Strategier för en gräsrotsbyråkrat
en intervjustudie av biståndshandläggning i äldreomsorgen
In our paper we chose to study care management in the old age care. According to the law for the social services the needs of elderly should govern the assistance they are granted. But research has shown that municipal guidelines govern the assistance and that the elderly have to adjust their needs to them. Thus there is a discrepancy between law and practice. The aim of this study was to understand how care managers relate to municipal guidelines, laws and the requests of elderly when the application for assistance is established. We wanted to understand what strategies they use to deal with situations when the aforementioned factors are not consistent. The theoretical approaches we chose were Lipsky?s theory of street-level bureaucrats. The method we used was qualitative and consisted of six informal interviews made with care managers in the municipality of Växjö, Sweden. Based on our interviews we identified eight different themes: the availability of resources, directing conversations and the use of routines, legitimize decisions, legitimize through the possibility of entering an appeal, legitimize through constructing the client, the adaptation of the objectives to the possibilities to perform them, diminishing their capability and professionalism. Our conclusion was that the requests of elderly did govern their assistance, as long as they coincided with the municipal guidelines. If the requests fell outside the guidelines it often required medical or social reasons for granting them. The municipal guidelines were never abandoned to create a uniquely designed assistance.