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Olaison, A. & Nilsson, E. (2025). Hitta vägar runt det svåra- biståndshandläggares möten med äldre par med demenssjukdom. In: Hanna Mac Innes och Helena Bjurbäck (Ed.), Socialt arbete med äldre människor: att se både utmaningar och möjligheter (pp. 136-151). Stockholm: Liber
Open this publication in new window or tab >>Hitta vägar runt det svåra- biståndshandläggares möten med äldre par med demenssjukdom
2025 (Swedish)In: Socialt arbete med äldre människor: att se både utmaningar och möjligheter / [ed] Hanna Mac Innes och Helena Bjurbäck, Stockholm: Liber, 2025, p. 136-151Chapter in book (Refereed)
Abstract [sv]

När biståndshandläggare möter äldre par där det finns en demenssjukdom behöver de balansera olika perspektiv och behov. I kapitlet presenteras biståndshandläggares berättelser av hur de hanterar svåra situationer i behovsbedömningsmöten.  

Place, publisher, year, edition, pages
Stockholm: Liber, 2025
National Category
Social Work
Identifiers
urn:nbn:se:liu:diva-210831 (URN)9789147152704 (ISBN)
Projects
Förbättrade samtal i äldreomsorgen: Implementering av en forskningsbaserad metod för utredande samtal med äldre par.
Funder
The Kamprad Family Foundation, 20210209
Available from: 2025-01-08 Created: 2025-01-08 Last updated: 2025-03-06Bibliographically approved
Nilsson, E., Olaison, A., Taghizadeh Larsson, A. & Hjalmarsson Österholm, J. (2024). ‘Control or support?’ Professional roles and judgements in problem solving in adult social work team conferences. Journal of Social Work Practice, 38(4), 387-408
Open this publication in new window or tab >>‘Control or support?’ Professional roles and judgements in problem solving in adult social work team conferences
2024 (English)In: Journal of Social Work Practice, ISSN 0265-0533, E-ISSN 1465-3885, Vol. 38, no 4, p. 387-408Article in journal (Refereed) Published
Abstract [en]

The purpose of this paper is to explore how care managers in team conferences jointly solve problems related to difficult cases involving clients with cognitive decline, focusing specifically on their professional roles and judgements. Team conferences in a Swedish social work setting mean that social workers assess and interpret previously collected information and discuss how to proceed with cases. We use conversation analysis to study two case sequences from 137 audio-recorded cases, focussing on professional judgements and accomplishing agreement. We show how care managers make use of different conversational practices, such as hypothetical talk and shared authority as a 'we' when conveying institutional routines, as well as when providing support to care managers. We also show how the care managers make use of expanding techniques that challenge their manager's advice. This paper offers new perspectives on how organisational norms are reproduced and how shared professional judgements are accomplished.

Place, publisher, year, edition, pages
ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD, 2024
Keywords
Team conference; cognitive decline; professional judgements; adult social work; conversation analysis
National Category
Social Work
Identifiers
urn:nbn:se:liu:diva-209988 (URN)10.1080/02650533.2024.2420902 (DOI)001361570700004 ()2-s2.0-85209922558 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2019-00610
Note

Funding Agencies|Forskningsradet om Halsa, Arbetsliv och Valfard [2019-00610]

Available from: 2024-11-22 Created: 2024-11-22 Last updated: 2025-05-01
Ekström, A., Nilsson, E. & Majlesi, A. R. (2024). You Know This Better: Interactional Challenges for Couples Living with Dementia when the Epistemic Status Regarding Shared Past Events Is Uncertain. In: Peter Muntigl, Charlotta Plejert, Danielle Jones (Ed.), Dementia and Language: The Lived Experience in Interaction (pp. 226-248). Cambridge University Press
Open this publication in new window or tab >>You Know This Better: Interactional Challenges for Couples Living with Dementia when the Epistemic Status Regarding Shared Past Events Is Uncertain
2024 (English)In: Dementia and Language: The Lived Experience in Interaction / [ed] Peter Muntigl, Charlotta Plejert, Danielle Jones, Cambridge University Press, 2024, p. 226-248Chapter in book (Refereed)
Abstract [en]

In this chapter, we investigate how a couple where one of the spouses is diagnosed with dementia handle challenges in narrations of past shared events that arise when the spouse with dementia has limited access to these events. Partners of people diagnosed with dementia recurrently have to take into consideration that their spouse may not remember details in stories they tell, even though the person with dementia is a main participant in the events being retold. The design of such stories is complex as the interactants must keep track of both the content of the story and manage the potential sensitivity of telling a story that should already be known to both spouses. We show how the spouse without dementia (re)organizes the participation framework in resourceful ways and delicately deals with her spouse’s limited memory using a variety of face-saving practices. The analyses highlight how issues related to knowledge and dementia can benefit from using an interactional and distributed perspective. While access and rights to knowledge is usually divided between participants depending on the knowledge domain and the participants’ relation to the topic, in the case of a dementia disease a more flexible approach towards such divisions could be advantageous.

Place, publisher, year, edition, pages
Cambridge University Press, 2024
Series
Studies in Interactional Sociolinguistics
Keywords
joint storytelling; distributed perspective; participation framework; unclear epistemic status; face-saving practices
National Category
Health Sciences
Identifiers
urn:nbn:se:liu:diva-212905 (URN)10.1017/9781108339377.015 (DOI)9781108424530 (ISBN)9781108339377 (ISBN)
Available from: 2025-04-09 Created: 2025-04-09 Last updated: 2025-06-12Bibliographically approved
Nilsson, E. & Olaison, A. (2023). “I See What You Mean”—A Case Study of the Interactional Foundation of Building a Working Alliance in Care Decisions Involving an Older Couple Living with Cognitive Decline. Healthcare, 11(15), Article ID 2124.
Open this publication in new window or tab >>“I See What You Mean”—A Case Study of the Interactional Foundation of Building a Working Alliance in Care Decisions Involving an Older Couple Living with Cognitive Decline
2023 (English)In: Healthcare, E-ISSN 2227-9032, Vol. 11, no 15, article id 2124Article in journal (Refereed) Published
Abstract [en]

Background: Social workers have a key role in needs assessment meetings with families dealing with dementia, providing information, support, and advocacy, while also assessing needs and making decisions about care services for several parties. These contacts are especially important during the introduction of home care services, where often the person has previously relied on informal support from relatives. The needs assessment process entails the involvement of all present parties, with the aim to reach a mutual agreement, a working alliance, regarding which services to apply for. Purpose: The aim of this case study is to explore how the participants, by means of different conversational practices, jointly create a working alliance between the different parties in one family. The study provides insights into the process of co-constructing a working alliance in the needs assessment process for elder care services. Methods: This article addresses the process by which social workers build a working alliance in a multi-party conversation with a family living with cognitive decline; a meeting that lasted 50 min. In this case study, we benefit from an inductive and detailed conversation analytic methodology. The theoretical framework of working alliances in institutional interaction has informed the analysis. Results: The findings illustrate how the social worker in this case study involves all parties in the decision regarding care services and explores the use of the conversational practices of mitigations, positive framing, adding information, and positioning, as a “we” achieve mutual agreement toward the end of several sequences. Conclusions: Drawing on the results of this case study, we argue that multi-party interaction involving relatives enables diversity in role-taking, where the professional, for instance, can pursue a more empathic role. Also, our results indicate that minimal agreement to a proposal is sufficient in a multi-party interaction involving clients with cognitive decline.

Place, publisher, year, edition, pages
MDPI, 2023
Keywords
dementia; families; needs assessment meetings; social work; the working alliance; conversation analysis; case study
National Category
Social Work
Identifiers
urn:nbn:se:liu:diva-196458 (URN)10.3390/healthcare11152124 (DOI)001045437200001 ()37570364 (PubMedID)2-s2.0-85167838608 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2019-01069
Note

Funding agencies: The work is supported by funding from the Swedish Research Council for Health, Working Life, and Welfare (2019-01069) and the Kamprad Family Foundation for Entrepreneurship, Research, and Charity (2021-0209)

Available from: 2023-08-07 Created: 2023-08-07 Last updated: 2025-02-20
Nilsson, E. & Olaison, A. (2022). Att balansera äldres och anhörigas behov: utredande samtal med par som lever med demenssjukdom. In: Clara Iversen, Marie Flinkfledt (Ed.), Samtal i socialt arbete: ett samtalsanalytiskt perspektiv (pp. 117-132). Malmö: Gleerups Utbildning AB, Sidorna 117-132
Open this publication in new window or tab >>Att balansera äldres och anhörigas behov: utredande samtal med par som lever med demenssjukdom
2022 (Swedish)In: Samtal i socialt arbete: ett samtalsanalytiskt perspektiv / [ed] Clara Iversen, Marie Flinkfledt, Malmö: Gleerups Utbildning AB, 2022, Vol. Sidorna 117-132, p. 117-132Chapter in book (Other academic)
Abstract [sv]

Vid bedömningar av äldres behov kan biståndshandläggare behöva möta och balansera flera parters perspektiv och behov. I kapitlet presenteras utmaningar kopplade till denna problematik i ett utredande samtal som en biståndshandläggare inom äldreomsorgen har med ett par som lever med demenssjukdom. Vi visar hur biståndshandläggaren arbetar för att följa socialtjänstlagen och de kommunala riktlinjer som finns för att bevilja insatser samtidigt som de också ska beakta klientens självbestämmande och anhörigas behov av indirekt stöd. Denna balansakt kan anses utgöra en central del av det sociala arbetet inom myndighetsutövande samtal.

Place, publisher, year, edition, pages
Malmö: Gleerups Utbildning AB, 2022
Keywords
Socialtjänst, Äldre, Demenssjuka
National Category
Social Work
Identifiers
urn:nbn:se:liu:diva-188199 (URN)9789151107288 (ISBN)
Available from: 2022-09-06 Created: 2022-09-06 Last updated: 2022-09-06Bibliographically approved
Nilsson, E. (2022). Framing dementia experiences in a positive light: Conversational practices in one couple living with dementia. Dementia, 21(3), 830-850, Article ID 14713012211059028.
Open this publication in new window or tab >>Framing dementia experiences in a positive light: Conversational practices in one couple living with dementia
2022 (English)In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, Vol. 21, no 3, p. 830-850, article id 14713012211059028Article in journal (Refereed) Published
Abstract [en]

The general approach to a life with dementia is negatively charged, and alternative views are rarely found in research or in media coverage. This case-study explores conversational practices for framing dementia in a more positive light, employed by a husband of a wife with dementia. Framing regards the structured experiences of dementia, drawing on Goffmans Frame Analysis. Benefitting from conversation analysis, this article presents principal results of four conversational practices used by the spouse without dementia: mitigating trouble, normalising trouble, justifying trouble, and praising. The conclusions drawn are that the practices contribute to the challenging of the dominant negative framework of the dementia experience, as they facilitate talk which emphasises the wife with dementias positive progression and skills in managing the household chores. Despite a positive framing of dementia, this couple still embed their talk in the overall negative framework of loss and decreased cognitive competence. The visualisation of a positive framing could add to a broadened view of dementia, which in turn could contribute to greater well-being for those affected. However, the results may also imply a risk of one spouses conversational practices of normalising and mitigating trouble being dominant in interaction and thereby neglecting the other spouses experience of the situation.

Place, publisher, year, edition, pages
Sage Publications, 2022
Keywords
dementia; couplehood; epistemics; frame analysis; conversation analysis
National Category
Geriatrics
Identifiers
urn:nbn:se:liu:diva-182222 (URN)10.1177/14713012211059028 (DOI)000735628800001 ()34920672 (PubMedID)
Note

Funding Agencies|bank of Sweden Tercentenary Foundation, program Dementia: Agency, personhood and everyday life [M10-0187:1]

Available from: 2022-01-12 Created: 2022-01-12 Last updated: 2023-04-12Bibliographically approved
Nilsson, E. & Olaison, A. (2022). Persuasion in practice: Managing diverging stances in needs assessment meetings with older couples living with dementia. Qualitative Social Work, 21(6), 1123-1146
Open this publication in new window or tab >>Persuasion in practice: Managing diverging stances in needs assessment meetings with older couples living with dementia
2022 (English)In: Qualitative Social Work, ISSN 1473-3250, E-ISSN 1741-3117, Vol. 21, no 6, p. 1123-1146Article in journal (Refereed) Published
Abstract [en]

The Swedish Social Services Act stipulates an individual perspective that promotes self-determination. In practice, this means that relatives lack formal rights to intrude on a person with dementias right to self-determination in decisions about elder care services. However, the Social Services Act also states that family members who are caring for a close relative should be offered support. This legislation may lead to contradictions within social work practice with couples. The aim of the present article is to explore how social workers manage needs assessment meetings in which couples living with dementia express diverging stances and the partner with dementia resists an offer for elder care services. We benefit from conversation analytic theory and methodology. The findings suggest that social workers accomplish persuasion through these four conversational practices: providing information about the offer, mitigating the offer, positive framing of the offer and laying down conditions for the offer. Also, local alliances with the partner of the person with dementia were demonstrated throughout. The analysis shows that PwDs provide resistance to the offered services, but there are no examples of a PwD influencing the outcome in terms of offered services. The results raise questions about the effectiveness of persuasion in needs assessment meetings. The findings also add to the critical debate on how social workers may be constrained by institutional logics and where relational competence is needed to balance and coordinate decision-making when assessing the needs of older couples living with dementia.

Place, publisher, year, edition, pages
Sage Publications Inc, 2022
Keywords
Dementia; persuasion; conversation analysis; needs assessments; couples
National Category
Social Work
Identifiers
urn:nbn:se:liu:diva-188421 (URN)10.1177/14733250221124213 (DOI)000849580100001 ()
Note

Funding Agencies|Forskningsradet om Halsa, Arbetsliv och Valfard [2019-01069]

Available from: 2022-09-14 Created: 2022-09-14 Last updated: 2023-04-12Bibliographically approved
Nilsson, E. & Olaison, A. (2021). An interactional perspective on needs assessment meetings with older couples in times of Covid-19. In: : . Paper presented at 15th ESA European Sociological Association Conference Barcelona.
Open this publication in new window or tab >>An interactional perspective on needs assessment meetings with older couples in times of Covid-19
2021 (English)Conference paper, Oral presentation with published abstract (Other academic)
National Category
Social Work
Identifiers
urn:nbn:se:liu:diva-180477 (URN)
Conference
15th ESA European Sociological Association Conference Barcelona
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2021-10-22 Created: 2021-10-22 Last updated: 2021-10-27Bibliographically approved
Landmark, A. M., Nilsson, E., Ekström, A. & Svennevig, J. (2021). Couples living with dementia managing conflicting knowledge claims. Discourse Studies, 23(2), 191-212
Open this publication in new window or tab >>Couples living with dementia managing conflicting knowledge claims
2021 (English)In: Discourse Studies, ISSN 1461-4456, E-ISSN 1461-7080, Vol. 23, no 2, p. 191-212Article in journal (Refereed) Published
Abstract [en]

This conversation analytic study investigates how couples manage conflicting knowledge claims when one of the persons has dementia (PWD). The data are video-recordings of 16 couples talking with a third party. The analysis focuses on the negotiation of epistemic rights, more precisely how partners initiate repair and correct claims made by the PWD on matters belonging to the latters epistemic domain. We identified three main practices for correcting the PWD: (1) correcting the statement, thereby claiming epistemic authority for oneself and denying it to the PWD, (2) inviting the PWD to self-correct, thereby attributing some epistemic authority to the PWD, and (3) disagreeing and providing reasons for ones alternative claim, establishing a more symmetric epistemic gradient. The PWDs responses to the corrections displayed different degrees of acceptance, ranging from self-denigration to resistance and insistence.

Place, publisher, year, edition, pages
Sage Publications, 2021
Keywords
Conversation analysis; couples; dementia; disagreement; epistemics; epistemic authority; knowledge claims; corrections
National Category
Other Social Sciences not elsewhere specified
Identifiers
urn:nbn:se:liu:diva-174777 (URN)10.1177/1461445620966918 (DOI)000627922600001 ()2-s2.0-85102312664 (Scopus ID)
Note

Funding Agencies|Research Council of Norway through its Centers of Excellence funding scheme [223265, 250093]; Bank of Sweden Tercentenary Foundation [M10-0187:1]; Swedish Research Council for Health, Working Life and WelfareSwedish Research CouncilSwedish Research Council for Health Working Life & Welfare (Forte) [2016-07207]

Available from: 2021-04-01 Created: 2021-04-01 Last updated: 2023-09-01
Nilsson, E. & Olaison, A. (2021). Needs assessment meetings with older couples in times of Covid-19: challenges for gerontological social work. In: : . Paper presented at 10th ECSWR European Conference for Social Work Research Bucharest, 5 - 7 May, 2021.
Open this publication in new window or tab >>Needs assessment meetings with older couples in times of Covid-19: challenges for gerontological social work
2021 (English)Conference paper, Oral presentation with published abstract (Other academic)
National Category
Social Work
Identifiers
urn:nbn:se:liu:diva-180478 (URN)
Conference
10th ECSWR European Conference for Social Work Research Bucharest, 5 - 7 May, 2021
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2021-10-22 Created: 2021-10-22 Last updated: 2021-10-27Bibliographically approved
Projects
Until needs do us part - Identifying supportive strategies within needs assessment interaction involving couples living with different care needs [2019-01069_Forte]; Uppsala University
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-6877-1544

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