Advertisement

European Journal of Ageing

, Volume 9, Issue 2, pp 119–129 | Cite as

Care work in changing welfare states: Nordic care workers’ experiences

  • Gun-Britt Trydegård
Original Investigation

Abstract

This article focuses on Nordic eldercare workers and their experiences of working conditions in times of change and reorganisation. In recent years New Public Management-inspired ideas have been introduced to increase efficiency and productivity in welfare services. These reforms have also had an impact on day-to-day care work, which has become increasingly standardized and set out in detailed contracts, leading to time-pressure and an undermining of care workers’ professional discretion and autonomy. The empirical data comes from a survey of unionised eldercare workers in home care and residential care in Denmark, Finland, Norway and Sweden (N = 2583) and was analysed by bi- and multi-variate methods. The care workers reported that they found their working conditions physically and mentally arduous. They had to a great extent experienced changes for the worse in terms of working conditions and in their opportunity to provide good quality care. In addition, the majority felt they did not receive support from their managers. An alarming finding was that one out of three care workers declared that they had seriously considered quitting their jobs. Care workers with multiple problems at work were much more likely to consider quitting, and the likelihood was increasing with the number of problems reported. Furthermore, care workers lacking support from their managers had double odds of wanting to quit. The Nordic welfare states with growing older populations are facing challenges in retaining care staff in the eldercare services and ensuring they have good working conditions and support in their demanding work.

Keywords

Nordic welfare state New public management Eldercare Care worker Work environment Manager support 

Notes

Acknowledgments

This study was supported by a research programme financed by the Swedish council for working life and social research, ‘Transformations of care: living the consequences of changing public policies’, and the strand ‘Care in ageing and diversifying societies’ within the Nordic excellence centre REASSESS. The author thanks Professor Marta Szebehely, Stockholm University, for valuable advice in the course of writing.

References

  1. Anttonen A, Häikiö L (2011) Care ‘going market’: Finnish elderly-care policy in transition. Nordic journal of social research. Special issue: Welfare-state change, the strengthening of economic principles, and new tensions in relation to care in EuropeGoogle Scholar
  2. Anttonen A, Sipilä J (1996) European social care services: Is it possible to identify models? J Eur Soc Policy 6(2):87–100CrossRefGoogle Scholar
  3. Aronsson G, Lindh T (2004) Långtidsfriskas arbetsvillkor. En populationsstudie (Long-term healthy people’s working conditions. A population study). No 2004:10. Arbetslivsinstitutet, StockholmGoogle Scholar
  4. Astvik W (2003) Relationer som arbete. Förutsättningar för omsorgsfulla möten i hemtjänsten (Relating as a primary task. Prerequisits for sustainable caring relations in home-care services). Dissertation, Stockholm University. Arbetslivsinstitutet, StockholmGoogle Scholar
  5. Bowers BJ, Esmond S, Jacobson N (2003) Turnover reinterpreted: CNAs talk about why they leave. J Gerontol Nurs 29:36–43Google Scholar
  6. Clarke J, Newman J (1997) The managerial state. Sage, LondonGoogle Scholar
  7. Colombo F, Nozal AL, Mercier J, Tjadens F (2011) Help Wanted? Providing and Paying for Long-Term Care, OECD Health Policy Studies. OECD Publishing, ParisGoogle Scholar
  8. Dahl HM (2009) New public management, care and struggles about recognition. Crit Soc Policy 29:634–654CrossRefGoogle Scholar
  9. Daly M, Lewis J (2000) The concept of social care and the analysis of contemporary welfare states. Br J Sociol 51(2):281–298CrossRefGoogle Scholar
  10. Daly T, Szebehely M (2011) Unheard voices, unmapped terrain: care work in long-term residential care for older people in Canada and Sweden. Int J Soc Welf. doi: 10.1111/j.1468-2397.2011.00806.x
  11. Dellve L (2003) Explaining occupational disorders and work ability among home care workers. Dissertation, Göteborg University, GöteborgGoogle Scholar
  12. Dybbroe B (2008) Crisis of care in a learning perspective. In: Wrede S, Henriksson L, Høst H, Johansson S, Dybbroe B (eds) Care work in crisis. Reclaiming the Nordic ethos of care. Studentlitteratur, Lund, pp 41–48Google Scholar
  13. Edebalk PG, Samuelsson G, Ingvad B (1995) How elderly people rank-order the quality characteristics of home services. Ageing Soc 15:83–102CrossRefGoogle Scholar
  14. Elstad JI, Vabø M (2008) Job stress, sickness absence and sickness presenteeism in Nordic elderly care. Scand J Public Health 36:467–474CrossRefGoogle Scholar
  15. Fersch B, Jensen PH (2011) Experiences with the privatization of home care: evidence from Denmark. Nordic journal of social research. Special issue: Welfare-state change, the strengthening of economic principles, and new tensions in relation to care in EuropeGoogle Scholar
  16. Fläckman B (2008) Work in eldercare—staying or leaving. Caregivers’ experiences of work and support during organizational changes. Dissertation, Karolinska institutet, StockholmGoogle Scholar
  17. Gustafsson RÅ, Szebehely M (2009) Outsourcing of eldercare services in Sweden: effects on work environment and political legitimacy. In: King D, Meagher G (eds) Paid care in Australia: politics, profits, practices. University Press, Sydney, pp 81–112Google Scholar
  18. Hansen HK (2008) Neglected opportunities for personal development: care work in a perspective of lifelong learning. In: Wrede S, Henriksson L, Høst H, Johansson S, Dybbroe B (eds) Care work in crisis. Reclaiming the Nordic ethos of care. Studentlitteratur, Lund, pp 75–96Google Scholar
  19. Henriksson L, Wrede S (2008) Care work in the context of a transforming welfare state. In: Wrede S, Henriksson L, Høst H, Johansson S, Dybbroe B (eds) Care work in crisis. Reclaiming the Nordic ethos of care. Studentlitteratur, Lund, pp 121–130Google Scholar
  20. Hood C (1998) The Art of the state—culture, rhetoric and public management. Oxford University Press, OxfordGoogle Scholar
  21. Johnson JV (2008) Globalization, workers’ power and the psychosocial work environment—is the demand–control–support model still useful in a neoliberal era? Scand J Work Environ Health Suppl. 6:15–21Google Scholar
  22. Karasek R, Theorell T (1990) Healthy work: stress, productivity and the reconstruction of working life. Basic Books Inc., New YorkGoogle Scholar
  23. Kautto M (2000) Two of a Kind? Economic crises, policy responses and well-being during the 1990s in Sweden and Finland. SOU 2000:83. Fritzes, StockholmGoogle Scholar
  24. Kröger T (2011) The adoption of market-based practices within care for older people: is the work satisfaction of Nordic care workers at risk? Nordic journal of social research. Special issue: Welfare-state change, the strengthening of economic principles, and new tensions in relation to care in EuropeGoogle Scholar
  25. NBHW, National Board of Health and Welfare (2011) Äldre och personer med funktionsnedsättning—regiform mm för vissa insatser år 2010 (Management Form for Certain Services to Older persons and to Persons with Impairments). Socialstyrelsen, StockholmGoogle Scholar
  26. Norman TM, Rønning E, Nørgaard E (2009) Challenges to the Nordic welfare state—comparable indicators. NOSOSCO, CopenhagenGoogle Scholar
  27. NOSOSCO, Nordic Social-statistical Committee (2009) Social protection in the Nordic countries: scope, expenditure and financing 2008/2009. NOSOSCO, CopenhagenGoogle Scholar
  28. OECD (2010) OECD Family data base. http://www.oecd.org/els/social/family/database
  29. Petersen JH (2008) Hjemmehjælpens historie. Idéer, holdinger, handlingar (The history of home help. Ideas, attitudes, actions). Syddansk universitetsforlag, OdenseGoogle Scholar
  30. Pollitt C, Boucaert G (2000) Public management reform—a comparative analysis. Oxford University Press, OxfordGoogle Scholar
  31. Rostgaard T, Thorgaard C (2007) God kvalitet i ældreplejen. Sådan vægter de ældre, plejepersonale og visitatorer (Good quality in eldercare. How older persons, staff and assessors evaluate quality). SFI 07:27. SFI—Det Nationale Forskningscenter for Velfærd, CopenhagenGoogle Scholar
  32. Sipilä J (ed) (1997) Social care services: the key to the Scandinavian welfare model. Avebury, AldershotGoogle Scholar
  33. Szebehely M (2005) Dilemmas of care in the Nordic welfare state. In: Dahl HM, Eriksen TR (eds) Care as employment and welfare provision—child care and eldercare in Sweden at the dawn of the 21st century. Avebury, Aldershot, pp 80–97Google Scholar
  34. Tainio L, Wrede S (2008) Practical nurses’ work role and workplace ethos in an era of austerity. In: Wrede S, Henriksson L, Høst H, Johansson S, Dybbroe B (eds) Care work in crisis. Reclaiming the Nordic ethos of care. Studentlitteratur, Lund, pp 177–198Google Scholar
  35. Trydegård GB (2005) Äldreomsorgspersonalens arbetsvillkor i Norden—en forskningsöversikt (Working conditions of eldercare staff in the Nordic countries: A research overview). In: Szebehely M (ed) Äldreomsorgsforskningen i Norden. En kunskapsöversikt (Nordic eldercare research. An overview). Nordic Council of Ministers, Copenhagen, pp 143–195Google Scholar
  36. Trydegård GB, Thorslund M (2010) One uniform welfare state or a multitude of welfare municipalities? The evolution of local variation in Swedish eldercare. Soc Policy Adm 44(4):495–511CrossRefGoogle Scholar
  37. Vabø M (2005) New public management i nordisk eldreomsorg—hva forskes det på? (New Public Management in Nordic eldercare: what do researchers focus on?) In: Szebehely M (ed) Äldreomsorgsforskning i Norden. En kunskapsöversikt (Nordic eldercare research. An overview) Nordic Council of Ministers, Copenhagen, pp 73–111Google Scholar
  38. Vabø M (2007) Organisering for velferd. Hjemmetjenesten i en styringsideologisk brytningstid (Organizing welfare. Home help services in times of steering-ideological changes). Dissertation, Oslo University. NOVA Rapport 11/07, OsloGoogle Scholar
  39. Vabø M (2009) Home care in transition. The complex dynamic of competing drivers of change in Norway. J Health Organ Manag 23(3):346–359CrossRefGoogle Scholar
  40. Vabø M, Szebehely M (2012) A caring state for all older people? In: Anttonen A, Häikiö L, Stefansson K (eds) Welfare state, universalism and diversity. Edward Elgar, Cheltenham (forthcoming)Google Scholar
  41. Waerness K (1984) The rationality of caring. Econ Ind Democr 5(2):185–211CrossRefGoogle Scholar
  42. Wolmesjö M (2005) Ledningsfunktion i omvandling: om förändringar av yrkesrollen för första linjens chefer inom den kommunala äldre- och handikappsomsorgen (Management in transition: on changes of the professional roles of first-line managers in municipal elder- and disability care). Dissertation, Lund University, LundGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  1. 1.Department of Social WorkStockholm UniversityStockholmSweden

Personalised recommendations