Making home care work : Older adults' everyday agency
(2026) In Lund dissertations in social work 76.- Abstract
- This dissertation examines what older home care users do to make home care arrangements work in everyday life and what their actions show about Swedish home care as a care regime. It builds on and extends research focusing on older people’s own perspectives on care. Across the dissertation’s five articles, care users are shown to contribute extensively to the provision of the services they rely on. They adapt their daily lives to organisational routines, build continuity in services characterised by frequent staff changes, coordinate support across multiple providers, and develop relationships with care workers. They also often support staff working under pressured conditions. Together, these activities show that the provision of home care... (More)
- This dissertation examines what older home care users do to make home care arrangements work in everyday life and what their actions show about Swedish home care as a care regime. It builds on and extends research focusing on older people’s own perspectives on care. Across the dissertation’s five articles, care users are shown to contribute extensively to the provision of the services they rely on. They adapt their daily lives to organisational routines, build continuity in services characterised by frequent staff changes, coordinate support across multiple providers, and develop relationships with care workers. They also often support staff working under pressured conditions. Together, these activities show that the provision of home care depends not only on professionals’ work but also on the everyday efforts of those who use the services.
The dissertation originates in an ethnographically oriented qualitative research project including in-home interviews, home observations, and follow-up interviews, as well as diaries with older home care users in Sweden. Rather than focusing on organisations, policies, or professionals, it examines home care through the everyday actions and experiences of service users, adopting a microsociological, bottom-up approach grounded in symbolic interactionism.
Care users’ agency, understood as situated efforts to influence everyday life, may take the form of initiative and protest, but also cooperation, adaptation, silence, and deliberate nonaction. To analyse this agency, the dissertation introduces the concept of regime competence to describe the knowledge and skills that older home care users develop in response to the conditions of a particular care regime. This includes learning how to organise time and relationships, coordinate care providers, and adapt to organisational constraints. Rather than
being treated primarily as an individual attribute, regime competence is used as an analytical tool for understanding care users’ actions and, through them, the care regime itself. The competences people must develop make visible key features of Swedish home care, including fragmentation, time pressure, and poor continuity.
By placing older home care users’ agency at the centre of the analysis, the dissertation contributes to a deeper understanding of both everyday care and the organisation of Swedish home care. (Less) - Abstract (Swedish)
- Denna avhandling undersöker vad äldre hemtjänstanvändare gör för att få hemtjänsten att fungera i vardagen och vad deras handlingar visar om svensk hemtjänst som omsorgsregim. Avhandlingen bygger vidare på forskning som fokuserar på äldre personers egna perspektiv på den omsorg deras vardag genomsyras av.
I avhandlingens fem artiklar visas och analyseras hur hemtjänstanvändare i betydande utsträckning bidrar till att de insatser de behöver fungerar. De anpassar sina vardagsliv till organisatoriska rutiner, skapar kontinuitet i verksamheter som annars sakar det, samordnar stöd från olika utförare i ett fragmenterat system, och utvecklar relationer till omsorgspersonal. De stöttar också ofta personal som arbetar under pressade villkor.... (More) - Denna avhandling undersöker vad äldre hemtjänstanvändare gör för att få hemtjänsten att fungera i vardagen och vad deras handlingar visar om svensk hemtjänst som omsorgsregim. Avhandlingen bygger vidare på forskning som fokuserar på äldre personers egna perspektiv på den omsorg deras vardag genomsyras av.
I avhandlingens fem artiklar visas och analyseras hur hemtjänstanvändare i betydande utsträckning bidrar till att de insatser de behöver fungerar. De anpassar sina vardagsliv till organisatoriska rutiner, skapar kontinuitet i verksamheter som annars sakar det, samordnar stöd från olika utförare i ett fragmenterat system, och utvecklar relationer till omsorgspersonal. De stöttar också ofta personal som arbetar under pressade villkor. Sammantaget visar dessa aktiviteter att hemtjänstens utförande inte bara är beroende av professionellas arbete, utan också av de vardagliga insatser som görs av dem som använder tjänsterna.
Avhandlingen härrör från ett etnografiskt orienterat kvalitativt forskningsprojekt med intervjuer i hemtjänstanvändares hem, observationer av hemtjänstinsatser, uppföljande intervjuer och dagböcker skrivna av hemtjänstanvändare i Sverige. I stället för att fokusera på organisationer, policy eller professionella undersöker den hemtjänsten genom användarnas vardagliga handlingar och erfarenheter. Den använder ett mikrosociologiskt underifrånperspektiv med grund i symbolisk interaktionism.
Omsorgsanvändarnas agens, förstådd som situerade försök att påverka vardagslivet, kan ta sig uttryck i protester och motstånd, men också i samarbete, anpassning, tystnad och medveten icke-handling. För att analysera denna agens introducerar avhandlingen begreppet regimkompetens, som beskriver den kunskap och de färdigheter äldre hemtjänstanvändare utvecklar som svar på villkoren inom en viss omsorgsregim. Detta omfattar att lära sig organisera tid och relationer, samordna omsorgsgivare och anpassa sig till organisatoriska begränsningar. Regimkompetens är inte främst en individuell egenskap, utan ett analytiskt verktyg för att förstå omsorgsanvändarnas handlingar och, genom dem, själva omsorgsregimen. De kompetenser som människor fås att utveckla synliggör centrala drag i svensk hemtjänst, däribland fragmentering, tidspress och bristande kontinuitet.
Genom att placera äldre hemtjänstanvändares agens i analysens centrum bidrar avhandlingen till en fördjupad förståelse av såväl vardaglig omsorg som organiseringen av svensk hemtjänst.
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Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/e0c0ed81-a730-4ac0-ae36-41631b84776f
- author
- Möllergren, Glenn LU
- supervisor
-
- Håkan Jönson LU
- Tove Harnett LU
- opponent
-
- Professor Dahl, Hanne Marlene, Roskilde University
- organization
- alternative title
- Att få hemtjänsten att fungera : Äldres vardagsagens
- publishing date
- 2026-08
- type
- Thesis
- publication status
- published
- subject
- keywords
- hemtjänst, Äldre, agens, omsorgsregimer, regimkompetens, Older adults, Home care, regime competence, Agency, care regimes
- in
- Lund dissertations in social work
- volume
- 76
- pages
- 117 pages
- defense location
- Hörsalen, Socialhögskolan, Allhelgona Kyrkogata 8, Lund
- defense date
- 2026-09-17 10:15:00
- ISSN
- 1650–3872
- ISBN
- 978-91-89604-84-1
- project
- Vård- och omsorgssystemets navigatörer – hur äldre förstår, förhandlar och koordinerar hemtjänst och andra hjälpinsatser i sin vardag
- language
- English
- LU publication?
- yes
- id
- e0c0ed81-a730-4ac0-ae36-41631b84776f
- date added to LUP
- 2026-08-13 13:37:21
- date last changed
- 2026-08-24 09:11:33
@phdthesis{e0c0ed81-a730-4ac0-ae36-41631b84776f,
abstract = {{This dissertation examines what older home care users do to make home care arrangements work in everyday life and what their actions show about Swedish home care as a care regime. It builds on and extends research focusing on older people’s own perspectives on care. Across the dissertation’s five articles, care users are shown to contribute extensively to the provision of the services they rely on. They adapt their daily lives to organisational routines, build continuity in services characterised by frequent staff changes, coordinate support across multiple providers, and develop relationships with care workers. They also often support staff working under pressured conditions. Together, these activities show that the provision of home care depends not only on professionals’ work but also on the everyday efforts of those who use the services.<br/>The dissertation originates in an ethnographically oriented qualitative research project including in-home interviews, home observations, and follow-up interviews, as well as diaries with older home care users in Sweden. Rather than focusing on organisations, policies, or professionals, it examines home care through the everyday actions and experiences of service users, adopting a microsociological, bottom-up approach grounded in symbolic interactionism.<br/>Care users’ agency, understood as situated efforts to influence everyday life, may take the form of initiative and protest, but also cooperation, adaptation, silence, and deliberate nonaction. To analyse this agency, the dissertation introduces the concept of regime competence to describe the knowledge and skills that older home care users develop in response to the conditions of a particular care regime. This includes learning how to organise time and relationships, coordinate care providers, and adapt to organisational constraints. Rather than<br/>being treated primarily as an individual attribute, regime competence is used as an analytical tool for understanding care users’ actions and, through them, the care regime itself. The competences people must develop make visible key features of Swedish home care, including fragmentation, time pressure, and poor continuity.<br/>By placing older home care users’ agency at the centre of the analysis, the dissertation contributes to a deeper understanding of both everyday care and the organisation of Swedish home care.}},
author = {{Möllergren, Glenn}},
isbn = {{978-91-89604-84-1}},
issn = {{1650–3872}},
keywords = {{hemtjänst; Äldre; agens; omsorgsregimer; regimkompetens; Older adults; Home care; regime competence; Agency; care regimes}},
language = {{eng}},
school = {{Lund University}},
series = {{Lund dissertations in social work}},
title = {{Making home care work : Older adults' everyday agency}},
url = {{https://lup.lub.lu.se/search/files/257951041/M_llergren_G_2026_Dissertation_Making_home_care_work.pdf}},
volume = {{76}},
year = {{2026}},
}