The study aims to describe and analyse how case managers reflect and act in the regards to self-determination when caring for residents with dementia diagnosis. Our main questions dealt with how the case managers handle the right to self-determination in relation to the residents’ relatives’ opinions when a person has dementia. To find answers to our questions, we interviewed seven care takers within elderly care in four different municipalitys in the Southern Sweden. We used qualitative interviews based on a semi-structured interview guide and two vignettes. The vignettes were based on two fictive narratives which both included persons with dementia but with different relatives and opinions. The purpose of the vignettes were to investigate whether there was different perceptions among the case managers in terms of consideration the residents’ self-determination in relation to their relatives. The results of the study were analyzed using Hasenfeld’s theory on Human service organizations, Lipsky’s street-level bureaucracy and Strauss’ negotiation-perspective. We displayed similarities to previous research showing that the case managers work with the residents’ best interest in mind even though relatives can be very obstinate. Our main conclusions are that the interpretation of self-determination is fluidity according to the case managers is fluidity and the case managers at some occasions try to persuade the person with dementia to apply for care and welfare. Furthermore can the relatives of the person with dementia be both beneficial and disadvantageous depending of the relation between them.

No description available.

The purpose of this study was to investigate how social workers within LSS relate to her professional space in the writing practice. The method we used to collect data was through qualitative semi structured interviews. Our study found that when there are no clear guidelines for writing an investigation text, the responsibility falls on the individual social worker. The social worker has the ability to customize the language so that a user with low reading comprehension understands, but they choose not to because they are hindered by a strong idea from the organization that a representative of a authority should write correctly and professionally, which becomes a form of power.

Although alcohol consumption among the elderly is rising this is still modestly noted. Care managers in elderly care come in contact with elderly people. The purpose with the study was therefore to examine how care managers experience the work with elderly people with alcohol problems and six qualitative interviews have been conducted. Empirical data has been analyzed with thematic analysis and linked to previous research and Hasenfelds theory about people-processing, people-sustaining and people-changing. The results show that care managers experience routines regarding elderly with alcohol problems, does not differ much from traditional elderly cases. These cases demand a higher level of cooperation between different departments, because they lack resources to help the elderly. Important factors in the work are considered to be motivational work, building a trust and a functioning interaction. They request more knowledge about elderly and alcohol, support from colleagues and the substance abuse unit are considered important. / Även om alkoholkonsumtionen bland den äldre generationen stiger är detta fortfarande blygsamt uppmärksammat. Biståndshandläggare inom äldreomsorgen kommer i kontakt med många äldre i sitt arbete. Syftet med studien var därför att undersöka hur biståndshandläggare upplever arbetet med äldre som har en alkoholproblematik. För att besvara studiens syfte har kvalitativa intervjuer genomförts med sex biståndshandläggare i skilda kommuner. Empirin har analyserats med tematisk analys och kopplats till tidigare forskning samt Hasenfelds teori om people-processing, people-sustaining och people-changing. Resultatet visar att biståndshandläggare upplever att det som skiljer ärenden rörande äldre med alkoholproblematik rutinmässigt från traditionella äldreomsorgsärenden är att de kräver en högre grad av samverkan mellan olika funktioner då biståndshandläggare inte besitter resurser att hjälpa dessa äldre. Viktiga faktorer i arbetet anses vara motivationsarbete, skapa en förtroendefull relation och uppnå en fungerande samverkan. Biståndshandläggarna efterfrågar mer kunskap om äldre och alkohol och stöd från kollegor samt missbruksenheten upplevs vara viktigt.

Föreliggande studies syfte var att undersöka biståndsläggarens arbete för att minska ensamhet och social isolering hos äldre personer. En kvalitativ explorativ design användes och materialet till studien samlades in genom semistrukturerade intervjuer med sex biståndshandläggare. Genom en tematisk analys framkom fyra huvudteman: vad är ensamhet och social isolering, identifiering och information, betydelsen av insatser och sociala sammanhang samt biståndshandläggaren och den äldre personen. Sammanfattningsvis beskriver de intervjuade biståndshandläggarna att ensamhet och social isolering kan förebyggas och minskas genom kommunala insatser men att den viktigaste faktorn är närheten till familj och sociala nätverk. Biståndshandläggarna beskriver också att de kan uppleva maktlöshet, både i förhållande till den enskilde och i förhållande till riktlinjer och brist på resurser inom den egna verksamheten. Maktlösheten kopplas i diskussionsavsnittet till Lipskys teori om frontlinjebyråkrater. Trots de utmaningar som finns är biståndshandläggarna överens om att de har en viktig och betydande roll i arbetet för att tillgodose den enskildes behov. / The aim of this study was to investigate the care managers’ work to reduce loneliness and social isolation in older people. A qualitative exploratory design was used and the material for the study was collected through semi-structured interviews with six care managers. Through a thematic analysis, four main themes emerged: "what is loneliness and social isolation", "identification and information", "the importance of activities and the social context" and "the care manager and the older person". In summary, the interviewed care managers describe that loneliness and social isolation can be prevented and reduced through governmental interventions, but the most important factor is proximity to family and social networks. Moreover, the care managers describe that they can experience impotency, both in relation to the individual client and in relation to framework and lack of resources within their own operation. The impotency is discussed in relation to Lipsky's theory of street level bureaucrats. Despite the challenges that exist, the care managers agree on the importance and significance of their role in working to meet the individual’s needs.

<p>This essay is about needs assessors within public elder care. The method is a quantitative vignette study. The aim of the study is to find out whether there is an existing consensus among the needs assessors when a relative to a client with reduced cognitive functions wants to make an application even though the client does not want to. We also wanted to find out whether there are any underlying circumstances which have influence on the needs assessors’ reactions to this specific situation. We used a questionnaire which consisted of four vignettes that illustrated a meeting between a needs assessor, a client and a relative to the client. The vignettes was complemented with questions that made it possible to find underlying circumstances that determine whether the needs assessors do accept the application from the clients relative. The result shows that professional experience and education is significant for whether the needs assessors choose to accept the application or not. It is also clear that there are variations depending on which town district the needs assessors work in. In some town district the needs assessors act with great similarity while there are huge differences in other town districts.</p>

This essay is about needs assessors within public elder care. The method is a quantitative vignette study. The aim of the study is to find out whether there is an existing consensus among the needs assessors when a relative to a client with reduced cognitive functions wants to make an application even though the client does not want to. We also wanted to find out whether there are any underlying circumstances which have influence on the needs assessors’ reactions to this specific situation. We used a questionnaire which consisted of four vignettes that illustrated a meeting between a needs assessor, a client and a relative to the client. The vignettes was complemented with questions that made it possible to find underlying circumstances that determine whether the needs assessors do accept the application from the clients relative. The result shows that professional experience and education is significant for whether the needs assessors choose to accept the application or not. It is also clear that there are variations depending on which town district the needs assessors work in. In some town district the needs assessors act with great similarity while there are huge differences in other town districts.

Syftet med denna uppsats var att beskriva hur socialarbetarens yrkesroll och yrkesidentitet kan konstrueras i uppdraget som biståndshandläggare och i förhållande till rådande diskurser inom området. Kunskapsläget inom fältet visade att arbetet som biståndshandläggare är komplext och att det därför kan vara svårt att arbeta på det sätt lagen föreskriver. Dels beroende på att den ideologiska och ekonomiska samhällsutvecklingen kan leda till lagändringar och organisatoriska förändringar, dels beroende på hänsynstagandet till det allmänna intresset. Studiens empiriska material utgörs av intervjuer med fem biståndshandläggare/socialsekreterare, varav den ena inte hade ett myndighetsutövande uppdrag. Ett diskursteoretiskt perspektiv användes som verktygslåda för att analysera socialsekreterarnas utsagor och för att besvara studiens syfte och frågeställningar. Studiens resultat visade på att yrkesrollen konstrueras diskursivt, avhängigt kontexten och i förhållande till organisationens uppdrag för den enskilde socialsekreteraren. Socialarbetaridentiteten/ identiteterna tillskrevs olika former av betydelser men också olika former av diskursiva krav och förväntningar på både beteende och handlande. / The aim of this study was to describe how the social worker’s professional role and work identity can be constructed in the case manager’s assignments and in relation to the existing discourses in the field. Previous research in this field has shown that a case manager’s work is complex and that it can be difficult to perform their assignments according to the law. Partly because of the ideological and economic development in society, which might lead to changes in the organization, and partly due to the consideration of public interest. The empirical part of the study consists of interviews with five social workers. One of these social workers did not have a regulatory exercise assignment. To reach the aim of the study, a theoretical discourse perspective was used. The result showed that the work identity of the case manager is constructed through the discourses of the context and in relation to the assignments given to each case officer from the organization. The social worker identity was assigned with different meanings and different discursive requirements and expectations regarding how to behave and act.

This study aims to understand how care managers approach consent and user influence related to older people with dementia. The study was conducted through qualitative interviews with individual care managers and with a hermeneutic approach. We have interviewed ten care managers in smaller municipalities whom are experienced in their profession and have been in contact with older people with dementia. throughout all the interviews, we had a semi-structured interview guide at our disposal, and after all the interviews were conducted, we analyzed them with the hermeneutic circle and theoretically analyzed the material with Lipsky´s theory about street level bureaucracy, acting space and, what we call it, the social service as a last resort and finally with Johansson´s theory of client relationships. Our main conclusions regarding consent is that care managers need to relate to the law simultaneously have the individual needs and wishes in regards. Also, the care managers have a few ways to circumvent the absolute that the individual needs to give his or hers consent to everything. Our main conclusions regarding user influence is that the care managers need to use other professions for information regarding the individual, such as nurses, carers, dependants and so on. They also prefer to get in touch with the individual whom is diagnosed with dementia as early into the disease as possible to get to know them and learn how they want their care to be. As a last conclusion about the whole study is that the care managers find working with older people with dementia is a vastly difficult task, and they need to rely on dependants, other professions and have a lot of knowledge about the individual.

Syftet med denna kvalitativa studie var att undersöka hur biståndshandläggare upplever det möjligt att tillgodose självbestämmanderätten för äldre personer med demenssjukdom. Studien utgår ifrån en tvärsnittsdesign med semistrukturerade intervjuer med sex målstyrt utvalda biståndshandläggare. Genom en tematisk analys framkom två huvudteman arbetsrollens vardag och en lång process. Huvudtemana innehåller subteman vilket vidare beskriver det som utmärker upplevelsen. Studiens resultat tolkades i förhållande till Lipskys teori om frontlinjebyråkrater. Självbestämmande uttrycktes av biståndshandläggarna som något tidskrävande, utmanande och problematiskt. Vägen till självbestämmandet beskrivs som krokig och varierande, biståndshandläggarna fann sinsemellan liknande sätt att agera för att nå självbestämmande för individen. Arbetets komplexitet och svårighet till trots upplevdes arbetsrollen som spännande och tillfredsställande. / The purpose of this qualitative study was to investigate how care managers find it possible to assure the self-determination of older people with dementia. The study employed a cross-sectional survey design with semi-structured interviews of six purposively sampled care managers. Through a thematic analysis, two main themes emerged, the work role’s everyday routine and a long process. The main themes containeds sub-themes which further elaborated the care managers’ experience. The results of the study were interpreted from the perspective of Lipsky’s theory of street-level bureaucrats. Assuring self-determination was experienced by the care managers as time-consuming, challenging and problematic. While the path to self-determination was tortuous and varied, the care managers found similar ways to act in order to achieve self-determination. Despite the impression of the work as complex and difficult it was experienced as an exciting and satisfying job.