Accounts of professional and institutional tension in the context of Swedish elderly care

Abstract

This article describes need assessment dialogues, the circumstances surrounding care, and the provision of residential care and in-home support for the elderly in Sweden, as seen from a communicative perspective. The purpose was to systematically describe and analyse the accounts of welfare officers concerning elderly care. The research questions were: How is the internal care context perceived and constituted through discourse? How do welfare officers manage the daily demands, expectations, tasks, and dilemmas in the encounter with the individual citizen? What significance do the welfare officers give their work and their professional tasks? Eleven interviews with welfare officers from elderly and handicapped care organisation of three municipalities were held, and a discursive analysis was made from the collected data. Four characteristic discursive phenomena in the welfare officers' accounts were observed: (I) the rights of the elderly, (II) living at home, (III) good relations, and (IV) the complaisance. The study shows that the dialogues with elderly contain communicative dilemmas and mixed loyalties. The welfare officers navigate between different perspectives and double approaches. She/he uses the navigating as a strategy and proficiency in their work. However, these proficiencies remain largely unnoticed and unreflected as techniques, strategies, or tools for attaining favourable care.