People with dementia are commonly in need of some form of social care from the social services in order to manage their everyday situations. However, social services are shaped by the construction of policy targets. The aim of this dissertation is to explore the social citizenship for people with dementia. Social citizenship for people with dementia is explored by studying how people with dementia, in policy documents, have been constructed as a target group and also by studying how policies are enacted in practice by care managers, in their work and in their meetings with people with dementia. This is illustrated by studying policy documents from national level which range over nearly 40 years and 19 interviews with care managers. It is shown that, if and when, people with dementia are visible in policy documents, they commonly have a negative construction based on their cognitive and communicative abilities, as a burden, disturbing and incapable. It is further investigated how street-level bureaucrats, in this case care managers, experience meeting with people with dementia when they apply for social services. It is shown that care-managers experience difficulties concerning this group comprised of the exchange of information between care managers and people with dementia, refusal of social services by the person, the influence of relatives and other professions as well as moral dilemmas, such as the relations between the person with dementia and their relatives. The study shows that care managers have little support from policies, e.g. legislation and guidelines, in how to handle these dilemmas, and must thus create their own local ways of handling these situations. Care managers are thus influential policy actors concerning the policy target group of people with dementia. The policy processes which this dissertation illustrates, affect the social citizenship of people with dementia. It is shown that they, to an extent, have difficulties in influencing their own everyday situation concerning social services. Finally, the policy processes, will affect their possibility to influence their social citizenship. / Personer med demenssjukdom behöver vanligtvis någon form av socialt stöd från socialtjänsten för att kunna hantera sin egen vardag. Emellertid så är socialt stöd format av konstruktionen av policymålgrupper. Syftet med denna avhandling är att undersöka det sociala medborgarskapet för personer med demenssjukdom genom att studera hur dessa personer, som policymålgrupp, har konstruerats i policydokument samt hur policys iscensätts i praktiken av biståndshandläggare inom socialtjänsten, i deras arbete och i deras möten med personer med demenssjukdom. Detta belyses genom studier policydokument på nationell nivå som spänner över nästan 40 år samt intervjuer med 19 biståndshandläggare. Studien visar att om och när personer med demenssjukdom är synliga i policydokument så har de vanligtvis en negativ konstruktion som baseras på deras kognitiva- och kommunikativa förmågor, som betungande, störande och inkapabla. Vidare undersöks i denna avhandling hur gräsrotsbyråkrater, i form av biståndshandläggare, upplever mötet med personer med demenssjukdom då de ansöker om socialt stöd från socialtjänsten. Det visas att handläggare upplever svårigheter i deras möten med denna grupp. Svårigheterna ligger i utbytet av information mellan handläggare och personen med demens, vägran från personen att ta emot stöd, inflytande från anhöriga och andra professioner samt moraliska dilemman som relationen mellan personen med demenssjukdom och anhöriga. Handläggare har lite stöd från policys, såsom lagar och riktlinjer, i hur de ska hantera dessa svårigheter och måste således hitta egna, lokala, sätt att hantera dessa situationer. Handläggare är således inflytelserika policyaktörer rörande policymålgruppen personer med demenssjukdom. De policyprocesser som avhandlingen berör påverkar det sociala medborgarskapet för personer med demenssjukdom. Det visas att de, till viss del, har svårigheter att påverka sin egen vardag i relation till stöd från socialtjänsten. Slutligen påverkar policyprocesser möjligheten för personer med demens att påverka sitt sociala medborgarskap.

This dissertation examines how perceptions of competence affect the care of older persons, and the values ​​and vocational conceptions of care work and care recipients that are tied to the perceptions of what skills that are needed and why. Competence is defined by three parts with relevance for the content of care work: what knowledge the care workers should have, what tasks they should perform and how they should respond to care recipients. The aim of this dissertation is to analyse how the care managers' and care workers' perceptions of competence form the direction of the care work and how that direction relates to the care recipients’ perceptions of and expectations on the care work.   The care work is characterised by what is analysed as an activation of the recipients - that the recipients themselves should perform as much of the care work as possible. The activation aims at managing the decay of the aging body and is motivated by a vocational conception of the care recipients as different from others, with designations as grateful and passive. This conception is analysed as generation character based on an idea among the care managers and care workers that the society in which the recipients grew up gave them certain cognitive prerequisites that have to be managed in the practical care work.   The care recipients in the study have opposing conceptions and perceptions of care work compared with the care managers and care workers. The recipients’ central objective with the care work is to prevent what has been interpreted as the disrepair of the home. The care recipients’ position in the organisation raises the problem of loyalty towards the care workers and in some sense the care managers. Their loyalty reduces their ability to complain and to influence their situation to the better.   Keywords: care of older persons, care needs, care work, care relationship, care receivers, care workers, care managers, competence, technologies, activation, generation character

Previous studies show that elderly people with mental illness tend not to have their needs met due to lack of interaction between authorities (Grundberg, Hansson, Religa & Hillerås 2016). The purpose of this study is therefore to investigate what care managers in social psychiatry and elderly care experience affect their work and collaboration between them. In this way, we want to create a deeper understanding of how work and collaboration affect the care of older people with mental illness. This qualitative study is based on semi-structured interviews with six care managers. We have used a thematic analysis to analyze our empirical material. Through transcription and reading of the empirical material, we have highlighted quotations that have identified repetitions, similarities and differences that have since shaped themes. Furthermore, the material was analyzed based on theories of collaboration (Danermark & Kullberg 1999; Grape 2015) and Lipsky's street level bureaucracy. Our study shows that care managers feel that collaboration is a prerequisite for being able to meet the needs of elderly people with mental illness, but opinions differ on whether the support needs of the target group are actually met. Collaboration between social psychiatry and elderly care is generally perceived to work well, even though our results show some contradictions to this claim. Finally, the study shows that collaboration and social work is influenced by various factors such as proximity and distance, as well as laws and guidelines and knowledge about these. These factors affect the care manager's room for manoeuvre and professional identity, which is also perceived to affect the possibilities for collaboration. Collaboration, room for manoeuvre and professional identity seem to be related and through interaction all parts form a whole.