Municipal care for older people : experiences narrated by caregivers and relatives

Abstract

The overall aim with the longitudinal studies of the thesis was to gain an understanding of caregivers´ experiences of working with older people within municipal care and of whether education and support have been meaningful for them (I-III). A further aim was to gain an understanding of which aspects are important so that work will be able to be carried out in a care environment that provides fulfilment and work satisfaction and thereby creates the prerequisites for the staff to provide the older people with better care. Furthermore narratives from relatives were studied (IV) in order to increase knowledge about their experiences of having an old family member in special housing within municipal care and to increase knowledge about the relatives wishes and their possibility of taking part in the care.

Studies I and III comprised an investigation of the deeper meaning of work satisfaction and work dissatisfaction at a newly opened nursing home for elderly residents before an intervention had started (I) and after a two-year intervention (III). The studies focused on the narratives supplied by the caregivers at the nursing home. The interviews were analysed with a phenomenological-hermeneutic method inspired by Ricoeur s philosophy. The conclusion drawn is that the caregivers experience of work dissatisfaction overshadowed their experience of work satisfaction before the intervention had started (I). There was a shift from this dominance to a dominance of work satisfaction after the two-years intervention, which indicates that the intervention, consisting of: education, support, and supervision, might have facilitated this positive development (III).

According to the caregivers feelings of work dissatisfaction which appeared in study I the aim of study II was to investigate whether the caregivers previous experiences could be understood and whether they reflected Ås´ Five Master Techniques Theory. The interviews were analysed with a qualitative content approach. The findings showed that it was obvious that the caregivers experiences of work dissatisfaction reflected and could be understood from feelings of being made to feel invisible, deprived of information, double punishment, and feelings of guilt and shame which is the content of Ås´ Five Master Techniques Theory.

The aim of study IV was to describe the relatives´ experiences concerning older family members living in special housing facilities and to increase knowledge about relatives´ wishes and their possibilities of taking part in the care. The study focused on the narratives supplied by the relatives and was analysed using qualitative content analysis. The conclusion was that the relatives need more support and more opportunities, for a possibility to be able to participate in the care. The study also showed the relatives´ engagement, in working for a just society, obligation towards the protection of older peoples´ rights and the working conditions for staff.

The most important findings of this thesis (I-IV) were that in order to increase understanding for caregivers within municipal care for the older people and for the relatives situation of having a close relative that lives there, one should see their situation both from an individual perspective, i.e. the direct contact between the older people, the caregivers, the relatives, and from a society perspective, i.e. to see the elderlys´, caregivers and the relatives situation from a society perspective. Another conclusion one can make is that support, education and supervision are important and supervision needs to focus more on society s humanistic basic views in care work for both caregivers and relatives.