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  • 1.
    Harnett, Tove
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    Everyday day life and power relations in elder care2010Ingår i: The Stig Berg Symposium at 20 NKG Iceland: From Genes to Society - A Life Career in Research Caring for Aging and the Elderly, 2010Konferensbidrag (Refereegranskat)
  • 2.
    Harnett, Tove
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    Identity troubles as elder mistreatment?2010Konferensbidrag (Refereegranskat)
    Abstract [en]

    The person-centered care approach has gained increasing attention during the last years. Yet, little is known about different aspects of the construction of personhood and identity in concrete situations in elder care. Is the identity of an older person seen as changeable or stable by staff and family members? In this study I explore identity and elder mistreatment from the family members’ view, by using data from 21 in-depth interviews with relatives of care recipients. The specific aims are: 1) to explore the normative grounds (warrants) family members use in their arguments about mistreatment; and 2) to discuss how warrants can be used to gain understanding about conflicts between staff’s and family’s opinions of caring arrangements.

    The analysis revealed that family members continually positioned themselves as guardians of identity through their claims of mistreatment. Several claims about mistreatment were grounded in the opinion that the older person’s identity should be maintained while he or she receives formal care. For instance, one woman described her husband as an intellectual, who had studied Russian at the university after he retired. The woman claimed that her husband was victim for elder mistreatment, because the staff only offered him to play Bingo, which was not in line with his person.

    The family members were found to back claims about staff members’ violation of a care recipient’s identity by using arguments involving their unique knowledge of the care receiver´s appearance, daily routines, and preferred activities. What was elder mistreatment for one particular person was, according to this argumentation, not necessarily mistreatment for someone else.

    The study exposes considerable difficulties in introducing objective criteria for what elder mistreatment is and how mistreatment should be objectively measured. It also reveals problematic aspects in the person-centered care approach if taking for granted a stable or unambiguous identity.

  • 3.
    Harnett, Tove
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    Seeking exemptions from nursing home routines: Residents' everyday influence attempts and institutional order2010Ingår i: Journal of Aging Studies, ISSN 0890-4065, E-ISSN 1879-193X, Vol. 24, nr 4, s. 292-301Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Using ethnographic data collected from a Swedish nursing home, this article analyzes residents’ everyday or subtle influence attempts relative to the maintenance of institutional routines. Residents’ efforts to carve out some autonomy or fulfill personal preferences in everyday matters could be categorized as (1) disruptions, (2) disturbances, or (3) “good matches” relative to ongoing and up-coming nursing home routines. Striking disruptions were often fruitless, while attempts rendered as disturbances were typically postponed or modified. In general, the outcomes of residents’ maneuvers were shaped by brief and situational negotiations of whether (and how) temporary exemptions from the institutional order were deemed accountable or not by the staff. Although staff sometimes arranged situations in which residents were given some defined or symbolic decision-making authority, the findings of this study show how an inflexible local routine culture can constitute a constraining and only occasionally porous framework for residents’ self constructions and everyday life.

  • 4.
    Harnett, Tove
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    The Trivial Matters: Everyday power in Swedish elder care2010Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    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.

  • 5.
    Harnett, Tove
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    Jönson, Håkan
    Socialhögskolan, Lunds Universitet.
    That’s not my Robert!: Identity maintenance and other warrants in family members’ claims about mistreatment in old age care2010Ingår i: Ageing & Society, ISSN 0144-686X, E-ISSN 1469-1779, Vol. 30, nr 4, s. 627-647Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study has explored how family members of care recipients define and sustain claims of mistreatment in old-age care. Twenty-one informants were recruited from an association of relatives of care recipients in Sweden. Using argumentation analysis, four warrants about mistreatment were identified from the qualitative interview data: they referred to physical harm, psychological harm, social-care deficiencies and identity subversion. The first three categories are similar to those recognised in previous research on elder mistreatment, but the fourth, which is described in detail in the article, is less familiar : eldermistreatment as the violation of an older person’s identity. The family members backed their claims about staff members’ violation of a care recipient’s persona or identity by using arguments that drew on their unique knowledge of the care recipient’s appearance, daily routines and preferred activities. They also described their attempts to protect the dignity and identity of a care recipient, their fears of abuse, and actual cases of conflict and retribution by care staff. They consistently positioned themselves as guardians of identity through their claims of mistreatment. The study provides important knowledge about family members’ moral view of elder mistreatment, which may enhance the understanding of conflicts between formal care providers and family members.

  • 6.
    Harnett, Tove
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    Larsson, Birgitta
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    Äldre människors rättigheter.2011Ingår i: Äldre och åldrande.: Grundbok i gerontologi / [ed] Marie Ernsth Bravell, Stockholm: Gothia Förlag AB , 2011, s. 243-260Kapitel i bok, del av antologi (Övrig (populärvetenskap, debatt, mm))
  • 7.
    Persson, Tove
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi.
    Klagomålshantering – ett led i att höja kvaliteten eller prat om bagateller?2009Ingår i: Äldre i centrum, ISSN 1401-5110, nr 2, s. 14-15Artikel i tidskrift (Övrig (populärvetenskap, debatt, mm))
    Abstract [sv]

    På kommunernas hemsidor uppmanas äldre att klaga och komma med synpunkter. Klagomål beskrivs som ett värdefullt led för att förbättra verksamheten. Men hanteringen är rörig  och klagomålen bagatelliseras av ansvariga chefer, visar forskning från Hälsohögskolan i Jönköping.

     

    ”De klagar mest på småsaker, att hemtjänsten inte kommer ibland och så där”, sade en av de socialchefer jag intervjuade i mitt avhandlingsarbete, där de får beskriva äldres klagomål och den kommunala klagomålshanteringen. Klagomål är intressanta, eftersom vi genom att klaga kan utöva inflytande och påverka saker vi är missnöjda med. Om vi är missnöjda med brödet vi köpt på bageriet, kan vi antingen gå tillbaka och klaga eller köpa brödet någon annanstans. Även om äldre i teorin kan välja mellan att klaga eller att ”rösta med fötterna”, så byter man i praktiken inte äldreboende eller hemtjänstutförare på samma sätt som man byter bageri. Således återstår i stort sett bara klagomålsmöjligheten för äldre som vill uttrycka missnöje.

  • 8.
    Persson, Tove
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    “My Father Always Used to be Properly Dressed!”: Family Members as Guardians of Identity in Claims-Making about Mistreatment2008Konferensbidrag (Refereegranskat)
    Abstract [en]

    This study explores how family members define mistreatment in formal old age care. Twenty-one interviewees were recruited from a Swedish association for relatives of care recipients. Argumentation analysis was used and four warrants (normative grounds) was identified in family members’ argumentation about mistreatment. The warrants used were based on physical harm, psychological harm, social deficiencies and identity subversion. Particular interest was devoted to a how family members described elder mistreatment as the violation of an older person’s identity and to the way interviewees claimed that the older person’s identity and habits should be maintained while he or she receives formal care. The warrants used by family members show how difficult it is to objectively assess what elder mistreatment is (and not is) and how to measure it. In relation to staff, some family members take on a role as guardians of dignity. This has implications for how staff choose to understand and react to complaints and suggestions for change. Our analysis indicates that family members’ complaints about matters, which staff sees as “petty details”, can be interpreted as part of a greater project of guarding and preserving the identity and personality of the older person.

  • 9.
    Persson, Tove
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi.
    Berg, Stig
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi.
    Older people's 'Voices' on Paper: A Case Study of Sweden2008Ingår i: Transforming elderly care at local, national and transnational levels: International conference at the Danish National Centre for Social Research (SFI), Copenhagen, 26-28 June 2008, 2008Konferensbidrag (Refereegranskat)
    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.

  • 10.
    Persson, Tove
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    Jönson, Håkan
    Department of Social Work, Lund University.
    Family Members' Claims about Mistreatment in Old Age2008Konferensbidrag (Refereegranskat)
    Abstract [en]

    The aim of the study was to explore how family members of care recipients define mistreatment in old age care. Twenty one interviewees where recruited from a Swedish association for relatives of care recipients. Using argumentation analysis, four warrants about mistreatment were identified—warrants about physical harm; warrants about psychological harm; warrants about social deficiencies; and warrants about identity subversion. Particular interest was devoted to the way family members backed claims about the violation of a care recipients’ person or identity by using arguments about a unique knowledge of appearance, daily routines and preferred activities. Family members also related incidents from attempts to guard the dignity and identity of a care recipient to fear of and actual cases of conflict and retribution from members of the caring staff. The study provides important knowledge about the phenomenon of mistreatment and may enhance the understanding of conflicts between formal care providers and family members.

  • 11.
    Persson, Tove
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    Stig, Berg
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi.
    Older people's "voices" - On paper: Obstacles to influence in welfare states - A Case Study of Sweden2009Ingår i: Journal of Aging & Social Policy, ISSN 0895-9420, E-ISSN 1545-0821, Vol. 21, nr 1, s. 94-111Artikel i tidskrift (Refereegranskat)
    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.

  • 12.
    Persson, Tove
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi.
    Wästerfors, David
    Department of Sociology, Lund University, Sweden.
    Such trivial matters!: How nursing home staff accounts for restrictions of residents’ influence2007Ingår i: 7th Conference on Advances in Health Care Science Research, 2007Konferensbidrag (Refereegranskat)
    Abstract [en]

    National policies emphasize older people’s right to autonomy, yet nursing home residents often have restricted opportunities to make decisions about everyday matters. We use qualitative interview data to analyze staff members’ explanations of actions that conflict with both social norms and national policies. Two types of problematic actions are discussed: restrictions of elderly residents’ influence in decision making and neglect of residents' complaints. While staff members describe residents’ influence as desirable, they simultaneously formulate accounts that justify their inability to live up to this ideal. Further, we demonstrate how certain complaints are “made trivial” when they are described and treated in particular ways by the staff. We argue that the accounts offered by staff members draw on an implicit folk logic, a logic in which residents are allowed to exercise influence only as long as it does not conflict with the efficient running of the institution as a whole.

  • 13.
    Persson, Tove
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    Wästerfors, David
    Sociologiska institutionen, Lunds universitet.
    Such Trivial Matters: How staff account for restrictions of residents' influence in nursing homes2009Ingår i: Journal of Aging Studies, ISSN 0890-4065, E-ISSN 1879-193X, Vol. 23, nr 1, s. 1-11Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    National policies emphasize older people’s right to autonomy, yet nursing home residents often have restricted opportunities to make decisions about everyday matters. We use qualitative interview data to analyze staff members’ explanations of actions that conflict with both social norms and national policies. Two types of problematic actions are discussed: restrictions of elderly residents’ influence in decision making and neglect of residents' complaints. While staff members describe residents’ influence as desirable, they simultaneously formulate accounts that justify their inability to live up to this ideal. Further, we demonstrate how certain complaints are “made trivial” when they are described and treated in particular ways by the staff. We argue that the accounts offered by staff members draw on an implicit folk logic, a logic in which residents are allowed to exercise influence only as long as it does not conflict with the efficient running of the institution as a whole.

1 - 13 av 13
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