| 1. |
- Giertz, Lottie, 1954-, et al.
(författare)
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Family caregivers and decision-making for older people with dementia
- 2019
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Ingår i: Journal of Social Welfare and Family Law. - : Taylor & Francis Group. - 0964-9069 .- 1469-9621. ; 41:3, s. 321-338
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Tidskriftsartikel (refereegranskat)abstract
- This article addresses the dilemmas concerning legislation, individual autonomy and the reality of everyday life for people coping with dementia. We describe and analyse decision-making in relation to older people with dementia in Sweden, within the area of social work regulated by the Social Services Act and the Parental Act. Swedish legislation is based on the individual's autonomy and capacity to consent to services without anyone having legal authority to decide on behalf of the individual. Based on data from interviews with family caregivers living at home, decision-making through family caregivers is discussed and formal guardianship is also considered. Swedish legislation leaves individuals with dementia and family caregivers in a vacuum between self-determination and full autonomy with the ideal of citizenship emphasised and recognised in the Social Services Act on the one hand, and on the other, a strong need for support in everyday life and with decision-making.
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| 2. |
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| 3. |
- Lebeda Henriksson, Charlotte
(författare)
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Barns och ungdomars bilder av poliser : En studie i två lokala sammanhang
- 2015
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- SammanfattningI fokus för denna licentiatuppsats är barns och ungdomars bilder av poliser. Syftet är att beskriva dessa bilder och placera dem i en senmodern samhällelig kontext. Vägledande i beskrivningarna är tre meningsbärande begrepp – föreställningar, erfarenheter och förväntningar – vilka har utkristalliserats ur det empiriska materialet. Utgångspunkten är att bilderna är socialt konstruerade, med hänsyn till maktordning, habitus, sociala positioner och symboliskt kapital. För att förstå den betydelse unga tillskriver poliser är ansatsen därtill kulturellt sociologisk. Studien bygger på ett enkätmaterial med 1 945 barn och ungdomar utan specifik erfarenhet av kriminella handlingar, i åldern 10-22 år. 35 grundskolor och 11 gymnasieskolor har deltagit och svarsfrekvensen är 58 procent i vardera kommunen. Dessutom genomfördes samtalsintervjuer i grupp med sammanlagt 50 deltagare i direkt anslutning till enkätstudien. Analysmetoden är inspirerad av tematisk analys.Materialet visar att barns och ungdomars uppfattning om Polisen som institution är positiv, men att de är något mer kritiska till Polisen som organisation och betydligt mer kritiska till enskilda poliser. Den övervägande andelen av deltagarna har varit i kontakt med poliser, främst i skolan eller när de har ansökt om pass. Förväntningarna på poliser är att de ska rikta sin verksamhet mot vuxna. Den yngre gruppen, 10-12 år är i större utsträckning, positiva till poliser. Den något äldre gruppen, 13-16 år, är mer negativa, medan den äldsta gruppen, 17-22 år, har en betydligt mer nyanserad bild av poliser.Vidare visar det sig att föreställningar, erfarenheter och förväntningar intimt hänger samman. Föreställningar bygger på olika erfarenheter, vilket i sin tur genererar olika förväntningar mot bakgrund av olika förutsättningar i tillvaron. En del bilder är mer generellt förekommande medan andra framställs främst i mer avgränsade kategoriserade grupper med unga.Ungas bilder kan tolkas som en kamp inom fältet där habitus och symboliskt kapital utgör maktmedel. Om vi väljer att se på unga som seismografer kan deras bilder vara tecken på en allmänt hållen bild av poliser även bland vuxna. Det visar sig också finnas en mystik runt poliser. Samtidigt som de kan upplevas vara i vägen är det spännande att se dem agera i skarpt läge. Skrönor spär på mystiken samtidigt som Polisens sätt att vara förtegna om hur de verkar, bidrar till de bilder vi har av dem.
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| 4. |
- Melin Emilsson, Ulla, 1947-, et al.
(författare)
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Good personal finances or a strong social capital : on different life conditions of importance for an active life when becoming alone in old age : Gott om pengar eller ett starkt socialt kapital? Om skillnader i livsvillkor för män och kvinnor som blir ensamma på äldre dar
- 2016
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Ingår i: European Journal of Social Work. - : Routledge. - 1369-1457 .- 1468-2664. ; 19:5, s. 749-763
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Tidskriftsartikel (refereegranskat)abstract
- Becoming alone in old age can be a decisive life event that brings major changes depending on various causes as health status, financial resources, family situation, and available welfare services. This article discusses the situation of older people in Sweden who have transitioned from a two-person to single-person household in recent years and what impact this might have on their everyday lives. Through in-depth interviews with 18 older people, age 67–90, their experiences about life conditions and opportunities were examined. Findings showed large differences between the men and women. They all tried to live as they always had done and they used the same personal life strategies that they always had. But the men could live as before on their own financial merits, while the women needed assistance from children, grandchildren and the welfare system. Transportation options were central and clearly related to both private economy and social services available. Shortcomings in the welfare state's way of caring for the elderly were clearly uncovered. The gap between social policy promises of opportunities for autonomy and independence to live an active life in old age and the everyday reality for older people still seems to be wide.
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| 5. |
- Melin Emilsson, Ulla, et al.
(författare)
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Good personal finances or a strong social capital – on different life conditions of importance for an active life when becoming alone in old age.
- 2016
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Ingår i: European Journal of Social Work. - : Informa UK Limited. - 1369-1457 .- 1468-2664. ; 19:5, s. 749-763
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Tidskriftsartikel (refereegranskat)abstract
- Becoming alone in old age can be a decisive life event that brings major changes depending on various causes as health status, financial resources, family situation, and available welfare services. This article discusses the situation of older people in Sweden who have transitioned from a two-person to single-person household in recent years and what impact this might have on their everyday lives. Through in-depth interviews with 18 older people, age 67–90, their experiences about life conditions and opportunities were examined. Findings showed large differences between the men and women. They all tried to live as they always had done and they used the same personal life strategies that they always had. But the men could live as before on their own financial merits, while the women needed assistance from children, grandchildren and the welfare system. Transportation options were central and clearly related to both private economy and social services available. Shortcomings in the welfare state's way of caring for the elderly were clearly uncovered. The gap between social policy promises of opportunities for autonomy and independence to live an active life in old age and the everyday reality for older people still seems to be wide.
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| 6. |
- Renom-Guiteras, Anna, et al.
(författare)
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Potentially inappropriate medication among people with dementia in eight European countries
- 2018
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Ingår i: Age and Ageing. - : Oxford University Press (OUP). - 0002-0729 .- 1468-2834. ; 47:1, s. 68-74
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: to evaluate the frequency of potentially inappropriate medication (PIM) prescription among older people with dementia (PwD) from eight countries participating in the European study 'RightTimePlaceCare', and to evaluate factors and adverse outcomes associated with PIM prescription.Methods: survey of 2,004 PwD including a baseline assessment and follow-up after 3 months. Interviewers gathered data on age, sex, prescription of medication, cognitive status, functional status, comorbidity, setting and admission to hospital, fall-related injuries and mortality in the time between baseline and follow-up. The European Union(7)-PIM list was used to evaluate PIM prescription. Multivariate regression analysis was used to investigate factors and adverse outcomes associated with PIM prescription.Results: overall, 60% of the participants had at least one PIM prescription and 26.4% at least two. The PIM therapeutic subgroups most frequently prescribed were psycholeptics (26% of all PIM prescriptions) and 'drugs for acid-related disorders' (21%). PwD who were 80 years and older, lived in institutional long-term care settings, had higher comorbidity and were more functionally impaired were at higher risk of being prescribed two PIM or more. The prescription of two or more PIM was associated with higher chance of suffering from at least one fall-related injury and at least one episode of hospitalisation in the time between baseline and follow-up.Conclusions: PIM use among PwD is frequent and is associated with institutional long-term care, age, advanced morbidity and functional impairment. It also appears to be associated with adverse outcomes. Special attention should be paid to psycholeptics and drugs for acid-related disorders.
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| 7. |
- Ritenius Manjer, Åsa, et al.
(författare)
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Non-attendance in mammography screening and women’s social network : A cohort study on the influence of family composition, social support, attitudes and cancer in close relations.
- 2015
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Ingår i: World Journal of Surgical Oncology. - : Springer Science and Business Media LLC. - 1477-7819. ; 13, s. 211-217
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundMammography screening can reduce breast cancer mortality. The aim of the present study was to investigate non-attendance in mammography screening in relation to different aspects of a women’s social network, attitudes and cancer in close relations.MethodsData from the Malmö Diet and Cancer Study baseline examination in 1991–1996 was used. A re-examination began in 2007, and 1452 women participated. Family composition, social support, sense of belonging, attitudes on screening and breast cancer risk and on previous cancer in close relations were investigated in relation to self-reported participation in mammography screening using logistic regression analysis, yielding odds ratios with 95 % confidence intervals.ResultsBoth attendees (98.0 %) and non-attendees (95.2 %) considered mammography screening important. Non-attendance in mammography screening was associated with being unmarried vs. married (2.40:1.30–4.45) and with not having vs. having children (1.77:1.08–2.92). Non-attendees planned to abstain from mammography screening in the future more often than attendees (4.78:2.56–8.90), and they had often abstained from cervical cancer screening (1.69:1.04–2.75). No other statistically significant association was found.ConclusionsThis study indicates that family composition, but not necessarily the presence or absence of social support, perceived cancer risk or cancer in close relations, may affect non-attendance in mammography screening. A positive attitude towards mammography screening was found among both attendees and non-attendees, although the latter group planned to a lesser degree to attend mammography screening in the future.
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| 8. |
- Ritenius Manjer, Åsa, et al.
(författare)
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Non-take up i det svenska välfärdssystemet : Om betydelsen av social position för kvinnors beslut kring mammografiscreening
- 2016
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Ingår i: Sociologisk forskning. - Falun : Sveriges Sociologförbund. - 0038-0342 .- 2002-066X. ; 53:2, s. 101-126
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Tidskriftsartikel (refereegranskat)abstract
- Non-take up in the Swedish welfare system: On the impact of social position on women’s decision-making regarding mammography screeningCentral to a well-functioning and effective welfare system is that benefits reach the people to whom they are intended. By focusing on an example of so called non-take up – namely women’s decision not to attend mammography screening – this article discusses decision making in relation to living conditions, i.e. social position, and to the public health intentions of the welfare state. The main theoretical basis for the analysis is Rogers’ humanistic/existential theory. Qualitative semi-structured interviews were made with 18 women who had abstained from mammography screening. Their decision was described, analyzed and problematized focused on whether their living conditions, leading to a strong or weak social position, is of relevance to their decision to refrain from this health promoting examination. The women’s own experiences clearly showed how their social position was of great importance for how they explained their decision to abstain. Furthermore, social position affects how women handle different impact from living conditions, society’s expectations and personal experiences of mammography screening. This study makes visible the gap between public health intentions of the society and individual conditions.
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| 9. |
- Ritenius Manjer, Åsa, et al.
(författare)
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Non-take up i det svenska välfärdssystemet : Om betydelsen av social position för kvinnors beslut kring mammografiscreening
- 2016
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Ingår i: Sociologisk Forskning. - 0038-0342. ; 53:2, s. 101-126
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Tidskriftsartikel (refereegranskat)abstract
- Centralt för ett välfungerande och effektivt välfärdssystem är att förmånerna når ut till de människor de är avsedda för. Genom att sätta fokus på ett utslag av så kallad non-take up - nämligen kvinnors beslut att avstå från mammografiscreening - diskuterar denna artikel beslutsprocessen i förhållande till levnadsvillkorens betydelse för ageranden i hälsofrågor ställt i ljuset av välfärdsstatens folkhälsorelaterade intentioner. Utifrån kvalitativa semistrukturerade intervjuer med 18 kvinnor som avstått från mammografiscreening beskrivs, analyseras och problematiseras hur kvinnors levnadsvillkor kan vara av relevans för beslutet att avstå från denna hälsofrämjande undersökning ur ett samhällsperspektiv. Som teoretiskt analysverktyg på individuell nivå har Rogers’ humanistiskt/existentiella teori tillämpats. För att belysa kvinnornas beslut att avstå från mammografiscreening i en mer övergripande samhällelig kontext relateras till forskning om kopplingen mellan hälsa och socioekonomiska förhållanden. Kvinnornas egna erfarenheter visar tydligt hur deras levnadsvillkor hade stor betydelse för hur de förklarade beslutet att avstå. När det gäller den form av så kallad non-take up som icke-deltagande i mammografiscreening utgör, kan vi konstatera att välfärdssystemets intentioner inte når ända fram och en av de slutsatser vi drar är att samhället behöver ta individuella aspekter i större beaktande när hälsopreventiva program planeras och genomförs; om jämlika förutsättningar för hälsa skall kunna uppnås.
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| 10. |
- Ritenius Manjer, Åsa, et al.
(författare)
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On Women’s Ambivalence about Mammography Screening : Support in the Decision-Making Process a Potential Role for Health Care Social Workers?
- 2016
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Ingår i: British Journal of Social Work. - : Oxford University Press (OUP). - 0045-3102 .- 1468-263X. ; 46:2, s. 480-497
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this article is to reach a deeper understanding of women's decision-making process regarding non-attendance at mammography screenings. The article also discusses the health care social workers' role in providing support to women during this decision. Eighteen qualitative semi-structured interviews were conducted with women who had abstained from mammography screening in Malmö, Sweden. Thematic analyses were used as a method and The Rational Choice Theory, The Health Belief Model and the notion of Cross-Pressure were used as a theoretical framework. A prominent feature was that the relationship between the women's decision to abstain and the normative perception that mammography is an important examination led to ambivalent thoughts. It can be seen as an adjustment to the structure to be invited and a cross-pressure between performed and expected actions. Moreover, the decision to abstain from mammography screening was preceded by thoughts about the right choice, specifically in relation to what would happen to these women if they got breast cancer. Women who abstain need to think about their decision to a larger extent than women who attend the screening and we argue that they should be offered support by health care social workers in the invitation letter to mammography screening.
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| 11. |
- Ritenius Manjer, Åsa, et al.
(författare)
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Tillit och misstro : om synen på mammografiscreening vid bröstcancer
- 2017
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Ingår i: Socialvetenskaplig tidskrift. - 1104-1420. ; 2017:2, s. 127-147
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Tidskriftsartikel (refereegranskat)abstract
- One example of the welfare state’s health ambitions is to reduce the onset of illness and mortality from cancer, which among other things means that approximately 900,000 women in Sweden in the age group 40–74 years recurrently receive an invitation to mammography screening. The objective is to detect possible breast cancer at an early stage and thereby reduce mortality from the disease. For this to be possible a high participation is one of the basic conditions. This article deals with the view of mammography screening among women who have experienced breast cancer. Twenty-eight women were interviewed in six focus group settings. Data were processed through a thematic analysis and theories of coping were used as the analytical tool. The findings show how the confidence in the value of mammography screening was on trial in connection with the announcement of the diagnosis, especially for the women who discovered their breast cancer themselves between two screenings (interval cancers). The way the tumour was discovered marked a watershed between feeling confident or not to the value of mammography screening. The women in the study used three forms of coping strategies to continue maintaining confidence in the value of mammography screening: adaptation, control and avoidance. Overall, these strategies have been interpreted as an adaptation to the welfare state’s health ambitions and an enabling to continue the participation when the invitation for mammography screening arrives in the mailbox, regardless of their own experiences.
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| 12. |
- Söderberg, Maria, et al.
(författare)
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How the care managers handle the situation when older people consider relocation to a residential home
- 2015
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Ingår i: British Journal of Social Work. - : Oxford University Press (OUP). - 0045-3102 .- 1468-263X. ; 45:8, s. 2423-2440
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this article is to reveal how care managers handle the process when older people consider relocation to a residential home in a Swedish context. The article is based on vignette-based interviews with seven care managers. The main findings in the article are that the care managers assist older people in their decisions by turning ageing in place and relocation respectively into seemingly natural choices. In both approaches they use warrants related partly to ‘the best for older people’, partly to ‘the common good of economizing’. The conclusions drawn are that the care managers by applying risk management and extensive alliance-strategies are not really able to question their own work situation and that they perform their work in a context of different parties restraining themselves. The implications for social work policy and practice are that the approach referring to older people’s self-determination while actually dealing in risk assessment must be thoroughly reconsidered. Other practical implications are that the idea of the purchaser/provider-model must be clarified, beyond the assessment of resources.
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| 13. |
- Söderberg, Maria, et al.
(författare)
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Stratified structural and epistemic aspects of the care managers’ discretion - : A theoretical approach to the complex process related to older people’s relocation to a residential home
- 2015
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Ingår i: European Journal of Social Work. - : Taylor & Francis Group. - 1369-1457 .- 1468-2664. ; 18:3, s. 325-339
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Tidskriftsartikel (refereegranskat)abstract
- By applying a theoretical point of departure, the overarching aim of this article is to describe, analyze, and try to understand why care managers in their everyday occupational practice normalize the restrictive approach when older people consider relocation to a residential home. While earlier research to a large extent has drawn attention to how the care managers carry out the restrictive approach, this article pays attention to the circumstances paving its way. The focus is on influences from different sociological levels, thereby ‘stratified’, and from two aspects of discretion, where ‘structural aspects’ refer to choices between permitted alternatives and ‘epistemic aspects’ to practical reasoning under conditions of indeterminacy. With this combination, a multitude of circumstances contributing to the restrictive approach is revealed. Thus, the theoretical model includes levels as well as discretionary powers where formulas constitute the foundation at each level, subsequently related to multidisciplinary references in order to get the practice into perspective. The findings show that the priority given to home-based care in contrast to residential care is repeated and confirmed at each level and besides in an interchange between structural and epistemic aspects.Det övergripande syftet med artikeln är att med hjälp av en teoretisk utgångspunkt beskriva, analysera och försöka förstå varför biståndshandläggarna i sin dagliga yrkesutövning normaliserar en restriktiv hållning när äldre personer överväger en flytt till ett särskilt boende. Medan tidigare forskning i stor utsträckning har uppmärksammat på vilket sätt biståndshandläggarna tillämpar en restriktiv hållning, uppmärksammar den här artikeln omständigheter som möjliggör den. Fokus är på influenser från olika sociologiska nivåer, därigenom ‘stratifierade’, och från två aspekter av hur biståndshandläggarna går tillväga, där ‘strukturella aspekter’ avser val mellan tillåtna alternativ och ‘epistemiska aspekter’ ett praktiskt resonerande under betingelser av obestämdhet. Med denna kombination framträder ett flertal omständigheter som bidrar till den restriktiva hållningen. Därmed inkluderar den teoretiska modellen såväl nivåer som aspekter av biståndshandläggarnas handlingsutrymme och resonemang med formler som utgångspunkter på varje nivå, vilka i ett nästa steg relaterats till flervetenskapliga referenser för att ge praktiken perspektiv. Resultatet visar att den prioritet som ges den hembaserade omsorgen i motsats till omsorgen på särskilda boenden upprepas och bekräftas på varje nivå och dessutom i en växelverkan mellan strukturella och epistemiska aspekter.
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| 14. |
- Söderberg, Maria, et al.
(författare)
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Stratified structural and epistemic aspects of the care manager's discretion : A theoretical approach to social work related to older people's potential relocation to a residential home
- 2015
-
Ingår i: European Journal of Social Work. - : Informa UK Limited. - 1369-1457 .- 1468-2664. ; 18:3, s. 325-339
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Tidskriftsartikel (refereegranskat)abstract
- By applying a theoretical point of departure, the overarching aim of this article is to describe, analyze, and try to understand why care managers in their everyday occupational practice normalize the restrictive approach when older people consider relocation to a residential home. While earlier research to a large extent has drawn attention to how the care managers carry out the restrictive approach, this article pays attention to the circumstances paving its way. The focus is on influences from different sociological levels, thereby ‘stratified’, and from two aspects of discretion, where ‘structural aspects’ refer to choices between permitted alternatives and ‘epistemic aspects’ to practical reasoning under conditions of indeterminacy. With this combination, a multitude of circumstances contributing to the restrictive approach is revealed. Thus, the theoretical model includes levels as well as discretionary powers where formulas constitute the foundation at each level, subsequently related to multidisciplinary references in order to get the practice into perspective. The findings show that the priority given to home-based care in contrast to residential care is repeated and confirmed at each level and besides in an interchange between structural and epistemic aspects.
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| 15. |
- Tucker, S., et al.
(författare)
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Improving the mix of institutional and community care for older people with dementia : an application of the balance of care approach in eight European countries
- 2016
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Ingår i: Aging and Mental Health. - Abingdon : Informa UK Limited. - 1360-7863 .- 1364-6915. ; 20:12, s. 1327-1338
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To examine whether the mix of community and institutional long-term care (ILTC) for people with dementia (PwD) in Europe could be improved; assess the economic consequences of providing alternative services for particular groups of ILTC entrants and explore the transnational application of the ‘Balance of Care’ (BoC) approach. Method: A BoC study was undertaken in Estonia, Finland, France, Germany, the Netherlands, Spain, Sweden, and the UK as part of the RightTimePlaceCare project. Drawing on information about 2014 PwD on the margins of ILTC admission, this strategic planning framework identified people whose needs could be met in more than one setting, and compared the relative costs of the possible alternatives. Results: The findings suggest a noteworthy minority of ILTC entrants could be more appropriately supported in the community if enhanced services were available. This would not necessarily require innovative services, but more standard care (including personal and day care), assuming quality was ensured. Potential cost savings were identified in all countries, but community care was not always cheaper than ILTC and the ability to release resources varied between nations. Conclusions: This is believed to be the first transnational application of the BoC approach, and demonstrates its potential to provide a consistent approach to planning across different health and social care systems. Better comparative information is needed on the number of ILTC entrants with dementia, unit costs and outcomes. Nevertheless, the findings offer important evidence on the appropriateness of current provision, and the opportunity to learn from different countries' experience.
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| 16. |
- Tucker, Sue, et al.
(författare)
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What Makes Institutional Long-Term Care the Most Appropriate Setting for People With Dementia? Exploring the Influence of Client Characteristics, Decision-Maker Attributes, and Country in 8 European Nations
- 2016
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Ingår i: Journal of the American Medical Directors Association. - Philadelphia : Elsevier BV. - 1525-8610 .- 1538-9375. ; 17:5, s. 9-465
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Tidskriftsartikel (refereegranskat)abstract
- To explore the extent to which client characteristics, decision-maker attributes, and country influence judgments of institutional long-term care (ILTC) appropriateness for people with dementia. Design, setting, and participants: A total of 161 experts in dementia care from 8 European countries reviewed a series of 14 vignettes representing people with dementia on the cusp of ILTC admission and indicated the most appropriate setting in which to support each case in a simple discrete choice exercise: own home, very sheltered housing, residential home, or nursing home. At least 16 experts participated in each country (Estonia, Finland, France, Germany, the Netherlands, Spain, Sweden, and the United Kingdom). Measurements: Descriptive statistics were used to characterize the experts and their placement preferences. Logistic regression modeling was used to explore the extent to which the sociodemographic and clinical characteristics of people with dementia, and the profession, workplace, and country of decision-makers were associated with ILTC recommendation. Results: Client characteristics, decision-maker attributes, and country all seemed to play a part in influencing professionals' perceptions of the appropriateness of ILTC for people with dementia. Expert decision-makers were more likely to recommend ILTC for individuals who required help with mobility or had multiple care needs, and appeared to give more weight to carers' than clients' wishes. Community-based social workers were less likely than other professional groups to favor ILTC placement. Experts in Finland, Germany, and the United Kingdom were less likely to recommend ILTC than experts in France, the Netherlands, and Estonia; experts in Sweden and Spain took an intermediate position. Conclusion: This study provides new understanding of the factors that shape professionals' perceptions of ILTC appropriateness and highlights the need to construct multifaceted models of institutionalization when planning services for people with dementia. It also has several important clinical implications (including flagging interventions that could decrease the need for ILTC), and provides a basis for enhancing professionals' decision-making capabilities (including the greater involvement of clients themselves).
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| 17. |
- Vingare, Emme-Li
(författare)
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Paradoxer i välfärden : När anhöriga blir lösningen på demensomsorgens utmaningar
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis addresses dementia care in Sweden and the function family caregivers are given. The aim of the thesis is to analyse critically the system of municipal eldercare and the function of family caregivers in this system, and in various types of organisations. In the thesis, both organisational perspectives and the experiences of family caregivers are in focus. Eldercare has been a focus of the welfare state from its early days. Throughout the years both the organisation of care and the understanding of responsibility between family and state has changed several times. Today, family caregivers in Sweden have no formal responsibility for people with dementia, but many family caregivers still take on a caregiver responsibility. This raises questions about the function family caregivers play in dementia care and the reasons behind the choice of caregiving. The thesis consists of four papers on which a cumulative analysis was made. The empirical material is based on interviews with 146 family caregivers, of which 55 answered additional questions. Furthermore, a mapping study of activities and professional specialisation was used to study variations between municipalities. Text material was also utilised, both in the form of policies and formal documentation on a municipal level, and on research on family caregiving in dementia care on a national level. The cumulative analysis was made from the perspective of critical systems theory and resulted in three paradoxes: The welfare paradox, the value paradox and the responsibility paradox. The paradoxes are closely connected, and limit agency among family caregivers. Opposition in processes of familisation (the welfare paradox), individual values rather than family values (the value paradox), and the limitations in factual choice in taking on a caregiver responsibility (the responsibility paradox) cooperate in shaping the function of family caregiving and simultaneously limiting family caregiver agency. Since it is in the interest of dementia care to involve family caregivers the paradoxes also contribute to a solution to challenges in dementia care.
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