The Choice Situation in Swedish Elderly Care - A qualitative study of the system of choice within Swedish elderly care

Abstract: Last year’s demographical changes and times of internationalization and also individualization have led to changes in the way welfare services are delivered. More specifically there have been changes made within social care and health care. The new times that have led to privatization has also increased the amount of service providers. Within elderly care, this is not an exception. Waves of New Public Management have caused changes in the organization of welfare. Politicians introducing the law on freedom of choice and trying to find a market solution to be a tool to reach efficiency and increased quality, as well as the feeling of own responsibility and possibility to meet individual needs of users. Could New Public Management ideas and quasi market solutions lead to a feeling of empowerment among users within Swedish elderly care? It is the aim of this research to look deeper into the freedom of choice model and try to find out what consequences the law on freedom of choice has caused within elderly care in the welfare system of Sweden. What does the system really require from politicians, professionals, and not at least from users and their close ones? Looking deeper into the system of choice will hopefully lead to ideas on how a more well-functioning system could look like. Increased feeling of own responsibility and self-determination is what politicians through the law on freedom of choice intends to generate in, but the question remains to look closer into whether this is the case. If not, it remains to map out what the main obstacles are for a market situation to be functional and for elderly to feel empowered. Qualitative methods through semi-structured interviews and document analysis have been used in order to answer the research questions. Interviews have been followed through with two focus groups of elderly, two case managers, two relatives and one interview with Swedish Municipalities and Councils (SKL). Research has shown that all the above mentioned parties do think that being able to choose or change provider of elderly services has got a self-value. Thus it is not a fully functioning system as it is today. There are concerns from all parties regarding the structure of the system and questions are stated whether this should be the way to organize services, and if so-how should the system be further developed. The desire is to reach a structure so that elderly can feel empowered and as if they are responsible over their own lives. There are obstacles as well as benefits from such a system and in the thesis the topic is further analyze. At the end of the thesis conclusions are pulled and suggestions are given on how to furtherer reach policy intentions more efficiently.