Denna studie analyserar hur jobbkrav och jobbresurser påverkar personalens benägenhet att sluta respektive stanna kvar i arbetet inom äldreboende, hemtjänst, personlig assistans och LSS-boende. Resultaten visar att jobbkraven är mer omfattande inom äldreomsorgen medan skillnaden mellan yrkesgrupperna är mindre när det gäller jobbresurser. Det finns ett tydligt samband mellan omfattningen av jobbkrav och benägenheten att vilja sluta. Tillgång till jobbresurser har en viss skyddande effekt, men effekten avtar när personal upplever påfrestningar på fler områden. Slutsatsen är att det är påfrestningarna i arbetet som måste begränsas för att fler inom omsorgsyrken ska vara benägna att stanna kvar i arbetet.

Care work is shaped by the context in which it is carried out. This study explored the context, content, conditions and consequences of work in two fields of social care in Sweden: eldercare and disability services. Policy documents and statistical sources were used to analyse the context. Job content, working conditions and consequences of work were analysed using survey data collected in 2015 and 2017 in eldercare and disability services (N = 1307). The analysis of the political and economic context showed that the disability sector is characterised by a higher ambition level in legislation and funding. The survey of care workers reflected this difference: the work content differs; and the working conditions and their consequences are significantly worse for the eldercare staff than for the disability service staff. Possible explanations for these differences are discussed in terms of policy-framing, ageist notions and unintended consequences of policy changes.

Assuming care is a relationship that builds on strengths and attends to individual needs, this chapter explores the skills, information, and structural supports required to develop and maintain these complex relationships and the multiple competing demands and tensions that are complicated by inequities in power and in continually evolving capacities. Understanding nursing homes as both work and living spaces, as well as organizations that provide medical, social, and living supports, it argues that it takes the village that is the nursing home, and the community in which it is embedded, to appropriately promote such relationships. It identifies some central ingredients and tensions that should be balanced for promoting nursing home care relationships, including risk tolerance, care designed for living, and structures that make such care possible in order to make nursing homes as good as they can be.

This chapter draws on staff interview data and fieldnotes to examine the perspectives of staff and the relationships they have with relatives' families in Canadian, Norwegian and Swedish nursing homes. Jurisdictional contextual differences, including models of care, staffing levels and work organisation, vary considerably. These different contextual conditions shape the various roles that families navigate alongside and with staff, and the amount and form of unpaid work in which they engage. These conditions also shape the types and depth of relationships that form between staff and families. Such factors as having a contact-person model, small units and high staffing levels leave room and space for closer social connections between residents, family and staff and more continuity. However, these systems are not achievable without sufficient staffing levels and managerial support. Without them, there will continue to be tensions between staff and families and demands on both families and staff to bridge care gaps with unpaid work.

Introduction: framing and comparingunpaid care work

Drawing on fifteen years of international research employing mutiple methods, this chapter begins by explaining who provides care in Canada, Norway and Sweden, highlighting similarities and differences among countries in the training and organization of the nursing home labour force. After considering how race and gender shape the conditions of work and analyzing the kinds of conditions, such as staffing levels and health risks, that are experienced by the nursing home labour force in these three countries, the chapter moves on to describe the strategies introduced by each of these countries to address the Covid crisis. Informed by these more recent strategies, the chapter concludes by setting out the supportive working conditions that could transform nursing homes.

Increased demand for long-term care (LTC) services alongside precarious working conditions has resulted in labour shortages in the LTC sector, which has led to an increasing share of workers of migrant origin filling these jobs. Previous research on migrant care workers has also highlighted the seeming gap in working conditions relative to native workers. However, lack of disaggregated data on migrant and native care workers, alongside single-case studies, may have concealed potential disadvantages faced by certain groups and insufficiently accounted for differences in migration regimes and organisation of LTC sectors. To address these gaps, we carried out a comparative study on various working conditions of migrant and native LTC workers in Austria and Sweden. Using the international Nordcare survey on care sector working conditions, carried out in Austria in 2017 (n = 792) and in Sweden in 2015 (n = 708), we employed t-tests and multivariate logistic regressions to compare the working conditions of migrant and native carers in home and residential care in each country. We found that worse working conditions in Sweden compared to Austria may be explained by differences in training requirements of the LTC workforce and the relatively large for-profit private sector. Country of origin also plays a paramount role in the differences in working conditions experienced by migrants compared to native care workers, with non-European migrants being more likely to face a number of precarious working conditions. Our findings highlight the need to continue addressing precarious working conditions across the sector, particularly during the COVID-19 pandemic where poor working conditions have been linked to increased COVID-related deaths in nursing homes. Our findings also emphasise the importance of policies that consider the various challenges experienced by different migrant groups in the LTC sector, who may particularly be at risk of presenteeism during the COVID-19 pandemic.

The growth of the for-profit nursing home sector in Norway and Sweden : driving forces and resistance

The Social Democratic architects of the Swedish welfare state considered public provision as well as public funding of welfare services essential to realising their egalitarian ambitions. However, since the early 1990s, a highly concentrated, for-profit sector has emerged in welfare service provision. We analyse how the Swedish Social Democrats have discussed privatisation and the profit motive in welfare services from the 1980s to the present. We find that Social Democratic governments have defended public provision weakly across the period. The driving factors include the eclipse of the egalitarian ideal in favour of ideals of choice and diversity, internal disunity within the party on the profit question, and change in the political power order in Sweden, such that private welfare companies and their interest organisations have gained and now wield significant influence over welfare service policy.

Assistive personnel are the primary caregivers in long term residential care (LTRC) and their job autonomy is a major social determinant of health. Our goal is to explore experiences of assistive personnel in six industrialized countries (Canada, Germany, Norway, Sweden, England, and the U.S.), and consider innovations in the LTRC setting that might influence their job autonomy. The methodology is based on on-site observations at nursing homes and interviews with assistive personnel and other relevant LTRC staff in selected nursing homes in all six countries. Previously published statistical material from the study on staff characteristics like pay, formal education, unionization, employment-related benefits and extent of part-time work is employed as relevant context for discussing job autonomy. Our results show that assistive personnel are highly supportive of job autonomy though they interpret autonomy differently and report widely varying levels of job autonomy. Those LTRC organizations that have a reputation for encouraging autonomy of assistive personal, report recruiting is far easier even where there is a shortage. In some countries we were told that "resident-centered" ( "person-centered") care and a leveling of the division of labor, understood as more equal and horizontal division of labor, was on the rise and this could affect autonomy. Job autonomy is welcomed by assistive personnel. The wide variation in job autonomy across nursing homes and across countries is surprising. Within nursing homes variation may reflect imperfect or incomplete implementation of autonomy policies, or differential application of policies. The resident-centered philosophy and the leveling of the division of labor could make for greater autonomy for assistive personnel. These workplace innovations are not universal in all countries and they could be more difficult to apply where resources and commitment are lacking. The increasingly frail population of LTRC facilities and the general trend toward growth of specialized medical treatment within LTRC in some of the countries may support an argument for some limitations to job autonomy in assistive personnel. Autonomy is favored by assistive personnel though not all have it. The workplace innovations of resident-centered care and a leveling of the division of labor in LTRC, could make for a greater degree of autonomy for assistive personnel in the future, while increased demand for highly skilled care could work in the other direction.

Market-oriented restructurings of long-term care policies contribute significantly to the aggravation of care workers' situations. This article focuses on the effects of broader long-term care policy developments on market-oriented reforms. Germany, Japan and Sweden are three countries that have introduced market-oriented reforms into home-based care provision embedded in distinct long-term care policy developments. Conceptually, this article draws on comparative research on care to define the institutional dimensions of long-term care policies. Empirically, the research is based on policy analyses, as well as on national statistics and a comparative research project on home-care workers in the aforementioned countries. The findings reveal the mediating impact of the extension and decline of long-term public care support and the corresponding development of the care infrastructure on both the restructuring of care work and the assessments of the care workers themselves.

Welfare services such as child care, schools, medical care, elder care and other social services are important for most people's everyday life. Welfare services are created for the purpose of strengthening citizens' freedom of action and, in the long run, their welfare. New directives and new forms of management and operation have emerged on a broad front within the elder care sector, and the breakthrough of organizational models fashioned after the market has been more pronounced in this sector than in any other welfare service. In both child care and elder care, the ideal image of the universal Scandinavian welfare regime has become more remote, even though certain trends to the contrary have also been noted. Swedish child care policy has had a dual objective: on one hand, to make it easier for parents to combine parenthood and gainful employment or studies; and, on the other, to stimulate children's development through pedagogical interventions and to work towards equalising the conditions.