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How the care managers handle the process when older people consider relocation to a residential home
- Authors:
- SODERBERG Maria, STAHL Agneta, EMILSSON Ulla Melin
- Journal article citation:
- British Journal of Social Work, 45(8), 2015, pp.2423-2440.
- Publisher:
- Oxford University Press
The aim of this article is to reveal how care managers handle the process when older people consider relocation to a residential home in a Swedish context. The article is based on vignette-based interviews with seven care managers. The main findings in the article are that the care managers assist older people in their decisions by turning ageing in place and relocation, respectively, into seemingly natural choices. In both approaches, they use warrants related partly to ‘the best for older people’, partly to ‘the common good of economizing’. The conclusions drawn are that the care managers, by applying risk management and extensive alliance strategies, are not really able to question their own work situation and that they perform their work in a context of different parties restraining themselves. The implications for social work policy and practice are that the approach referring to older people's self-determination while actually dealing in risk assessment must be thoroughly reconsidered. Other practical implications are that the idea of the purchaser/provider model must be clarified, beyond the assessment of resources. (Publisher abstract)
Stratified structural and epistemic aspects of the care manager's discretion: a theoretical approach to social work related to older people's potential relocation to a residential home
- Authors:
- SODERBERG Maria, STAHL Agneta, EMILSSON Ulla Melin
- Journal article citation:
- European Journal of Social Work, 18(3), 2015, pp.325-339.
- Publisher:
- Taylor and Francis
By applying a theoretical point of departure, the overarching aim of this article is to describe, analyse, and try to understand why care managers in their everyday occupational practice normalise the restrictive approach when older people consider relocation to a residential home. While earlier research to a large extent has drawn attention to how the care managers carry out the restrictive approach, this article pays attention to the circumstances paving its way. The focus is on influences from different sociological levels, thereby ‘stratified’, and from two aspects of discretion, where ‘structural aspects’ refer to choices between permitted alternatives and ‘epistemic aspects’ to practical reasoning under conditions of indeterminacy. With this combination, a multitude of circumstances contributing to the restrictive approach is revealed. Thus, the theoretical model includes levels as well as discretionary powers where formulas constitute the foundation at each level, subsequently related to multidisciplinary references in order to get the practice into perspective. The findings show that the priority given to home-based care in contrast to residential care is repeated and confirmed at each level and besides in an interchange between structural and epistemic aspects. (Publisher abstract)