Ageing International

, Volume 43, Issue 1, pp 20–33 | Cite as

Same, Same but Different: Norwegian Nursing Homes Betwixt Equality and Autonomy

  • Gudmund Ågotnes


Nursing homes in Norway – as the health care sector in general – are generally presented and perceived as promoting the ideal of equality and universality. Nursing homes are meant to be similar or even “equal”; offering not only universal access but also similar care and support for its residents. Such is not necessarily the reality for Norwegian nursing homes. Nursing homes differ, not only in formal characteristics such as size, ownership and location, but also in degree of autonomy and independence. In general, nursing homes in Norway can be described as being in a perpetual tension between ideals of equality and universality on one side and autonomy and independence on the other. Consequently, nursing homes exhibit varying degrees of autonomy and self-governance. Such relative autonomy, we will argue in this paper, is grounded in the regulatory framework for Norwegian nursing homes. Exemplified with a municipality and a specific nursing home, we will demonstrate that a large bulk of the decision-making concerning the daily operations of nursing homes is placed locally. We see this premise as facilitating diversity and autonomy, producing variation between nursing homes. Nursing homes can, given this context, adapt to a flexible framework, securing local adjustments suitable for the local needs of administrators, staff and residents. The non-specific modes of governance can, in other words, contribute to flexibility and autonomy, although not necessarily in line with an overall ideal of universality.


Nursing home Governance Care work Regulations Accountability 



This article is a result of a research project supported jointly by Centre for Care Research, Bergen University College and the international research project “Re-imagining Long-Term Residential Care: an International Study of Promising Practices” supported by Social Sciences and Humanities Research Council of Canada.

Compliance with Ethical Standards

Conflict of Interest

The authors declare no conflict of interest.

Informed Consent

No data of individuals, being patients or staff, was collected in connection to this article.

Ethical Treatment of Experimental Subjects (Animal and Human)

This article does not contain any studies with human participants or animals performed by the authors.


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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.Centre for Care ResearchBergen University CollegeBergenNorway
  2. 2.Department of Global Public Health and Social MedicineThe University of BergenBergenNorway

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