This dissertation aims to examine and deepen the knowledge of family member caregiving where the care recipient is an elderly person who immigrated late in life. It also aims to contribute to the knowledge of the complexities underlying informal care giving and add to our understandings of what it means to be an immigrant in Sweden. The caregiver is in focus. The research conducted is explorative and partly inductive. The main material used is a qualitative interview study carried out with family members from different countries who are providing informal care to elderly immigrant relatives. The analysis gives three patterns of caregiving. One shows help from informal caregivers only who are not compensated economically. Another shows help from family members who are compensated. The third shows help from family members and staff from the public care system. Three ideal-typical informal caregiver roles show different positions vis-à-vis the new: “guardian”, “filter” and “reinterpreter of traditional care ideals”. Swedish born and immigrated informal caregivers are also compared through analysis of data gathered in telephone interviews with a representative selection of inhabitants in the County of Stockholm.

A philosophy of action together with theory on integration and multiculturalism serves as theoretical frameworks to understand discrepancies and ambiguities in the data. Young immigrants experience different integration processes than do the older ones. They strive to protect older family members from changes linked to the migration experience. Talk about dependence on culture underlines family feelings and legitimates the processes of protection. Preconceptions about great differences between Swedish born and immigrant families are not supported by quantitative data. A conclusion is that protection can be understood in relation both to the traditional and the new, the latter in the forms of meetings with Swedish society where unequal relations prevail. It is a kind of counter-strategy where the range of actions is diminished, and thus it has its own logic. Protection can be loosened up when the circumstances change and the range of actions grow.

The main purpose of this article is to discuss the role of the Swedish welfare state in transnational migration contexts involving older people in need of care. A pilot study about experiences and perspectives among care managers in the state elderly care sector forms the empirical point of departure. Late-in-life-immigrants come into focus here, which is an empirical result of the care managers´ perspectives. The article shows concrete examples of how care needs may be met through a combination of public elderly care, efforts by members of informal networks, and by the older people themselves travelling back and forth across national borders. An important finding is that care managers may have a comprehensive but tacit knowledge of the transnational mobility of this category of older care users. Their awareness of their own role in the transnational contexts seems to remain quite limited. Late-in-life immigrants to Sweden who are involved in transmigration processes are obviously dependent on the care managers’ professional autonomy and ability to take advantage of the legislation´s scope for individual assessments and special solutions.

Syftet med denna studie är att beskriva och analysera verksamheter och insatser inom frivilligorganisationer med en uttalad målsättning att öka integrationen av invandrade barn och unga respektive äldre i det svenska samhället.

Materialinsamlingen har gjorts genom semistrukturerade, kvalitativa intervjuer med nyckelpersoner på lokalnivå i tolv organisationer med olika profil på tre sinsemellan olika orter. Intervjupersonerna, alla verksamma i det dagliga arbetet, uttalar sig om egna erfarenheter och synpunkter. Det är deras berättelser som utgör empirin här.

The globalisation of international migration is challenging social work practice in general and elder care in particular all across Europe. This article gives insight into social work practice with elderly people in Sweden by focusing on older migrants and their families. The article addresses the changes that Swedish elder care has undergone through the past few decades and how elder care is organised. The cases of two migrant families who care for their elderly relatives are described also in an attempt to draw attention to some of the specific challenges that social work practice with older migrants and their families can pose. The article argues that social work practice with these specific populations needs to become aware of the implications that understandings of ethnic ‘Otherness’ have for how elder care is planned and provided. Moreover, it is argued that the globalisation of international migration we are witnessing across Europe and the ethnic diversity in older populations that it brings about demand that social work is delivered in a more generationally aware way. Aiming to solely increase the social integration of older migrants can end up jeopardizing the social and economic integration of their families.

Research on care managers' experiences of the needs assessment process is scarce even though the literature on needs assessment practice is relatively extensive. One of the research areas that has not received attention yet is the way in which care managers experience the challenges that are presumably posed by increased ethnic, cultural, linguistic and religious diversity among prospective elder care recipients. This article addresses this research gap. It is based on a project that aims to shed light on care managers' experiences of the needs assessment process in general and cross-cultural needs assessment meetings in particular. The data are constituted of focus group interviews with care managers in Sweden (N=60). In this article we focus on care managers' experiences of needs assessment with older people who have immigrated late-in-life, who come from cultures considered different from the Swedish one and who have not mastered the Swedish language. This was the group of older people that the care managers mostly thought of when asked to describe their experiences of cross-cultural needs assessment meetings. The interviewed care managers discussed the challenges that these meetings present, which were related to communication due to language barriers, different demands and expectations, insecurity regarding what is customary in such meetings, as well as perceived passivity among late-in-life immigrants. The article discusses the contributions of the findings to research on care management practices in general, as well as to needs assessment practice in particular.

Based on an exploratory study, this article asks whether foreign-born background, gender, and age have any relevance for needs assessment documentation in Swedish elderly care. Using quantitative content analysis and multiple logistic regression analysis of case files (n=202) containing investigations (n=489) into requests for welfare services, this study explores whether the identification grounds of older people matter for documentation practices. The content analysis unveiled that case file descriptions of foreign-born older people are more extensive than the descriptions of Swedish-born. The multiple logistic regression analysis suggests also that gender and background seem to be relevant for how decisions are justified in case files. Age is not as relevant as the other categories. The most substantial finding is that foreign-born older people in this material are granted home care allowance to greater extent than Swedish born. The results partially support the critical debate about how clients are constructed in social work documentation since they give some indication that background, gender and age can play a role in how older people’s applications for care are processed in case files.

This presentation departs from the ongoing debate about how care managers - who often function as ‘street level bureaucrats’ – perceive different aspects of professional discretion in needs assessment practice. Few studies within gerontological social work today have explored if length of work experience affect how care managers experience discretion in the decision-making process which is why this paper focuses on this. The presentation is based on a study that uses focus group interviews (n=12) with 60 care managers in Sweden. The findings show that care managers struggle with ambiguous expectations in balancing clients’ needs and requests against organizational systems, local guidelines and resources. Length of work experience seems to play a role in how they use their discretion and cope with the lack of clarity embedded in the needs assessment process. Experienced care managers describe how they deviate from the guidelines and in this way create an increased scope of action for themselves in decision making. Those with less time in the profession describe, greater difficulties in this respect. The results partially support the critical debate that professional discretion can be experienced in different ways by ‘street level bureaucrats’. The study also adds knew knowledge to this discussion by showing that length of work experience and other work experience-related aspects can play a role in the actual way in which care managers reason about and assess clients’ needs in the decision making process.

Research has explored how care managers in elder care – who often function as ‘street-level bureaucrats’ – regard professional discretion. The way in which length of work experience affects care managers’use of professional discretion remains, however, unexplored. This article present findings from 12 focus groups with 60 care managers. By bringing attention to how care managers experience the needs assessment process, this article sheds light on how these ‘street-level bureaucrats’ struggle when they try to balance their clients’ needs against institutional frameworks and local guidelines. Length of work experience seems to play a role in how care managers claim to use professional discretion. Experienced care managers describe how they deviate from the guidelines at times in order to create an increased scope of action in their decision-making process. Those with less time in the profession describe greater difficulties in this respect. Findings suggest that research should explore if length of work experience plays a role in the actual way in which care managers assess needs and make decisions. As such, they contribute to our understanding of how needs assessment processes are navigated by professionals while also pointing towards the nature of professional discretion in gerontological social work.