Care managers as administrators of the needs of the elderly - contradictions and diversity in Swedish eldercare
Department of social work Umeå university Umeå, Sweden
Swedish eldercare, which is predominantly publicly organised, is an arena for the implementation of political objectives such as gender equality and cultural diversity, which can lead to contradictions in care work practice. Since the early 1990s, the conditions to provide for the elder groups are continuously changing in Sweden. New forms of organisation, rationalisation, and strife for efficiency mean for one thing an increasing time pressure in care work. Today, freedom of choice and individual rights for the elder clients or costumers is leading concepts in eldercare. Within the context of organisational change and policy of legislation, these changes imply consequences and dilemmas on different levels and for different actors within eldercare. In this paper, focus is on care managers´ representations of dilemmas that may occur when diversity is put in the fore.
Methods and materials
A new organisation reform with strong emphasis on the elderly as customers and a good freedom of choice is the applied concept in the investigated municipality in one of the bigger towns in the middle of Sweden. The empirical material consists of a survey answered by 29 care managers that comprises more than two third of all the care managers in the municipality. The open-ended questions were analysed discursively with focus on how care managers referred to dilemmas in meetings with elder clients based on gender and ethnicity.
In needs assessments, the care managers have to follow the law and political standards equally. However, the managers gave unequal support to older men and women. Within this rationality of economy, older women are under-privileged. The analysis further reveals that the care managers´ believed that elderly immigrants, compared to elderly ethnic Swedes, demanded different care solutions that were hard to fulfil. According to the care managers, one reason is that the immigrants do not understand the Swedish welfare system and how it operates.
Despite National goals on diversity, a homogenous standard is practiced in Swedish eldercare. Also, legislation with ideals of gender neutrality, further support the discourse of homogeneity. Thus, diversity within the context of eldercare seems to be contradictive as consequence.