Omsorgsarbete i hemtjänsten : – förändringar, utmaningar och möjligheter

Sammanfattning: The purpose of this thesis is to analyse the work situation in Swedish homecare from the perspective of care workers. In recent decades, the eldercare sector has faced challenges related to organisational changes and difficulties with retaining and recruiting staff. Due to an ageing population, increasing needs for care and a decline in residential care there has been an increased focus on ageing-in-place policies. Homecare is thus an increasingly important part of eldercare, both in Sweden and in other Western countries.The thesis consists of four studies that explore and analyse different aspects of the work situation in Swedish homecare. The empirical material consists of both quantitative and qualitative data. The quantitative part of the thesis derives from survey-data (Nordcare) from 2005 and 2015, whilst the qualitative material consists of 11 group interviews with 64 homecare workers. Theoretically, the thesis draws upon feminist perspectives on care work. In order to deepen the analysis of the work situation in homecare, the thesis joins work-life oriented research with feminist care research. The results are related to and analysed against the backdrop of recent structural changes and reorganisations in the eldercare sector.Study I shows that the work situation in Swedish home care has deteriorated between 2005 and 2015, both regarding intensification of work and the occurrence of work-related problems. For example, workers in 2015 reported meeting a larger number of recipients per day, receiving less support from their supervisor and colleagues, and having considerably less autonomy to affect the planning of their daily work. Study II illustrates geographical differences regarding homecare workers experiences of their work situation. Staff in larger cities experience worse working conditions and more mental strain, but better employments conditions, work-time arrangements and work-life balance, compared to those working in rural areas. Study III shows that homecare workers in Sweden experience a high level of multidimensional precariousness, and that several of the problematic working conditions are associated with physical strain, mental strain, poor work-life balance and considerations to quit the job. The main results of study IV are that the workers attribute their experiences of time pressure to the compression of time, the control of time and the unpredictability of time. Strategies adopted by the workers to handle time pressure include working unpaid hours, maximising efficiency, and reallocating time. Thus, the workers mainly adopt individual and short-term strategies to deal with time pressure, with potential negative consequences for both the workers and the care recipients.Overall, this thesis shows that the work situation in Swedish homecare has deteriorated over time and is characterised by several problematic employment- and working conditions, over a range of dimensions, with negative consequences for the workers’ health and wellbeing. The accumulation of work-related problems and multidimensional precariousness experienced by the workers strongly indicate that there is no easy solution to the issues experienced by the homecare workers, calling for wide-ranging political and organisational responses.