The project Aging in Place applies a novel approach to investigate how social care services in Sweden are adapted to preferences and needs of older persons (65 years and older) living at home with dementia, including their partners. The project covers the process that starts when a person is granted to receive services, which are communicated to a care provider – who should organize the services – and finally reach the receiving older person. This approach differs from previous research on elder care, which has focused either on the purchaser or the provider side of Swedish municipal elder care in the purchaser-provider model Sweden adopted since the mid-1990s. The project focuses on: 1) what specific social care services older persons living at home with dementia are granted; if a dementia diagnosis is needed for some services; and the differences between municipalities; 2) how care providers organise granted services and adapt them to people living with dementia; including differences between municipalities and care provider units; 3) how care recipients living with dementia (including co-habiting partners) experience and influence the receiving of services. The ambition is to generate both generalisable knowledge about social care services for people living with dementia in Sweden, including differences between municipalities and care providers, and in-depth, exploratory knowledge about how care providers organise services and how these services are received by care recipients. The project encompasses a necessary combination of methods and materials: register studies, web surveys, as well as observations and interviews. The project will provide important, elemental, knowledge on Swedish dementia- and eldercare. This knowledge is needed as a basis for further studies and as a contribution to discussions on how future social care can be developed to ensure people living with dementia, and their partners, equality, participation, and dignity in later life.

Decisions regarding welfare services take place within a web of legal, political, and organizational structures, shaping the scope of social workers’ legal decision-making authority (DMA). Social workers are often assumed to have full legal authority to decide on welfare services, yet the influence of local political policies on their legal options remains underexplored. This study examines how hard local political policies governing legal DMA affect social workers’ discretion in distributing elder care. By analysing these policies, we reveal the structures that condition social workers’ legal options to provide services. Using elder care in Swedish municipalities as an example, we investigate how different types of hard local political policies create varying premises for social workers’ legal authority to make decisions. Counter-texts are analysed through a comparison of four strategic examples. Our findings show that local politicians use different strategies when delegating authority. As a result, social workers face varying premises regarding what decisions they are legally permitted to make. These results highlight the dependence of social work practice on local politics and underscore the need to study macro-level contexts. Understanding these structures is crucial for interpreting social workers’ working conditions in the provision of welfare services.

Few studies have explored the moral and ethical dimensions of how, in practice, socialworkers talk about and handle cases as part of their daily work. At the same time,identifying and examining the ethical dimensions of actual social work practice can bechallenging because ethics is often hidden within the complex particularities of daily work.This article applies and develops Sarah Banks’ conceptualisation of “ethics work” toexamine how care managers in Sweden are “doing ethics”, while seeking and providingcollegial support and guidance on how to deal with the wishes of adult (potential) serviceusers who are reluctant to accept support – or whose wishes in the matter are difficult todetermine. The study is based on an analysis of 14 audio-recorded case conferences. With the help of Banks’ conceptualisation, the analysis makes visible how the case discussions inquestion encompass a complex “doing of ethics”, by means of which the welfare ofindividuals is balanced against care managers’ legal duty to adhere, without exception, tothe principle of self-determination. The findings suggest that further research that appliesand develops Banks’ conceptualisation of ethics work by examining “actual” social workpractice in situ, while recognising the particularities of the social and societal context inwhich this work is taking place, could provide new knowledge and understanding aboutboth the specific and common challenges that social workers face in different parts of the world. It could also make the ethical dimensions of social work practice more widely recognised and valued.

Research has explored how social workers in team constellations perform assessments of the needs of clients in case conferences. However, the process in which gatekeeping is applied in the categorization of clients as inappropriate receivers of support in collegial discussions has received less attention. This article presents findings from a case study of a complex case where a 64-year-old person with dementia was assessed by two teams of social workers handling the same case under two different forms of legislation (elder care and disability services). The data consist of recordings of two case conferences in one Swedish social work agency. The conferences were analysed using positioning theory. The findings suggest that the conferences contained different storylines where the social workers categorized the client as an inappropriate receiver of support. Furthermore, the discourses for gatekeeping differed depending on how the social workers positioned the client in the different storylines in the case conferences. The study shows that institutional and professional responsibilities are central to the assessments that the social workers perform, and that there is a risk that the client will be subject to gatekeeping when the case is handled on an ambiguous legal basis in different legislations, which may result in the client falling between two stools. The findings suggest that research needs to explore, in a more systematic manner, how social workers’ gatekeeping practices are performed in collegial team discussions.

Den som upplever behov av hjälp med aktiviteter i det dagliga livet har enligt socialtjänstlagen (SoL) möjlighet att vända sig till kommunens biståndshandläggare och få sin rätt till bistånd individuellt prövad. Då de flesta som erhåller denna typ av bistånd uppnått en hög kronologisk ålder, brukar de insatser som oftast beviljas kallas äldreomsorg. I SoL står dock inget om att hänsyn ska tas till (en vuxens persons) ålder då rätten till bistånd prövas. I det här kapitlet undersöker vi hur biståndshandläggare, trots detta, skapar och använder sig av informella ålderskategorier när de under så kallade ärendekonferenser diskuterar med sina kollegor om vilka behov enskilda individer har och hur dessa ska tillgodoses. Genom att fokusera på hur ålder görs i interaktion belyser vi hur handläggarna kategoriserar personerna som "för unga", "inte så gamla", "äldre" och "extraordinärt gamla" och hur "typiska" äldreomsorgsinsatser framställs som passande i vissa åldrar än andra.

Age categories are related to perceptions and norms concerning appropriate behaviour, appearances, expectations, and so forth. In Sweden, municipal home care and residential care are commonly referred to as “elder care”, primarily catering to individuals in their 80s or 90s. However, there is no set age limit reserving these services for an older age group.

In intra-professional case conferences, care managers convene with colleagues to discuss care needs and eligibility for elder care services. Despite their significance, these conferences have received limited scholarly attention. The aim of this study was to analyse how care managers categorise persons based on age in intra-professional case conferences when discussing care needs and appropriate support to meet these needs.

The study utilised data from 39 audio-recorded case conferences involving the discussion of 137 different cases, which were analysed using discourse analysis. Our findings showed that chronological age was frequently made relevant and applied in discussions about the appropriateness of usual elder care services.

Four themes emerged, representing how the care managers implicitly and explicitly categorised clients of different chronological ages as typical/normal or atypical/deviant in these discussions: the “too young”, the “not-so-old”, the “old”, and the “extraordinarily old”.

The findings contribute to research on ageing by demonstrating that, in an elder care context, being categorised as atypical/deviant (in terms of being younger) may be more beneficial than being seen as a normal or older elder care recipient. This underscores the importance of further research on the impact of informal age categorisations of clients on actual decisions about welfare services.

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.

Within a context where New Public Management [NPM] has become increasingly influential in shaping everyday working practices, social workers often handle risks in their everyday work using formalised bureaucratic procedures, among other strategies. As the COVID-19 pandemic progressed, rapid changes occurred in Swedish elder care that social workers were required to address in their everyday work. Intra-professional case conferences amongst social workers provide one opportunity to discuss individual viewpoints and obtain suggestions from colleagues on how to proceed with a case. These discussions have so far received little scholarly attention. In this study we used a data set consisting of 39 audio-recorded case conferences to analyse social workers intra-professional discussions about risks during the COVID-19 pandemic. In the case conferences, social workers discussed the risks that were accentuated by the pandemic, such as the risk of spreading COVID-19 to clients, the risk of unmet care needs amongst clients, risks related to accountability, and the risks pertaining to blurred boundaries between different organisations. The collegial discussions in case conferences included opportunities for social workers to use their collective professional experience and competency to establish creative solutions on the go and to discuss various ways of handling and balancing different risks while continuing to carry out their work in the changing and unknown situation. Our findings highlight the importance of collegial support in social work in dealing with accentuated risks during the pandemic.