problems in everyday life but also on the ability to use and benefit from technology such as home modifications. Interventions increase safety for older adults should primarily be focused on the presence and fulfilment of prerequisites and later on other interventions such as technology. Technology such as home modifications and assistive devices was not found in this study to facilitate the feeling of safety unless supported by the fulfilled prerequisites.
Methodological challenges in the implementation and evaluation of social welfare policies
- Authors:
- ANDERSSON Katarina, KALMAN Hildur
- Journal article citation:
- International Journal of Social Research Methodology, 15(1), 2012, pp.69-80.
- Publisher:
- Taylor and Francis
As social reality is quite elusive, even regarding seemingly well-recognised everyday concepts and objects, assessments and evaluations of implementation policies will always present methodological challenges. There is a need to consider such assessments and evaluations in a critical perspective to investigate whether the desired knowledge is really being acquired. The purpose of this article is to address some of the challenges that underlie assessments and evaluations of the implementation of social welfare policies by presenting a rereading and analysis of an empirical study of elderly home care services. The rereading and analysis is described in terms of 4 stages: ecological analysis of institutions; shadowing; focus on common concepts and objects; and applying the analytical concept of boundary objects. The results reveal the emergence of a dissolution of common and professional key concepts and objects in these welfare services to a degree that challenges both the implementation policy and the evaluation of policy. The article concludes that this has methodological implications for the evaluation of implementation policies in general.
The meaning of a knowledge-based organization in Swedish municipal elderly care
- Authors:
- WESTERBERG Kristina, et al
- Journal article citation:
- Social Work Education (The International Journal), 31(4), 2012, pp.465-484.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This study investigated the concept of a ‘knowledge-based organisation in municipal elderly care’ as it was perceived by informants at different organisational levels and professional and political functions in the social services. The selection of participants for the interview study was made on basis of organisational level and engagement in different kinds of development of elderly care. Twelve individual and four group interviews were conducted. The participants in individual interviews were: two local politicians who were members of the local Board for Social Welfare, three senior managers in the organisation, four people belonging to the management staff, two project managers, and one assistant nurse. The four groups that participated were: the process group; the elderly care team; and two work groups in residential homes for the elderly. The research questions concerned how different informants perceive, and to what extent they share, the meaning of a knowledge-based organisation and to relate these perceptions to the organisational conditions for learning and knowledge use. The results showed that there were different views on the meaning of knowledge-based elderly care, mainly related to professional functions and organisational levels. It is argued that these views have implications for organisational learning and change as well as formal training and education.
Usability of a new electronic assistive device for community-dwelling persons with mild dementia
- Authors:
- MEILAND Franka J.M., et al
- Journal article citation:
- Aging and Mental Health, 16(5), July 2012, pp.584-591.
- Publisher:
- Taylor and Francis
COGKNOW is a three-year project supported by the Inclusion unit of the European Commission’s Information Communication Technology (ICT) Research Programme. The project commenced in September 2006 and concludes in late summer of 2009. The goal of COGKNOW is to develop an integrated cognitive prosthetic solution that supports people with mild dementia in four areas: memory, social contact, recreational activities and experiences of safety. A user participatory method was applied to evaluate the development process of the COGKNOW Day Navigator (CDN), and consisted of three iterative 1-year cycles with field tests in Amsterdam, Belfast and Luleå. In the successive cycles 16, 14 and 12 persons with dementia and their carers participated. Data on usability were collected by means of interviews, observations, questionnaires, logging and diaries. The CDN prototype consists of a touch screen, a mobile device, sensors and actuators. The evaluation showed that persons with dementia and carers valued the CDN overall as user-friendly and useful. CDN was expected to be a useful tool for supporting community-dwelling persons with mild dementia and their carers. Implication for practice are discussed.
Long-term care quality assurance policies in European countries
- Authors:
- DANDI Roberto, et al
- Publisher:
- European Network of Economic Policy Research Institutes
- Publication year:
- 2012
- Pagination:
- 89p.
- Place of publication:
- Brussels
This report present the findings and conclusions of research undertaken in the context of research projects carried out by a consortium of ENEPRI member institutes. This report is a contribution to Work Package 5 of the ANCIEN project, which focuses on the future of long-term care for the elderly in Europe. This report analyses the quality assurance policies for long-term care (LTC) in the following countries: Austria, Estonia, Finland, France, Germany, Hungary, Italy, Latvia, Poland, Slovakia, Slovenia, Spain, Sweden, the Netherlands, and the United Kingdom. First, it discusses quality assurance in LTC by analysing: the dimensions of quality, the policy frameworks for quality in LTC, the different levels of development of LTC quality policies at the international, national, organisational, and individual levels. Second, it describes the methodology for collecting and analysing data on quality policies in the selected countries. Finally, it discusses the results, identifying four clusters of countries based on quality policies and indicators for LTC. These clusters are compared to the clusters identified in Work Package 1 of the ANCIEN project. Policy recommendations are proposed.
Quality assurance indicators of long-term care in European countries
- Authors:
- DANDI Roberto, CASANOVA Georgia
- Publisher:
- European Network of Economic Policy Research Institutes
- Publication year:
- 2012
- Pagination:
- 128p.
- Place of publication:
- Brussels
This report present the findings and conclusions of research undertaken in the context of research projects carried out by a consortium of ENEPRI member institutes. This report is a contribution to Work Package 5 of the ANCIEN project, which focuses on the future of long-term care for the elderly in Europe. The report presents the quality indicators that were collected by the ANCIEN project partners in each country. The main contribution of this report is a classification of the quality assurance indicators in different European countries according to three dimensions: organisation type; quality dimensions; and system dimensions. The countries that provided quality indicators, which are used at a national level or are recommended to be used at a local level by a national authority, are: Estonia, Finland, France, Germany, Hungary, Italy, Latvia, the Netherlands, Spain, Sweden and the United Kingdom. In total, 390 quality indicators were collected. Each quality indicator has been assigned to one or more options in each dimension.
Self and next of kin's assessment of personality and sense of coherence in elderly people: implications for dementia care
- Authors:
- HOLST Göran, RENNEMARK Mikael, HALLBERG Ingalill R.
- Journal article citation:
- Dementia: the International Journal of Social Research and Practice, 11(1), January 2012, pp.19-30.
- Publisher:
- Sage
The best people able to understand the behaviour of individuals with severe dementia are usually close family members, rather than the nurses who care for them. This study evaluated the inter-rater agreement between healthy elderly people's self-assessment and the assessment made by a next of kin concerning personality and sense of coherence. Participants included 154 individuals from Sweden. Findings revealed a high or moderate agreement in ratings, showing that, in general, a close relative was able to report on the personality of a next of kin. The agreement was high on coherence and extraversion and lower on neuroticism. For neuroticism, length of time in the relationship increased the odds for a good inter-rater agreement. The authors concluded that next of kin provided reliable information and could therefore aid nurses in the care of older people with dementia.
Care planning at home: a way to increase the influence of older people?
- Authors:
- BERGLUND Helene, et al
- Journal article citation:
- International Journal of Integrated Care, 12(3), 2012, Online only
- Publisher:
- International Foundation for Integrated Care
The purpose of care-planning meetings is for professionals to co-ordinate the planning of future care, in interaction with the older person. The meeting generally takes place in the hospital, prior to discharge. The purpose of this research was to investigate whether the organisation of care-planning meetings has an impact on the opportunity for the older person to influence the decision-making processes. The study was part of a larger project including a comprehensive continuum-of-care model conducted in a city on the west coast of Sweden. As part of this study, 19 care-planning meetings were audio-recorded; 10 in the older person’s home and 9 in hospital. The meetings were transcribed and a qualitative content analysis was performed. The findings show that care-planning meetings at home appeared to enable older people's involvement in the discussions. Fewer people participated in the meetings at home and there was less parallel talking. Unrelated to the place of the care-planning meeting, the older people were able to influence concerns relating to the amount of care, and the choice of provider. However, they were not able to influence the way the help should be provided or organised. The article concludes that planning care at home enabled an increase in involvement on the part of the older people, but this did not appear to be enough to obtain any real influence.