Nordic eldercare has traditionally been characterised by universalist ambitions and relatively high service standards. In recent decades, however, municipal eldercare has increasingly been shaped by labour shortages, demographic ageing, resource constraints, and growing demands for prioritisation. At the same time, policy has placed greater emphasis on rehabilitation, activation, and self-reliance as key responses to these challenges.
This PhD thesis examines how such policy ambitions are translated into everyday care practice and how institutional conditions shape the relationship between policy ideals and frontline work in municipal eldercare. While reablement serves as a central empirical entry point, the thesis addresses broader questions concerning care organisation, professional discretion, and prioritisation in home care services.
The thesis draws on ethnographic observations, interviews, and document analysis from Danish and Norwegian municipalities. The findings demonstrate that policy ideals are not implemented in a uniform manner. Rather, their meaning and practical implications are shaped by legislation, organisational arrangements, governance structures, and local contexts. The study further shows that the commonly assumed distinction between rehabilitative and compensatory care is often difficult to sustain in everyday practice. Frontline workers routinely combine different forms of support in order to balance functional goals with older people's well-being, dignity, and everyday needs.
The thesis also highlights how frontline workers navigate tensions between policy ambitions, limited resources, and citizens’ needs through professional judgement and informal prioritisation. In this context, social and relational aspects of care often become less visible than tasks that can be more easily measured and managed.
Overall, the thesis argues that the quality and character of eldercare are shaped not only by the competencies and commitment of care workers, but also by the institutional and organisational conditions under which care is delivered. The findings underline the importance of understanding how policy ideals are transformed as they move through different institutional contexts and are enacted in everyday care practice.
This PhD thesis examines how such policy ambitions are translated into everyday care practice and how institutional conditions shape the relationship between policy ideals and frontline work in municipal eldercare. While reablement serves as a central empirical entry point, the thesis addresses broader questions concerning care organisation, professional discretion, and prioritisation in home care services.
The thesis draws on ethnographic observations, interviews, and document analysis from Danish and Norwegian municipalities. The findings demonstrate that policy ideals are not implemented in a uniform manner. Rather, their meaning and practical implications are shaped by legislation, organisational arrangements, governance structures, and local contexts. The study further shows that the commonly assumed distinction between rehabilitative and compensatory care is often difficult to sustain in everyday practice. Frontline workers routinely combine different forms of support in order to balance functional goals with older people's well-being, dignity, and everyday needs.
The thesis also highlights how frontline workers navigate tensions between policy ambitions, limited resources, and citizens’ needs through professional judgement and informal prioritisation. In this context, social and relational aspects of care often become less visible than tasks that can be more easily measured and managed.
Overall, the thesis argues that the quality and character of eldercare are shaped not only by the competencies and commitment of care workers, but also by the institutional and organisational conditions under which care is delivered. The findings underline the importance of understanding how policy ideals are transformed as they move through different institutional contexts and are enacted in everyday care practice.
