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Older people's "voices" - On paper: Obstacles to influence in welfare states - A Case Study of Sweden
Jönköping University, School of Health Science, HHJ, Institute of Gerontology. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
Jönköping University, School of Health Science, HHJ, Institute of Gerontology.
2009 (English)In: Journal of Aging & Social Policy, ISSN 0895-9420, E-ISSN 1545-0821, Vol. 21, no 1, p. 94-111Article in journal (Refereed) Published
Abstract [en]

The official rhetoric of welfare states unconditionally pays tribute to older people’s right to express dissatisfaction. In practice, users of ‘older service’ in welfare states may be deprived of their ‘exit’ option and face considerable constraints when it comes to raising their ‘voices’. For example, when older people in nursing homes would like to lodge a complaint, they may well be referred to the very staff members they depend upon in their everyday life. This article analyses a national case in which these contradictory tendencies are especially explicit: formal influence channels for older people in Sweden. Using data from structured interviews with 100 representatives of Swedish municipalities, and drawing on Hirschman’s (1970) theory on exit and voice, the article analyses obstacles for older service users’ influence in Sweden and develops explanations for these obstacles in terms of social contexts.

Place, publisher, year, edition, pages
2009. Vol. 21, no 1, p. 94-111
Keywords [en]
influence, exit, voice, older people, welfare state, Sweden
National Category
Other Social Sciences not elsewhere specified
Identifiers
URN: urn:nbn:se:hj:diva-5372OAI: oai:DiVA.org:hj-5372DiVA, id: diva2:36192
Available from: 2008-02-28 Created: 2008-02-28 Last updated: 2017-12-12Bibliographically approved
In thesis
1. The Trivial Matters: Everyday power in Swedish elder care
Open this publication in new window or tab >>The Trivial Matters: Everyday power in Swedish elder care
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This is a study about fairly ordinary situations in elder care: how staff deal with older people’s influence, how staff talk about older people’s complaints, how family members talk about elder mistreatment, and how older people act in order to exert influence in a nursing home. However ordinary, these are situations where relational power is accentuated, accomplished and able to be empirically explored. The aim here is to analyze power and influence as social phenomena in elder care. More specifically, the aims are 1) to analyze the political and bureaucratic frame in which older people have formal “voice” options; 2) to analyze staff members’ “folk logic” as they respond to residents’ complaints in Swedish nursing homes; 3) to analyze how family members of care recipients define and sustain claims of elder mistreatment; and 4) to ethnographically depict how older people’s attempts at influence unfold in everyday interactions in a nursing home and how these attempts can be understood in the context of a “local routine culture.”

Several kinds of empirical material have been used: 100 structured telephone interviews with local municipal officials, 13 qualitative interviews with nursing home staff, 21 interviews with family members of care recipients, and ethnographic data comprised of field notes and field-based interviews from five months of observation in a nursing home.

The findings demonstrate the difficulties of turning policies about older people’s influence into practice. Yet, the main finding is not the “policy–practice gap” per se, but rather an understanding of how this gap is situationally shaped and maintained. The dissertation shows how the subtleties of actions and talk have powerful implications, and can constitute barriers to older people’s influence. Two examples are the “rhetoric of trivialization” and a “local routine culture”; both can easily and quite inconspicuously restrict older people’s autonomy and influence. A routine culture is a locally and situationally generated action repertoire and as such provides an understanding of how routines shape power relations in a nursing home. The findings also show how a rhetoric of trivialization can function as a power resource, through which older people’s and family members’ views are “made trivial” by the ways they are described and rhetorically treated by staff and local officials. Through the use of trivializing accounts, staff members legitimized their neglect of complaints and restrictions of older people’s influence. The study argues that by recognizing how older people’s influence is “made trivial,” we gain an understanding of how to accomplish just the opposite. Local routines and accountability practices have a strong inertia, but the findings indicate that if actors reframe influence and complaints, they may substantially affect power relations in elder care.

Place, publisher, year, edition, pages
Jönköping: Intellecta infolog, 2010
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 9
National Category
Other Social Sciences not elsewhere specified
Identifiers
urn:nbn:se:hj:diva-11674 (URN)978-91-85835-08-9 (ISBN)
Public defence
2010-03-26, Forum Humanum, Hälsohögskolan, Box 1026, 551 11, Jönköping, 13:00 (English)
Opponent
Supervisors
Available from: 2010-03-02 Created: 2010-03-01 Last updated: 2013-01-14Bibliographically approved

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