ABSTRACT

The aim of this article is to reveal how care workers in the home-help services handle the process when older people’s relocation to a residential home is under consideration. Since the care workers are engaged daily in defining care receivers’ needs and yet have no formal influence on care decisions in Sweden, the focus is on how they solve this dilemma. In this inductive study, the theoretical framework is based on occupational alliances, relationship-based practice, and discretion. Thirty-three care workers in home-help services are included in open semi-structured interviews. Prominent features in the findings are that the care workers take their stand at the borderland of care management, when they know or try to find out what is right. The conclusions drawn are that care workers find ways to informally influence the decision-making process, quite contrary to the idea of approaches referred to as purchaser/provider models. The implications for social work policy and practice are that a distinction between assessment and intervention may not benefit the field of eldercare and should therefore be regarded as an area in need of thorough reconsideration.

摘要

本文的目的是揭示在考虑老年人搬迁到住宅时，家庭帮助服务中的护理人员如何处理该过程。由于护理人员每天都参与定义护理人员的需求，但对瑞典的护理决策没有正式影响，因此重点在于他们如何解决这一难题。在本归纳研究中，理论框架基于职业同盟，基于关系的实践和自由裁量权。开放式半结构式访谈中包括了33名在家中服务的护理人员。研究结果的显着特征是，当护理人员知道或尝试找出正确的方法时，他们会站在护理管理的边缘地带。得出的结论是，护理人员找到了非正式地影响决策过程的方法，这与所谓的购买者/提供者模型的想法完全相反。对社会工作政策和实践的影响是评估与干预之间的区别可能不会对老年人护理领域有利，因此应被视为需要重新考虑的领域。