Aspects of municipal culture in care for the elderly : a hermeneutic documentary analysis of reports of abuse

• Introduction: Care culture is an important contextual factor in care practice. Care culture refers to a process of creating meaning out of tradition, horizon and bildung. The care culture is often taken into consideration in situations which go beyond the everyday routine, such as cases of mistreatment. In Sweden, health care professionals are obliged  to document and report any suspected bad conditions. Aim: To understand aspects of the municipality’s care culture for the elderly, in the light of reports of suspected mistreatment. Design and methods: A hermeneutic documentary analysis was conducted on 269 incident reports concerning suspected mistreatment of the elderly in three municipalities in Sweden. The hermeneutic analysis followed a four-stage process: selecting and reading the text, setting out the context, closing the hermeneutic circle, and finally creating a conceptual bridge towards a critical understanding from a phenomenological lifeworld perspective, which is the theoretical basis for this study. Findings: It was found that care of the elderly in the municipality was based on a social culture which placed residents' needs at the centre. Following routines were considered important in preventing mistreatment, and were intended to ensure that all patients were treated fairly and equally. Care was described as task-oriented and often lacking in interpersonal relations. From a phenomenological lifeworld perspective, it was shown that in the municipality’s care of the elderly there was a focus on elderly people’s freedom at the expense of the vulnerability aspects of well being. Conclusion: Raising awareness of the values underlying care could help to understand care practice. Change is only possible when we reflect on the existing perspectives underpinning the care culture, and integrate them into a broader framework for caring. This will provide the basis moving towards a caring culture based on the meaning and values that promote humanistic care.

Nyckelord

Care culture

Caring

Document analysis

Elderly care

Hermeneutic

Municipal

Publikations- och innehållstyp

vet (ämneskategori)

ovr (ämneskategori)