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Örebro Universitet ÖREBRO UNIVERSITET Institutionen för juridik, psykologi och socialt arbete Socialt arbete som vetenskapsområde och forskningsfält, avancerad nivå D-uppsats, 15 högskolepoäng HT 2012 Inflytande inom äldreomsorgen En studie om äldres möjligheter till brukarinflytande i Kumla kommun Författare: Christina Lindvall Handledare: Pia Aronsson Inflytande inom äldreomsorgen – En studie om äldres möjligheter till brukarinflytande i Kumla kommun Christina Lindvall Örebro Universitet Institutionen för juridik, psykologi och socialt arbete Socialt arbete som vetenskapsområde och forskningsfält, avancerad nivå D-uppsats, 15 högskolepoäng HT 2012 Sammanfattning Brukare och brukarinflytande har på senare tid, blivit allt mer uppmärksammat inom den offentliga sektorn i socialt arbete (Svensson., Johansson & Laanemets, 2008, sid. 133-136). Frågan är huruvida brukare inom äldreomsorgen, kan göra sina röster hörda och vilka möjligheter till inflytande det finns för äldre i samhället? Det övergripande syftet med denna studie är att söka kunskap om äldres möjligheter till brukarinflytande, inom äldreomsorgen i Kumla kommun. Ett delsyfte är att undersöka vilka former av brukarinflytande som tillvaratas i Kumla kommun, efter genomförandet av projektet ”Vägar till ökat brukarinflytande och medborgerligt inflytande över kvaliteten i äldreomsorgen”. Frågan om på vilket sätt brukarinflytande kan ske i det praktiska arbetet med äldre med demenssjukdom, utgör även det fokus för denna studie. Genom en kvalitativ forskningsansats, har intervjuer genomförts med tre respondenter; en tidigare projektledare, en representant från Väntjänsten i kommunen samt med nuvarande äldreomsorgschefen i kommunen. Kvalitativ data har därefter analyserats genom meningskoncentrering, i syftet att utmynna i tematiseringar. Resultaten av studien påvisar att det i Kumla kommun, finns flera olika möjligheter till inflytande för brukare inom äldreomsorgen. Bland annat kan äldre ges inflytande över sitt eget ärende genom talesombud eller så kan de äldre genom att ingå i brukarråd, ges möjligheter till inflytande mellan omsorgsgivare och omsorgstagare. Brukarinflytande bland äldre med demenssjukdom, innebar vanligen att vårdpersonal förde de äldres talan och att anhörigas önskemål för den äldre prioriterades sekundärt. Nyckelord: Brukarinflytande, äldreomsorg, demokrati, makt, äldre. Influence in elderly care – A study about elderly and their possibilities for user influence in Kumla municipality Christina Lindvall Orebro University School of Law, Psychology and Social Work Social work as a discipline and field of research, graduate level, 30 points D-essay, 15 points Autumn term 2012 Abstract Users and user influence has in recent years, become more noticed in the public sector in social work (Svensson., Johansson & Laanemets, 2008, p. 133-136). The question is whether users of the elderly care, can make their voices heard and what possibilities there is for older people to influence in society? The overall aim of this study is to learn about older people´s opportunities to user influence, in elderly care in Kumla community (in Sweden). A second aim is to examine which forms of user influence that are procured in Kumla, after the implementation of the project "Vägar till ökat brukarinflytande och medborgerligt inflytande över kvaliteten i äldreomsorgen ". The question of how user involvement can occur in the practical work with older people with dementia is also the focus of this study. Through a qualitative research approach, interviews were conducted with three respondents; a previous project manager, a representative from Väntjänst in the municipality and with the current elder care manager in the municipality. Qualitative data were then analyzed by sentence concentrator, with the purpose to culminate in themes. The results of the study indicate that in Kumla community, there are several possibilities to influence by patients in nursing homes. One example is that elderly people are given control over their own case through spokespersons or by the elderly thought participating in user councils, and thereby be provided opportunities for influences between caregivers and care recipients. User influence among elderly with dementia usually meant that health workers helped the elderly with their claims and that relatives requests for the elderly where prioritized secondary. Keywords: User influence, elderly care, democracy, power, elderly. Innehållsförteckning 1.0 Inledning och bakgrund ..................................................................................................... 6 2.0 Problemområde .................................................................................................................. 7 2.1 Projektet i Kumla kommun .............................................................................................. 7 2.2 Syfte och frågeställningar ................................................................................................. 9 2.2.1 Avgränsningar ........................................................................................................... 9 3.0 Tidigare forskning .............................................................................................................. 9 3.1 Formella kanaler som möjliggörare för brukarinflytande .............................................. 10 3.2 Äldres begränsningar i deltagandet av politiska aktiviteter ........................................... 11 3.3 Relations- och identitetsskapande hos äldre med demenssjukdom ................................ 12 3.4 Socialarbetares interaktioner med äldre inom vård och omsorg .................................... 13 3.5 Projekt som praktik ........................................................................................................ 13 3.6 Brukarinflytande, ett komplicerat begrepp ..................................................................... 14 3.7 Makt, inflytande och delaktighet .................................................................................... 16 4.0 Teoretiska utgångspunkter .............................................................................................. 18 4.1 Demokratiteorier ............................................................................................................ 18 4.1.1 Representativ demokratiteori .................................................................................. 18 4.1.2 Deltagardemokrati ................................................................................................... 20 4.1.3 Deliberativ demokrati .............................................................................................. 21 5.0 Metod ................................................................................................................................. 22 5.1 Vetenskapsteoretisk utgångspunkt för vald metod ......................................................... 22 5.2 Urval och bortfall ........................................................................................................... 24 5.2.1 Urvalsprocess .......................................................................................................... 24 5.2.2 Bortfall och hinder .................................................................................................. 24 5.3 Datainsamlingstekniker och kunskapskällor .................................................................. 25 5.4 Etiska överväganden ...................................................................................................... 26 5.5 Bearbetning av data ........................................................................................................ 27 5.5.1 Analysmetod ............................................................................................................ 27 5.6 Metoddiskussion ............................................................................................................. 28 5.6.1 Validitet ................................................................................................................... 28 5.6.2 Reliabilitet ............................................................................................................... 28 6.0 Resultat .............................................................................................................................. 29 6.1 Fyra centrala teman ........................................................................................................ 29 6.1.1 Vem är brukare och synen på brukarinflytande inom äldreomsorgen .................... 30 6.1.2 Hinder och möjligheter för olika former av brukarinflytande ................................. 30 6.1.3 Projektets betydelse för utvecklingen av brukarinflytande i kommunen ................ 35 6.1.4 Anhöriga, resurs eller belastning? ........................................................................... 35 7.0 Analys ................................................................................................................................ 36 8.0 Diskussion ......................................................................................................................... 39 8.1 Förslag på vidare forskning ............................................................................................ 42 9.0 Slutsatser ........................................................................................................................... 43 Referenser Bilaga 1. Pensionärernas Väntjänst Bilaga 2. Intervjuguide Figurförteckning Figur
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