Coping within constrained social care: emotion work, collective rulemaking, and prioritization in Nordic eldercare

Despite policies in Nordic countries advocating ageing-in-place and holistic, person-centred care, fiscal constraints have pressured homecare services to prioritise physical and somatic care at the expense of social care provision. This has limited professional caregivers’ roles, with practical and emotional aspects of care being largely removed from their remit. This study examines how home care workers use coping strategies to navigate high workloads and the diverse, shifting needs and personal behaviour of clients. Such coping involves both socially negotiated ‘collective rules’ and embodied forms of ‘emotion work'. Our study comprises ethnographic data from Danish and Norwegian home care services. Through shadowing care workers, we observed how they adapt coping strategies to their informal categorisations of clients. In doing so, care workers often prioritise meeting the emotional and social needs of vulnerable clients at the expense of clients perceived by care workers as more resourceful or ‘demanding’. The marginalisation of social care and the necessity for informal prioritisations due to time constraints place significant moral burdens on care workers. This not only diminishes recognition of their vital contributions to client well-being but also obscures unmet care needs and moral dilemmas that should warrant open discussion.