Omsorg under förhandling - om tid, behov och kön i en föränderlig hemtjänstverksamhet

Sammanfattning: The Swedish welfare state, and public elderly care of today in particular, is under transformation in many respects. Organisational restructuring, such as downsizing and new forms of organisation, mainly influenced by New Public Management, are some of the factors that have affected home care service. The purchaser/provider model is the applied organising model in the investigated municipality in one of the bigger towns in Northern Sweden. These changes, in combination with demographic changes which means an increasing elderly group who receive home care service, and the fact that more men carry out the care work, point towards some important themes such as time, needs and gender.The empirical material, consisting mainly of interviews, has been analysed from both a theoretical and empirical perspective. The voices of three groups; the care managers’, the care workers’ and the elderlys’ have been allowed to “inform” each other. The focus has directly and indirectly been on the elderly and the care they do or do not receive. The aim is to describe and analyse the conditions for meetings that take place between the elderly and staff in a home care service in transformation, based on the statements given by the different actors. Twelve women and four men in the group of care workers and six female care managers were interviewed. Four women and two men represented the group of elderly. A perspective on strangership, influenced by Simmel, is introduced to illustrate some of the aspects that cannot be taken for granted in care in a changing public home care service.Methodological choices and how these are handled, have been crucial. Important conclusions made are that meetings that take place in the home care service may look very different and can therefore not be viewed in terms of either only one aspect or another, or a combination of both, but rather as in concurrence. Time, needs and gender are subjected to negotiations in the hierarchy of the social services. The problems connected with time and the view of needs, are constantly moving around within and between the groups, but nevertheless remain. Gender is present in home care service in a way that contradicts the officially fixed neutrality of gender. A typical example is when care managers argue that gender is not a relevant factor in the needs assessments, even though this seems to be the case. The public home care service constitutes an arena, where constant negotiations between different groups and on different levels take place. In this divided organisation, negotiations concerning time, needs and gender are continuously in progress.Keywords: Care, elderly care meetings, elderly, care managers, care workers, public home care service, home care service in transformation, time, needs, gender, strangership, negotiations