Artikeln diskuterar den ökande internationella migrationens utmaningar för äldreinriktat socialt arbete. Konkret undersöks erfarenheter hos äldreomsorgens biståndshandläggare gällande att möta sent-i-livet-invandrare som önskar anhörigomsorg med betalning genom anhöriganställning eller kontantbidrag. Biståndshandläggarna erfar situationer där de i rollen som myndighetsutövare upplever sig sakna såväl kunskap som resurser att hantera sådana önskemål.
Research on care managers' experiences of the needs assessment process is scarce even though the literature on needs assessment practice is relatively extensive. One of the research areas that has not received attention yet is the way in which care managers experience the challenges that are presumably posed by increased ethnic, cultural, linguistic and religious diversity among prospective elder care recipients. This article addresses this research gap. It is based on a project that aims to shed light on care managers' experiences of the needs assessment process in general and cross-cultural needs assessment meetings in particular. The data are constituted of focus group interviews with care managers in Sweden (N=60). In this article we focus on care managers' experiences of needs assessment with older people who have immigrated late-in-life, who come from cultures considered different from the Swedish one and who have not mastered the Swedish language. This was the group of older people that the care managers mostly thought of when asked to describe their experiences of cross-cultural needs assessment meetings. The interviewed care managers discussed the challenges that these meetings present, which were related to communication due to language barriers, different demands and expectations, insecurity regarding what is customary in such meetings, as well as perceived passivity among late-in-life immigrants. The article discusses the contributions of the findings to research on care management practices in general, as well as to needs assessment practice in particular.
This article discusses the role of the Swedish welfare state in transnational migration contexts involving older people in need of care. A pilot study about experiences and perspectives among care managers in the public elderly care sector forms the empirical point of departure, with focus on late-in-life-immigrants. The article shows concrete examples of how care needs may be met through a combination of public elderly care, support from informal networks, and the travelling of older people back and forth across national borders. Care managers may have a comprehensive but tacit knowledge of the transnational mobility of this category of older care users. Their awareness of their own role in the transnational contexts remains quite limited. Late-in-life immigrants to Sweden who are involved in transmigration processes are dependent on the care managers" professional autonomy and ability to take advantage of the scope of legislation for individual assessments and special solutions.
Research has explored how care managers in elder care -who often function as 'street-level bureaucrats' -regard professional discretion. The way in which length of work experience affects care managers' use of professional discretion remains, however, unexplored. This article present findings from 12 focus groups with 60 care managers. By bringing attention to how care managers experience the needs assessment process, this article sheds light on how these 'street-level bureaucrats' struggle when they try to balance their clients' needs against institutional frameworks and local guidelines. Length of work experience seems to play a role in how care managers claim to use professional discretion. Experienced care managers describe how they deviate from the guidelines at times in order to create an increased scope of action in their decision-making process. Those with less time in the profession describe greater difficulties in this respect. Findings suggest that research should explore if length of work experience plays a role in the actual way in which care managers assess needs and make decisions. As such, they contribute to our understanding of how needs assessment processes are navigated by professionals while also pointing towards the nature of professional discretion in gerontological social work.
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