Nursing homes on public display : Reputation management in the new landscape of Swedish eldercare
(2020)- Abstract
- The general perception of Swedish nursing homes has historically been gloomy. Nursing homes have been associated with a passive, isolated, and institutionalised ‘fourth age’ life. Media reports and the public debate have largely stressed the need for organisational improvements, and called for transparency and control. In recent years, marketisation, audits, and mediatisation have become new conditions that together have shaped the landscape of Swedish eldercare, leading to increased organisational sensitivity to public perception. These changes have made organisational images more difficult to control and cultivate. The dissertation thus examines nursing homes’ publicly displayed images and how nursing home representatives act and react... (More)
- The general perception of Swedish nursing homes has historically been gloomy. Nursing homes have been associated with a passive, isolated, and institutionalised ‘fourth age’ life. Media reports and the public debate have largely stressed the need for organisational improvements, and called for transparency and control. In recent years, marketisation, audits, and mediatisation have become new conditions that together have shaped the landscape of Swedish eldercare, leading to increased organisational sensitivity to public perception. These changes have made organisational images more difficult to control and cultivate. The dissertation thus examines nursing homes’ publicly displayed images and how nursing home representatives act and react in relation to such images to defend and improve their organisational reputation. The dissertation answers these questions: (1) What kinds of images of nursing homes are constructed in the mass media and social media? (2) What have marketisation, audits, and mediatisation meant for nursing homes’ reputation management practices? (3) How do nursing home representatives manage their organisational reputation in the context of external demands and descriptions? Organisations are theoretically understood as open systems in a dynamic relationship with their institutional environment, and in need of external support to survive and succeed. Organisational reputation is an essential asset in an era of marketisation, particularly for organisations with difficulties demonstrating success and whose goals are uncertain or undefined, such as nursing homes. The analysis is based on 42 qualitative interviews with nursing home representatives, 338 pictures from nursing homes’ Instagram accounts, and 124 newspaper articles about eldercare user satisfaction surveys. The findings show that while the mass media construct nursing homes as places needing continuous improvement and control, the nursing homes’ self-presentations assert that these are settings where life is both normal and better than before. Increased marketisation, audits, and mediatisation have enforced the need to manage reputation by adhering to externally formulated demands, and to provide documented evidence of successful adaption to norms and expectations. Nursing home representatives manage reputation by adjusting organisational activity to external demands on different levels and in different situations: while the validity of externally formulated demands was to some extent dismissed, representatives still express the need to address and act on such expectations. The dissertation shows that the new conditions in the landscape of Swedish eldercare have given way to new institutional logics for reputation management: there is a perceived need to compete and compare; to produce content and communicate images; and to manage and appeal to their intended audience. Organisations attribute validity and adapt to externally formulated demands in different ways. They embrace the validity of external demands and conform; they dismiss and reject demands; they substitute images for action; or they adhere to external demands for the sake of an improved reputation. (Less)
- Abstract (Swedish)
- Äldreboenden har traditionellt uppfattats som dystra platser. Livet på äldreboenden har skildrats i termer av isolering och passivitet, och själva platsen har beskrivits som ’dödens väntrum’. Krav på organisatorisk förbättring, ökad insyn och styrning har framförts i media och i den allmänna debatten. Under senare år har ökad marknadisering, granskning och medialisering förändrat villkoren i de svenska äldreboendenas landskap. Dessa förändringar har gjort det svårare för verksamheter att kontrollera och kultivera sin organisatoriska image, och lett till ökad organisatorisk känslighet för allmänhetens omdöme och godkännande. Denna avhandling undersöker publika skildringar av äldreboenden, och hur äldreboenden agerar och reagerar i relation... (More)
- Äldreboenden har traditionellt uppfattats som dystra platser. Livet på äldreboenden har skildrats i termer av isolering och passivitet, och själva platsen har beskrivits som ’dödens väntrum’. Krav på organisatorisk förbättring, ökad insyn och styrning har framförts i media och i den allmänna debatten. Under senare år har ökad marknadisering, granskning och medialisering förändrat villkoren i de svenska äldreboendenas landskap. Dessa förändringar har gjort det svårare för verksamheter att kontrollera och kultivera sin organisatoriska image, och lett till ökad organisatorisk känslighet för allmänhetens omdöme och godkännande. Denna avhandling undersöker publika skildringar av äldreboenden, och hur äldreboenden agerar och reagerar i relation till dessa för att försvara och förbättra organisatoriskt anseende. Studien besvarar följande frågor: (1) Vilka bilder av äldreboenden konstrueras genom massmedia och sociala medier? (2) Vad har marknadisering, medialisering och granskning inneburit för äldreboendens anseendehantering? (3) Hur hanterar äldreboenden anseende i relation till externa krav och beskrivningar? Analysen är baserad på 42 kvalitativa intervjuer med företrädare för äldreboenden, 338 bilder från fyra äldreboendens Instagram-konton, och 124 tidningsartiklar om en brukarundersökning på äldreboenden. I avhandlingen visas hur massmedia porträtterar äldreboenden som platser i behov av ständiga förbättringar. Äldreboendenas självpresentationer på sociala medier visar hur livet på äldreboende är normalt och vanligt, men också bättre och lyxigare än normalt. Ökad marknadisering, granskning och medialisering ställer krav på verksamheter att presentera bevis på hur de lever upp till externt formulerade krav och förväntningar för att på så sätt uppnå ett gott anseende. Företrädare för äldreboenden hanterar anseende genom att anpassa organisatoriska aktiviteter till yttre krav på olika nivåer och i olika situationer: medan giltigheten i externt formulerade krav i viss mån avfärdades, uttryckte företrädarna samtidigt att det var nödvändigt att agera i enlighet med sådana förväntningar och normer. Studien visar att de nya villkoren har medfört nya institutionella logiker för hur verksamheter hanterar anseende: verksamheter behöver konkurrera med varandra; de behöver producera tilltalande bilder och beskrivningar; och de behöver hantera den tilltänka publikens önskemål. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/019165b1-b9e2-466b-b04b-2f642e3d150a
- author
- Carlstedt, Elisabeth LU
- supervisor
-
- Håkan Jönson LU
- Tove Harnett LU
- opponent
-
- Lektor Lövgren, Karin, University of Gävle
- organization
- alternative title
- Äldreboenden till allmän beskådan : Anseendehantering i den svenska äldreomsorgens nya landskap
- publishing date
- 2020-10-22
- type
- Thesis
- publication status
- published
- subject
- keywords
- Nursing homes, eldercare, reputation management, marketisation, audits, mediatization, neo-institutional theory, Äldreboende, äldreomsorg, anseendehantering, marknadisering, granskning, medialisering, nyinstitutionell teori
- issue
- 60
- pages
- 246 pages
- publisher
- Lund University
- defense location
- Edens hörsal, Allhelgona kyrkogata 14, Lund. Join via: https://lu-se.zoom.us/j/67063629204, Passcode: 300343
- defense date
- 2020-11-12 13:15:00
- ISSN
- 1650-3872
- ISBN
- 978-91-89604-67-4
- language
- English
- LU publication?
- yes
- id
- 019165b1-b9e2-466b-b04b-2f642e3d150a
- date added to LUP
- 2020-10-20 10:28:08
- date last changed
- 2020-11-09 11:17:52
@phdthesis{019165b1-b9e2-466b-b04b-2f642e3d150a,
abstract = {{The general perception of Swedish nursing homes has historically been gloomy. Nursing homes have been associated with a passive, isolated, and institutionalised ‘fourth age’ life. Media reports and the public debate have largely stressed the need for organisational improvements, and called for transparency and control. In recent years, marketisation, audits, and mediatisation have become new conditions that together have shaped the landscape of Swedish eldercare, leading to increased organisational sensitivity to public perception. These changes have made organisational images more difficult to control and cultivate. The dissertation thus examines nursing homes’ publicly displayed images and how nursing home representatives act and react in relation to such images to defend and improve their organisational reputation. The dissertation answers these questions: (1) What kinds of images of nursing homes are constructed in the mass media and social media? (2) What have marketisation, audits, and mediatisation meant for nursing homes’ reputation management practices? (3) How do nursing home representatives manage their organisational reputation in the context of external demands and descriptions? Organisations are theoretically understood as open systems in a dynamic relationship with their institutional environment, and in need of external support to survive and succeed. Organisational reputation is an essential asset in an era of marketisation, particularly for organisations with difficulties demonstrating success and whose goals are uncertain or undefined, such as nursing homes. The analysis is based on 42 qualitative interviews with nursing home representatives, 338 pictures from nursing homes’ Instagram accounts, and 124 newspaper articles about eldercare user satisfaction surveys. The findings show that while the mass media construct nursing homes as places needing continuous improvement and control, the nursing homes’ self-presentations assert that these are settings where life is both normal and better than before. Increased marketisation, audits, and mediatisation have enforced the need to manage reputation by adhering to externally formulated demands, and to provide documented evidence of successful adaption to norms and expectations. Nursing home representatives manage reputation by adjusting organisational activity to external demands on different levels and in different situations: while the validity of externally formulated demands was to some extent dismissed, representatives still express the need to address and act on such expectations. The dissertation shows that the new conditions in the landscape of Swedish eldercare have given way to new institutional logics for reputation management: there is a perceived need to compete and compare; to produce content and communicate images; and to manage and appeal to their intended audience. Organisations attribute validity and adapt to externally formulated demands in different ways. They embrace the validity of external demands and conform; they dismiss and reject demands; they substitute images for action; or they adhere to external demands for the sake of an improved reputation.}},
author = {{Carlstedt, Elisabeth}},
isbn = {{978-91-89604-67-4}},
issn = {{1650-3872}},
keywords = {{Nursing homes; eldercare; reputation management; marketisation; audits; mediatization; neo-institutional theory; Äldreboende; äldreomsorg; anseendehantering; marknadisering; granskning; medialisering; nyinstitutionell teori}},
language = {{eng}},
month = {{10}},
number = {{60}},
publisher = {{Lund University}},
school = {{Lund University}},
title = {{Nursing homes on public display : Reputation management in the new landscape of Swedish eldercare}},
url = {{https://lup.lub.lu.se/search/files/85590473/e_spik_ex_Elisabeth.pdf}},
year = {{2020}},
}