This paper studies, from a client perspective, how three Swedish municipalities work with information about a voucher system in homecare. The paper is a qualitative study using structured informant interviews and analysis of documents. The interviewees are responsible of information about the voucher system in the municipalities. The studied documents describe and clarify the voucher system of the municipality. Neo-institutional organization theory is used to analyse the result. Existing research has showed how pensioners find information on the voucher systems lacking. The research also shows how care managers have difficulties relating to their new roles as information coordinators on the voucher system. With this background, the study focuses on examining how the municipalities work with and organises the information on the voucher system as well as how the responsibiliy of the information is handled. The result shows that the studied municipalities mainly deal with the issue from a market point of view, where the care providers are to be presented in a neutral way. However, one of the municipalities has reconsidered the principle of neutrality and works to clarify the information to the elders. All three municipalities place the responsibility of information on the care managers in their interaction with the elder. There is no further communication between the municipality and the elderly people in the form of client studies or fora of discussion and review of the information on the voucher system.

The aim of this study was to describe and analyse the constructions and interplay of gender, ethnicity and sexuality between female and male careworkers and residents in a nursing home. To explore this from a qualitative everyday life’s approach, material was collected through participating observations, interviews, and informal conversation with careworkers and residents. The result points out that historical patterns of gender and caring related to this context still matter and affect both careworkers and residents. For example, female careworkers talked about the concept of caring as a genuine female experience, while male careworkers, who were in a minority, instead talked about caring in more gender-neutral words. The result also indicates that a larger number of male careworkers not necessarily leads to a higher grade of gender equality. Instead, the presence of male careworkers made the traditional gender-power order more visible. When analyzing outcomes of the interplay of gender, ethnicity and sexuality, it was obvious that this was a complicated process. On one hand this interplay of different categories seemed to affect female and male careworkers in a similar way. On the other hand the interplay of gender, ethnicity and sexuality can confront female and male careworkers with different types of dilemmas. Therefore, an attempt to understand the position and experience of being a careworker with non-Swedish background or being a nonheterosexual careworker must include a gender-perspective. A main result from the study was that the careworkers supported the residents to perform their social gender-identity through the daily interactions. These interactions were foremost influenced by the careworkers’ own expectations about older women’s and older men’s needs and behaviour. The four gender-constellations that occurred in the care-interactions also differed from each other with regard to what careworkers and residents talked about, and how they talked and acted. Even if the outcome from different types of gendered meetings differed, there were also some similarities. It was obvious that both female and male careworkers seemed to think and talk about the female residents as more dependent and vulnerable than male residents. To conclude, traditional norms and a gender-power order that influences society also affects careworkers and residents in the nursing home.

Bakgrund: Runt omkring oss i samhället finns det organisationer av olika slag. De organisationer som påverkar oss mest i vårt dagliga liv är dock troligen de kommersiella. För sådana organisationer utgör ägarna en stark intressentgrupp då de tillför kapital till verksamheten och för detta kräver ersättning i form av avkastning. För många kommersiella organisationer finns det dock fler intressenter med andra krav på organisationen och dess verksamhet, till exempel måste industrier investera i reningsanläggningar för att inte släppa ut skadlig rök till omgivningen. För de flesta organisationer finns det följaktligen minst två olika måldimensioner. Å ena sidan har vi ägare och investerare som vill ha avkastning på sitt kapital. Å andra sidan finns det intressenter som kräver saker som hög kvalitet, hög säkerhet och tillförlitlighet. Dessa olika krav kan skapa en målkonflikt för verksamheten. Syfte: Syftet med denna uppsats är att studera och analysera hur målkonflikten mellan intressenters säkerhets- och lönsamhetskrav hanteras i verksamhetsstyrningen. Genomförande: Med hjälp av intervjuer har vi genomfört fallstudier vid organisationer inom äldreomsorg och kärnkraftsindustri. Resultat: Vår studie visar på en rad faktorer som bör tas i beaktning vid organisationer med målkonfliktsproblematiken. Ledningen måste vara tydlig i sin målprioritering och kommunikation, ha en tydlig hantering av sina intressenter och deras krav samt att det bör finnas tillfredställande system för felidentifiering och rapporteringsmöjligheter för de anställda. / Background: In the society we live in, there are different kinds of organizations. The organizations that affect us the most however are probably the commercial ones. For these organizations, the owners form a strong a group of stakeholders since they invest capital and therefore require return on their investments. Nevertheless, some organizations also face demands of safety and quality from other stakeholders. With this in mind it becomes clear that organizations sometimes have to handle at least two dimensions of goals, owners that demand yield and the general public that demands a satisfying amount of safety. These different kinds of goals and demands can create a goal conflict situation within the organizations. Aim: The purpose of this study is to explore and analyze how the conflict between safety and economic goals is handled in the operating control.' Completion: A case study was carried out in the geriatric care and nuclear power industry by means of qualitative interviews. Results: The result of this study indicates that there are certain aspects to bear in mind for organizations facing the goal conflict situation. The management has to be clear about what to prioritize and then clearly communicate this priority to the employees. The organization should also have a clearly defined stakeholder strategy concerning their demands and requirements. Finally, it is also important for an organization that employees have proper communication channels and failure identification systems, so that problems can be emphasized.

The aim of the study was to examine the background and prerequisites for social services responsibility for carers according to the carers’ section in the Social Services Act. How the legislation is perceived and implemented in practice was also studied. The study’s theoretical basis was jurisprudence and the sociology of law. Preparatory work and other sections of importance for the interpretation of the carers’ section in the Social Services Act were also scrutinized. Interviews with four municipal politicians and four local civil servants were conducted. Various factors which affect the prerequisites for the social services duty of care towards carers were identified in the study. By studying the direct effects of legislation various indirect effects were also highlighted. The results showed that legislation is a weak instrument of control in municipalities’ planning and implementation of support for carers. Therefore social services responsibility for carers is unclear and imprecise. For carers themselves it is difficult to know what support they can demand or ask for from social services – municipalities have to offer support for carers but the carers’ section does not give carers any legal right to support.

Detta är en uppsats där normer och värderingar om vårdbiträdet i hemtjänst undersöks genom kritisk diskursanalys. Datamaterial omfattar SOU-rapporten I den äldres tjänst. Äldreassistenten – ett framtidsyrke samt två fokusgruppsintervjuer med omsorgspersonal från en hemtjänstenhet. Diskursanalysen utförs i förhållande till och i samspel med sekundärlitteraturen. Utöver den språkliga analysen tas även kulturella och sociala dimensioner med i studien. För att ringa in rådande diskurser studeras centrala termer och formuleringar genom att undersöka hur ofta och upprepat de förekommer, samt vilken inkludering och exkludering som görs. I spänningsfältet som uppträder mellan den statliga diskursen och den praktiknära diskursen framträder stridigheter om de brister som äldreomsorgen tillskrivs. På politisk statlig nivå framträder en normerande bild av vårdbiträdet som den bristande länken i lagarbetet kring den äldre. På praktiknära nivå framhålls en förklaringsmodell där organisering och ledning är centrala bristkomponenter. Praktiker-diskursens faktorer bemötande och lön konkurrerar med de överordnade faktorerna som återges i SOU-diskursen; utbildning och validering. / This study is a discourse analytical study of norms and values in the Swedish public home health care sector. The discourse is studied at two different levels in Swedish society: the political and the practical. Information is collected through focus-group interviews at the practical level and at the political level from a report in the Swedish Government Official Reports Series (SOU 2008:126), appointed by the Ministry of Health and Social Affairs.   Government-sponsored publications and reports are used as a basis for executive and legislative decision-making in the parliament and the government. The governmental study is an important template for the formation and maintenance of norms and valuations. Elder care workers constitute Sweden's largest labor force and a majority of them are employed by municipalities. The SOU report motivates competence-reform in light of pending waves of retirements within the elder care work force, increased demand for elder care, and decreasing high-school enrollment in care and service programs. The discourse analysis is executed in relation to and in concert with the secondary literature.   The theoretical and methodological perspective in this study takes its starting point in Fairclough's critical discourse analytical theory and method. This provides dialectic of structures and practices, where discourse has an influence on and is influenced by social structures. In Fairclough's view, discourse practices are an important form of social practice that contributes to the forming of identities and relationships. The study investigates discursive practices in the report in order to uncover their role in the perpetuation of an unequal balance of power, so called ideological effects.  The study reveals contradictions within the SOU report and discordance between the report and home health care workers. Despite a societal eagerness to professionalize the home health aide, the political discourse relegates the aide to the bottom of the care hierarchy, by excluding issues such as compensation and subordinating questions concerning the organization and management. Discourses and action-space for workers in the home health care environment can be investigated in light of current deficiencies in top-down guidance and limited opportunities for peer-group meetings, especially since an increasing number of home health care workers have Swedish as a second language. Interactive research with both workers and management could be investigated and developed with pedagogical tools as a part of process of reform. Because Swedish society places such a high value on government reports, it is of continuing importance to scrutinize through critical-discourse analysis the entity of governmental research.

Antalet äldre invandrare i Sverige ökar och många bland den gruppen har kommit sent i livet. Språksvårigheter och kulturella skillnader gör det svårt för dem att få samma omsorg som majoritetsbefolkningen.Syftet med denna uppsats är att undersöka hur faktorer som språksvårigheter och kulturella skillnader påverka situationen för äldre invandrare och deras kontakter med äldreomsorgen. Kommunikationsteorier och relaterade definitioner av språk, kultur och kommunikation har använts för analysen.Denna studie är en litteraturstudie. Sammanlagt 18 artiklar med både kvantitativa och kvalitativa ansatser samt litteraturstudier ingår.Resultatet har presenterats i ett antal underrubriker. Centralt är att det finns ett klart samband mellan språk- och kulturella barriärer och sämre hälsa, upplevelse av vårdkvalitet och tillgång till formell och systematisk hjälp.Detta samband och tolkens roll i kommunikation och hur äldreomsorg borde utformas för att vara mer tillgänglig för äldre invandrare har diskuterats liksom vad kulturanpassad äldreomsorg kan innebära. Slutsatsen är att det finns luckor i kunskapsläget när det gäller studier som är baserade på de äldre invandrarnas subjektiva upplevelser, önskemål och krav. / The population of elder immigrants in Sweden is increasing and many older people among the group have come late in life. Language difficulties and cultural differences make it difficult for them to get the same care as the majority population. The purpose of this essay is to examine how factors such as language barriers and cultural differences affect the situation of older immigrants and their contacts with elder care.  Communication theories and related definitions of language, culture and communication have been used for the analysis.This study is a literature review. A total of 18 articles with both quantitative and qualitative approaches, and literature reviews are included.The results have been presented in a number of subheadings. A central issue was that there was a clear connection between language and cultural barriers and poor health, perceived quality of care and access to formal and systematic means.This connection and the interpreter's role in communication and how elder care should be designed to be more accessible to elderly immigrants has been discussed as well as what culturally congruent elderly care could include. The conclusion is that there is a lack of knowledge based on the subjective experiences, wishes and requirements of older immigrants' themselves.

With examples from a single classroom situation, several educational moments show what goes on between the teacher and the student. The teacher’s responsibility in the learning process is, with a gesture frozen in the air of the moment, to lead and follow the student in her tentative efforts at seeking knowledge. Initially, it is an attempt to shed light upon the "not yet seen" with a certainty that the student herself possesses the capacity and the aptitude to reach greater insight and clarity in her understanding. The Validation/Feil Method presented in this instructional situation illustrates how best to communicate with elderly people suffering from Alzheimer’s dementia. This essay examines thoughts, reflections and somewhat deeper studies concerning the importance of the moment, or rather the various moments that appear along our journey. From this wandering, the importance of being open-minded, spontaneous and perceptive come to light as well as new concepts such as improvisation and lingering along the way. The art of perceiving is enhanced by concepts such as reading and intuition with the help and support of earlier philosophical tradition, primarily Aristotle’s various forms of knowledge and Hans-Georg Gadamer with his work within the hermeneutic tradition. The author also offers an example of knowledge and learning which, taken together, display the importance of being aware of the body of knowledge incorporated in the area of Practical Knowledge. This is one way of gaining understanding in harmony with others of existing reality and of life itself.

Bakgrund: Lärande betraktas idag vara av hög relevans när det gäller organisationers utveckling och konkurrenskraft på marknaden på grund av den snabbt föränderliga omgivningen. I en lärande organisation ses lärandet som ett medel för att skapa en förändringsbenägenhet inom organisationen, skapa innovation, anpassa sig efter omgivningen samt för att skapa konkurrensfördelar. Det finns ingen entydlig definition av organisatoriskt lärande och inte heller hur organisationer agerar eller bör agera för att uppnå detta. Syfte: Studien har ett tvådelat syfte: För det första syftar den till att undersöka konstruktionen av organisatoriskt lärande med avseende på såväl planerade som oplanerade aktiviteter. Detta för att se vad som karaktäriserar lärandet och hur aktiviteterna bidrar till att medarbetarna lär. För det andra syftar den till att lämna rekommendationer som bidrar till förbättringar av lärandet. Metod: För att besvara vårt syfte har en kvalitativ fallstudie utförts genom semistrukturerade intervjuer och observationer på äldreboendet Rosen. Studien har haft en induktiv ansats då empirin ligger till grund för valet av teorier. Slutsats: Genom studien har vi identifierat såväl formellt som informellt lärande i verksamheten. Fokus från organisationen ligger främst på det formella lärandet medan medarbetarna efterfrågar möjligheter att lära genom praktiska övningar. Vidare används möten som en viktig arena för att utbyta kunskaper och erfarenheter. En stor del av arbetet på Rosen handlar om att följa rutiner, minimera avvikelser och säkerställa att de givna ramarna efterföljs. Det finns små möjligheter för medarbetarna att förändra eller ifrågasätta de förutsättningar som styr arbetet och verksamheten. Vidare anser vi att de värderingar och normer som finns i verksamhet styr och vägleder medarbetarna vilket kan begränsa lärande- och kunskapsmöjligheter. / Background: Learning is today considered to be of high relevance in terms of organizations' development and competitiveness in the market due to the rapidly changing environment. In a learning organization, learning is seen as a means to create a propensity for change within the organization, create innovation, adapt to the environment and to create competitive advantages. There is no agreed definition of organizational learning, nor how organizations act or should act to achieve this. Aim/purpose: The study has a dual purpose: First, it aims to examine the structure of organizational learning with respect to both planned and unplanned activities. This in order to see what characterizes learning and how activities can help employees to learn. Secondly, it aims to make recommendations that contribute to the improvement of learning. Methodology: To answer our purpose, a qualitative case study was conducted through semi-structured interviews and observations at the elderly housing Rosen. The study had an inductive approach where empirical data is the basis for the selection of theories. Conclusions: Through the study, we have identified both formal and informal learning activities. The focus from the organization is primarily on formal learning while employees are demanding opportunities to learn by doing. Meetings are an important arena for the exchange of knowledge and experiences. A big part of the tasks at Rosen involves following procedures, minimize deviations and ensuring that the terms of reference is followed. There is little if any room for the employees to review or question the prevailing situation and conditions that govern the work and operations. We believe that the organizations values and norms controls and guides the employees which can limit learning and knowledge opportunities.

The aim of this study is to describe and analyse an elderly care team’s prerequisite to anchor a salutogenic perspective and approach in an elderly care team in Kalmar municipality. The study identifies factors that could impede or promote the anchoring and examine how the organisation aims to work in a single direction even if the multidisciplinary team processes a diversity of knowledge, education and abilities. The study is based on qualitative semi-structured interviews from representatives of all professions in the multidisciplinary team; social workers, paramedical professions, nurses and care-givers. The theoretical frame consisted of a translating perspective, leadership and ideas of interaction and power. The anchoring will be impact by the team’s member’s background and relation to the new method and organization. Therefore is it vital that the multidisciplinary care team strive to achieve a consensus, a consensus of how the salutogenic perspective and approach in different ways will affect their work.

The position of middle-management is a role where the manager is at risk of being caught between its management and its employees. Elderly care is an industry that has been discussed a lot, to a large extent on how businesses should be managed and by whom it should be conducted. Middle-management in the business of elderly care thereby possess a vulnerable position in a controversial industry. In this study the aim is to investigate the managers' roles and tasks in both the public sector and the private sector in elderly care. It also aims to examine whether there are differences between the roles and how they in such cases is manifested. Previous researchers treats middle-managements role in elderly care as uniform for both sectors and focuses on the conditions and challenges. The theoretical background of the thesis is partly Ritzers McDonaldization to explain efficiency work in elderly care and Goffman's theories of social roles between the managerial role. The study was conducted through qualitative semi-structured interviews with nine interviews conducted, divided of five respondents in the public sector and four in the private sector. The result shows that the conditions for middle-management in elderly care for both sectors are similar in most cases, for example responsibilities and economic impact and that middle-management in both sectors experience a lack of time. However, there are certain areas that differ slightly, for example it is described by the private players that they have a better financial situation than their rivals in the public sector. It is also clear from the thesis that there may be other influential factors, for instance whether a home for the elderly run by public sector is exposed for competeition, or if a privately elderly care-unit is owned and fully run in-house. / Mellanchefsrollen är en utsatt roll där chefen riskerar hamna i kläm mellan sin ledning och sina medarbetare. Det är ett stressfyllt arbete. Äldreomsorgen är en bransch som diskuterats mycket, till stor del kring hur verksamheter ska skötas och i vilken regi den ska bedrivas. Mellanchefen inom äldreomsorgen besitter därmed en utsatt roll i en omdiskuterad bransch. I den här studien syftas att undersöka mellanchefers roller och arbetsuppgifter i den offentliga sektorn och privata sektorn inom äldreomsorgen. Syftet är även att undersöka om det finns skillnader mellan rollerna och hur de i sådana fall tar sig uttryck. Tidigare forskning behandlar genomgående mellanchefsrollen inom äldreomsorgen som enhetligt för båda sektorerna och redogör för förutsättningar och utmaningar. Den teoretiska bakgrunden i uppsatsen är dels Ritzers McDonaldization för effektiviseringsarbetet inom äldreomsorgen och Goffmans teorier om sociala roller för mellanchefsrollen. Studien är genomförd genom kvalitativa semistrukturerade intervjuer där 9 intervjuer har genomförts fördelat på 5 respondenter i offentlig sektor och 4 i privat sektor. Resultatet visar att förutsättningarna för mellanchefer inom äldreomsorgen inom båda sektorerna är likartade i de flesta fall, bland annat gällande ansvarsområden och ekonomisk påverkan samt att de i båda sektorerna känner stor tidspress. Vidare finns det vissa områden där det skiljer sig åt en aning, exempelvis redogör de privata aktörerna för att de har en bättre ekonomisk situation. Det framgår även av uppsatsen att det kan finnas andra påverksansfaktorer, bland annat om en verksamhet är konkurrensutsatt eller om verksamheten privat drivs i egen regi.