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Developing Eldercare in Ageing Societies

A Qualitative Study on Misaligned Visions and Caged Change Agents

Bibliographic Data

ID15087165
AuthorsAnna Williamsson (0000-0001-5879-2280, KTH Royal Institute of Technology), Lotta Dellve (0000-0003-0480-1895, Department of Sociology and Work Science, Gothenburg University, Gothenburg, Sweden, corresponding author)
EditorsTommaso Martino (0000-0001-8877-4104)
Year2023
Volume2023
Pages1-10
Publication date2023-04-06
Open AccessYes
TypeARTICLE
VenueHealth & Social Care in the Community (JOURNAL)
Journal identifiersISSN: 0966-0410 • E-ISSN: 1365-2524
PublisherWiley (PUBLISHER • GB)
DOI10.1155/2023/2798463
OpenAlexW4362700643
LanguageEN
Citations received1
References cited25

Eldercare is facing current demands to develop due to changing demographics with increasing populations of elderly over the age of 85 combined with smaller populations of young people able to provide care and contribute to care via their taxes. The need for development of quality and safety was highlighted during the COVID-19 pandemic. Swedish government subsidies aimed at developing municipalities responsible for publicly managed eldercare have only been evaluated to a limited extent and the realisation of visions of future eldercare is shrouded in mystery. The study aims to explore the development work and strategies in Swedish municipal eldercare organisations, specifically in terms of alignment between democratic visions at political and strategic levels and operationalisation at operational levels. 28 interviews with development leaders were conducted in 14 Swedish municipality organisations between March and October 2021. The interviews focused on supporting roles and functions, responsibilities and collaborations, visions and operationalisations, and the follow-up and evaluation of eldercare development. A thematic analysis resulted in the main theme “top-down handling of unmanageable alignment” and the subthemes “shaping a high road for change;” “sticking to visions, hopes, and respect for practice;” and “self-serving focus on politics.” The quality of alignment strategies and putting the strategic vision into practice were related to organisation size and resources. A gap between strategic and operational levels was accentuated in terms of inconsistent responsibilities in following through with development projects and development being characterised by top-down initiatives and resources at the strategic level but strained implementation abilities at operational levels. Peripherally located change agents with legitimacy at multiple organisational levels are suggested to ease top-down as well as bottom-up drive, which could increase a vertical alignment of visions and practice

Business · Economic growth · Government (linguistics) · Political science · Politics · Public relations · Qualitative research · Social science · Sociology · Strategic planning · Thematic analysis · Vision · Work (physics) · Engineering · Geriatric Care and Nursing Homes · Healthcare innovation and challenges · Marketing · Mental Health and Patient Involvement

  • Swedish municipalities’ local governance strategies in co-creating health promoting conditions for senior adults

    Open Access•Anna Williamsson, Lotta Dellve•Public Policy and Administration•2025

  • Fostering implementation of health services research findings into practice

    Open Access•Laura J Damschroder, David C Aron et al.•Implementation Science•2009

  • Discrepancies between Expected and Actual Implementation

    Open Access•Fangyuan Chang, Andréa Eriksson et al.•International Journal of…•2020

  • The redefinition of the familialist home care model in France

    Open Access•Blanche Le Bihan•Health & Social Care in the…•2012

  • The Netherlands

    Open Access•Barbara Da Roit•Health & Social Care in the…•2012

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    Open Access•Marta Szebehely, Gun-Britt Trydegård et al.•Health & Social Care in the…•2011

  • Quality reforms in Danish home care - balancing between standardisation and individualisation

    Open Access•Tine Rostgaard•Health & Social Care in the…•2012

  • Norwegian home care in transition - heading for accountability, off-loading responsibilities

    Open Access•Mia Vabø•Health & Social Care in the…•2012

  • Home care in Italy

    Open Access•Cristiano Gori•Health & Social Care in the…•2012

  • Frontiers in Group Dynamics

    Open Access•Kurt Lewin•Human Relations•1947

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    Open Access•Braun, Virginia Braun et al.•Qualitative Research in Psychology•2006

Citations per year1
Citation span2025 - 2025 (1)
Highly citedNo

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