This article explores how policy narratives in national policy documents in Sweden inform associated politics on people with dementia. This is disentangled in terms of how people with dementia have been defined, what the problems and their imminent solutions have been, and if and how these have differed over time. Based on a textual analysis of policy documents at national level in Sweden, covering nearly 40 years the study shows how divergent policy narratives shape the construction of citizens with dementia as policy target groups. This study shows the temporal character of people with dementia as a political problem, the implications of policy narratives on people with dementia as a citizen group, and policy narratives as something being crafted rather than shaped by fixed pre-existing "facts". Dementia, and further citizens living with dementia, does not have a once and for all stabilised meaning. Instead, the meanings behind the categories continue to evolve and to be crafted, which affects the construction of citizens living with dementia, the space in which to exercise their citizenship and further belonging to the society.

A highly significant element in politics and policies is the process of constructing, categorizing and imagingsuch as categorizing citizens as target groups. In governing documents, distinctions are drawn to distinguish deserving and undeserving categories of citizens. This paper explores the construction of citizenship for people with dementia and the connection to underlying categories of rationales, by analyzing how this group has been categorized and imaged in policy documents. The study is based on a qualitative textual analysis of national policy documents in Sweden, covering nearly 40 years. It shows that the way people with dementia have been imaged has differed over time, where people living with dementia have been situated in various target groups and discourses. However, to a large extent, the underlying understanding has nevertheless remained persistent where the position of people with dementia has remained weak. It offers a taxonomy of categories of rationales and shows the interplay of rationales and target groups for certain social constructions. The study offers insights into the policy process related to policy change, and on citizenship as something transformative and interrelated that risks upholding democratic values that delimit disempowered groups, in this case people with dementia, to influence their citizenship.

No abstract

No abstract

iii ABSTRACTPeople with dementia are commonly in need of some form of social care from the social services in order to manage their everyday situations. However, social services are shaped by the construction of policy targets, i.e. the construction of people with dementia as citizens. The aim of this dissertation is to explore the social citizenship of people with dementia. Social citizenship for people with dementia is explored by studying how people with dementia have, in policy documents, been constructed as a target group, and also by studying how policies are enacted in practice by care managers, in their work and in their meetings with people with dementia. This is illustrated by studying policy documents from national level which range over nearly 40 years. It is shown that, if and when people with dementia are visible in policy documents, they commonly have a negative construction based on their cognitive and communicative abilities, and they are constructed as a burden, disturbing and incapable, wherein focus lies in their negative attributes. We further investigate in this dissertation, how street-level bureaucrats, in this case care managers, experience meeting with people with dementia when they apply for social services. This part of the dissertation is built upon 19 interviews with care managers from four different organisations, which show that care managers experience difficulties in their meetings with people with dementia. These difficulties comprise the exchange of information between care managers and people with dementia, refusal of social services by the person with dementia, the influence of relatives and other professions as well as moral dilemmas, such as the relations between the person with dementia and their relatives. The study also shows that care managers have little support from policies, e.g. legislation and guidelines, in how to handle these dilemmas, and must thus create their own local ways of handling these situations. This requires that care managers are influential policy actors concerning the policy target group of people with dementia.The policy processes which this dissertation illustrates, affect the social citizenship of people with dementia. It is shown that they, to an extent, have difficulties in influencing their own everyday situation concerning social services. Finally, the policy processes, such as the construction of people with dementia as well as the policy practice in which they encounter care managers, will affect their possibility to influence their social citizenship.Keywords: Social citizenship, people with dementia, policy, policy practice, policy actors, street-level bureaucrats, social work, care managers, rights Abstract iv Personer med demenssjukdom behöver vanligtvis någon form av socialt stöd från socialtjänsten för att kunna hantera sin egen vardag. Emellertid så är socialt stöd format av konstruktionen av policymålgrupper, dvs konstruktionen av personer med demenssjukdom som medborgare. Syftet med denna avhandling är att undersöka det ...