Vart är äldreomsorgen på väg?

Argument för och emot förenklad biståndshandläggning

Abstract

Many Swedish municipalities approve home-care services for persons above a particular age without individual need assessment (FBH) and following a change in the Social Service Act 2018, this policy is likely to increase. How can this development be understood in relation to larger trends within Swedish eldercare policy and practice? This article is based on an interview study with 50 representatives for municipal social services and aims to explore argument for and against FBH, and how these arguments represent differences in views on eldercare. Toulmin’s model of argumentation was used to sort data and Bacchi’s What’s the Problem Represented to be approach was used to relate findings to the development of eldercare. A striking finding was that arguments for and against FBH in several cases were based on the same warrants: user participation, independence and efficient use of resources. FBH was however also presented as a means to base services on trust, and to avoid the intrusive and blunt character of needs assessments. Arguments against FBH suggested that evaluated needs rather than age should be the foundation of services. A conclusion of the study is that FBH introduces a partly new concept of needs that is based on self-evaluation of older persons. This development could in one sense be regarded as empowering, but in another sense as part of the ongoing marketization of eldercare, where services are defined as commodities.