Swedish eldercare within home care services at night-time : perceptions and expressions of 'good care' from the perspective of care workers and care unit managers

This article aims to explore and analyse how good and dignified care is perceived and expressed at night-time within elder home care services, in which night-time care represents a knowledge gap. Dignity has become a legislated value in Swedish eldercare, aiming to increase the quality of care and to clarify the ethical values of everyday care practice. The data presented here come from a qualitative case study with in-depth interviews with six care unit managers and 14 care workers in four municipalities. The analysis of the interviewees’ perceptions and expressions of good care were informed by Nodding’s concepts: responsiveness, receptivity, and relatedness. The results showed that there was a relative unawareness of the new goals of the dignity policy and there was no specific guidance regarding dignity during night-time care. The care unit managers’ perspective was mainly administrative and related to the policy level and the staff’s ability to care. The care workers’ view of good and dignified care included aspects of ideal characteristics and user-centredness with a focus on older people’s individual needs. However, good care was conditioned by time. The dignity policy, as described in national documents, was perceived by the interviewees as vague and with unreachable goals constructed on the structural level. In social care practice, however, expressions of good and dignified care were already found in care ethics, regardless of the dignity policy. By bringing relationality to the dignity discourse on the structural policy level, recognition of care may be emphasized.