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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)
Identity and relationships: on understanding social work with older people suffering from dementia
- Author:
- EMILSSON Ulla Melin
- Journal article citation:
- Journal of Social Work Practice, 22(3), November 2008, pp.317-328.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This paper discusses how the identity confusion among older people suffering from dementia might influence relationships and the staff's behaviour, and in that sense, be part of the care problems reported. Three studies carried out between 1993 and 2003 are introduced aimed at illustrating the severe care problems identified. The interaction between the residents and the staff is focused on and discussed from a psychodynamic viewpoint. Data show that the caregivers also become confused and express a need of affirmation comparable with that of the older people suffering from dementia. That is, even the caregivers' behaviour seems to be influenced by an identity-preserving ambition similar to the one of the dementia sufferers, and this might explain some of the problems in this form of care.
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)
Independence as a stigmatizing value for older people considering relocation to a residential home
- Authors:
- SODERBERG Maria, STAHL Agneta, EMILSSON Ulla Melin
- Journal article citation:
- European Journal of Social Work, 16(3), 2013, pp.391-406.
- Publisher:
- Taylor and Francis
Based on older people's perspectives, this article aims to reveal how the culture of independence influences the decision-making process preceding relocation to a residential home. An ideology of ageing in place in Sweden is predominant; and as in many other welfare states, the focus is on how contining to live in ordinary housing is justified versus how relocation to a residential home is excused. This article reports on 21 older people who were included in open semi-structured interviews and in follow-up contacts. The findings show that the value of independence, originally intended to protect the position of older people, in practice led to stigmatising processes. In order to bridge the gap between values and declining capacities, expectations and actions, older people develop individual-oriented, family-oriented, and public-oriented justifications and excuses, so-called ‘accounts.’ (Edited publisher abstract)
Health care, social care or both?: a qualitative explorative study of different focuses in long-term care of older people in France, Portugal and Sweden
- Author:
- EMILSSON Ulla Melin
- Journal article citation:
- European Journal of Social Work, 12(4), December 2009, pp.419-334.
- Publisher:
- Taylor and Francis
The aim of this article is to describe, analyse and compare different approaches on care of older people with dementia, using examples from France, Portugal and Sweden. The questions are principally focused on the participants' attitudes to their tasks, the organisation of work, the professional role and cooperation with other professions. Daily care was studied through observations and participant observations and the staff's opinion was explored by means of interviews. Twenty-two care settings for older people were included. The findings showed that France provided mainly 'health care', Sweden 'social care' and Portugal an integrated 'health care and social care'. From a comparative perspective the Portuguese general care of older people, which focuses on integration of health care, social care and social work, also seems to provide care for older people suffering from dementia which best corresponds to the previously developed group living model.