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In the Swedish news-press, loneliness among older people is presented as a severe problem that needs to be solved. The issue of who is responsible for reducing loneliness and how this responsibility is designated is, however, rarely discussed. In this study, we have analysed how responsibility is designated and constructed in articles from the Swedish news-press. Focus has been on identifying responsibility in discourses proceeding from the concept of subject positions. This concept has enabled analysis on how responsibility is negotiated and who is positioned as a responsible actor with the ability to perform actions that reduce loneliness. Three dominating discourses were found. In the discourse of responsibility within politics and the welfare state, the responsibility is both self-taken and designated to other institutions held responsible for not initiating sufficient measures to reduce loneliness. In the discourse of responsibility within societal and evolutionary perspectives on loneliness, developments beyond the individual's control are considered to contribute to loneliness. At the same time 'we' in 'society' are considered capable of reducing loneliness, thereby constructing individuals as responsible actors. Within the discourses of responsibility within senior organisations, both senior organisations and people who participate in activities are constructed as responsible actors. In conclusion, the responsibility for reducing loneliness is, apart from the discourse on senior organisations, designated to those working with older people. ; Funding agencies: Norrkoping Municipality Research and Development Fund (Norrkopings fond for forskning och utveckling) [KS 2013/0721]

Cedersund E, Olaison A. Care management in practice: on the use of talk and text in gerontological social workInt J Soc Welfare 2010: 19: 339–347 © 2010 The Author(s), Journal compilation © 2010 Blackwell Publishing Ltd and International Journal of Social Welfare.This is a study of encounters between social workers and citizens in one type of welfare organisation, the municipal elder care system. The article sheds light on how older people's claims are dealt with in the processing of home care applications. Twenty encounters between social workers and older people were studied using discourse analysis. The findings reveal that discursive practices are part of the routine when the applications are processed. The application handling follows an agenda‐bound pattern that is visible in the encounters. In these standardised procedures, oral discourse is embedded in routines that also include the use of texts. However, within this institutional order, there is also an important element of negotiation between the parties. It is therefore claimed that the encounters include a negotiated order that does not exist on its own, but is achieved in the ongoing interaction.

Increased care worker knowledge has been emphasized for improving quality of care for older persons in organized elder care in Sweden. However, care workers and national policies are not always corresponding, with observations suggesting that care workers emphasize tacit knowledge. The aim of this article is to explore the nature of this kind of knowledge and how it can be identified and described. Field notes from participant observations at two elder care units in Sweden serve as the empirical material. Knowledge use for staff in elder care is part of a process of knowledge making and knowledge shaping. Analysis of the field notes identified the themes of "feeling for work" and "acting and artistry" as parts of a tacit knowledge in elder care. The processes of knowledge and job execution are closely intertwined, making them difficult to separate or even understand without a deeper insight.

• Summary: This article reports on an empirical research study exploring and describing variations in how front-line practitioners perceive service user participation (SUP), specifically in interprofessional practice. The settings comprised three Swedish health and social care organizations where the professionals worked in interprofessional teams: a program for chronic pain rehabilitation, a program for surgical treatment of obesity, and a short-term municipal home for older adults. The qualitative study design was informed by a phenomenographic approach and conducted as semi-structured individual interviews with 15 professionals representing nine professions, including social work. • Findings: The main findings show seven qualitative variations in understanding of SUP: 1) inclusion in activities and social events, 2) obtaining guidance, 3) having self-determination and choice, 4) getting confirmation from and contact with professionals, 5) negotiating for adjustment, 6) personal responsibility through insight, and 7) circumstance surrounding SUP. • Applications: The interprofessional dimensions discerned in the meaning attributed to SUP are mainly described in terms of amplified opportunities for participation. An interesting aspect of the findings is that in all the variations of perceptions of SUP, there are potentials to reverse to their opposites, that is, paradoxes that can be termed 'the dual faces of service user participation'. These aspects stress the need for continuing reflection on practices among both front-line practitioners and managers in empowering and paternalistic processes and on constantly improving organizational and policy conditions to facilitate SUP.

In Sweden, palliative care has, over the past decades, been object to policies and guidelines with focus on how to achieve"good palliative care". The aim of this study has been to analyse how experts make sense of the development and the currentstate of palliative care. Departing from this aim, focus has been on identifying how personal experiences of 'the self' areintertwined with culturally available meta-level concepts and how experts contribute to construct new scripts on palliativecare. Twelve qualitative interviews were conducted. Four scripts were identifed after analysing the empirical material: 1.script of paths towards working within palliative care; 2. script of desirable and deterrent reference points; 3. script of tensions between improvement and bureaucracy; and 4. script of low status and uncertain defnitions. The fndings of this studyillustrate how experts in complex ways intertwine experiences of 'the self' with meta-levels concepts in order to make senseof the feld of palliative care. The participants did not endorse one "right way" of "good" deaths. Instead, palliative care wasconsidered to be located in a complex state where the historical development, consisting of both desirable ideals, death denialsand lack of guidelines, and more recent developments of strives towards universal concepts, "improvement" and increasedbureaucracy altogether played a signifcant role for how palliative care has developed and is organised and conducted today. ; Funding: Linkoping University - FORTE-Swedish Research Council for Health, Working Life and Welfare [2017-01187]; Region Östergotland, Sweden

In Sweden there are several different professions that work within the welfare sector. Two of these are social pedagogues and socionoms. This article examines the similarities and differences between these professional fields by exploring four areas in more detail: education, the history of ideas and theory, research and practice. The results show that there are not only many differences but also some similarities. In practical work, social pedagogues and socionoms often work side by side and perform similar tasks. They are located in the same areas and often use the same methods. When it comes to the differences in educational history and current educations, they are large although they can also be found in, for example, the history of ideas. Furthermore, research in the various areas differs. In social pedagogy the interest has to a greater extent been focused on an understanding of the discipline through studies of the history of ideas, while in social work today one often focuses on studies of professional methods. Today's challenges in the welfare sector require new knowledge, ways of thinking and understanding. Here, social pedagogy with its philosophical roots and humanistic values can play an important role.

This article focuses on social pedagogy and how social pedagogical approaches are used in Swedish welfare contexts. Social pedagogy as a phenomenon has existed in a variety of settings and during different periods of time. However, the meaning of social pedagogy as a concept depends to a great extent on the context in which it occurs, and the concept therefore has various connotations. The aim of this article is to analyse and discuss trends, directions and goals in social pedagogical practice. Three research projects (cases) are described, analysed and related to three theoretical models. The three cases – (1) a 'drive-in football' project for young people in a suburb, (2) an alternative residential caresetting for young people with learning disabilities, and (3) a 'future workshop' for older people – involved different situations and different audiences, all with elements of marginalisation and exclusion. The analysis of the three examples shows that social pedagogical practice in the Swedish context is characterised by the challenge of balancing the tensions between the individual and the collective, between emancipation and adaptation and between action and negotiation. The social pedagogical activities are also characterised by the fact that they all contain social, practical and existential dimensions of social support and an approach rooted in ethical core values.

Introduction The provision of healthcare services is not dedicated to promoting maintenance of function and does not target frail older persons at high risk of the main causes of morbidity and mortality. The aim of this study is to evaluate the effects of a proactive medical and social intervention in comparison with conventional care on a group of persons aged 75 and older selected by statistical prediction. Methods and analysis In a pragmatic multicentre primary care setting (n=1600), a prediction model to find elderly (75+) persons at high risk of complex medical care or hospitalisation is used, followed by proactive medical and social care, in comparison with usual care. The study started in April 2017 with a run-in period until December 2017, followed by a 2-year continued intervention phase that will continue until the end of December 2019. The intervention includes several tools (multiprofessional team for rehabilitation, social support, medical care home visits and telephone support). Primary outcome measures are healthcare cost, number of hospital care episodes, hospital care days and mortality. Secondary outcome measures are number of outpatient visits, cost of social care and informal care, number of prescribed drugs, health-related quality of life, cost-effectiveness, sense of security, functional status and ability. We also study the care of elderly persons in a broader sense, by covering the perspectives of the patients, the professional staff and the management, and on a political level, by using semistructured interviews, qualitative methods and a questionnaire. Ethics and dissemination Approved by the regional ethical review board in Linköping (Dnr 2016/347-31). The results will be presented in scientific journals and scientific meetings during 2019–2022 and are planned to be used for the development of future care models.

INTRODUCTION: The provision of healthcare services is not dedicated to promoting maintenance of function and does not target frail older persons at high risk of the main causes of morbidity and mortality. The aim of this study is to evaluate the effects of a proactive medical and social intervention in comparison with conventional care on a group of persons aged 75 and older selected by statistical prediction. METHODS AND ANALYSIS: In a pragmatic multicentre primary care setting (n=1600), a prediction model to find elderly (75+) persons at high risk of complex medical care or hospitalisation is used, followed by proactive medical and social care, in comparison with usual care. The study started in April 2017 with a run-in period until December 2017, followed by a 2-year continued intervention phase that will continue until the end of December 2019. The intervention includes several tools (multiprofessional team for rehabilitation, social support, medical care home visits and telephone support). Primary outcome measures are healthcare cost, number of hospital care episodes, hospital care days and mortality. Secondary outcome measures are number of outpatient visits, cost of social care and informal care, number of prescribed drugs, health-related quality of life, cost-effectiveness, sense of security, functional status and ability. We also study the care of elderly persons in a broader sense, by covering the perspectives of the patients, the professional staff and the management, and on a political level, by using semistructured interviews, qualitative methods and a questionnaire. ETHICS AND DISSEMINATION: Approved by the regional ethical review board in Linköping (Dnr 2016/347-31). The results will be presented in scientific journals and scientific meetings during 2019–2022 and are planned to be used for the development of future care models. TRIAL REGISTRATION NUMBER: NCT03180606.

Introduction The provision of healthcare services is not dedicated to promoting maintenance of function and does not target frail older persons at high risk of the main causes of morbidity and mortality. The aim of this study is to evaluate the effects of a proactive medical and social intervention in comparison with conventional care on a group of persons aged 75 and older selected by statistical prediction. Methods and analysis In a pragmatic multicentre primary care setting (n=1600), a prediction model to find elderly (75+) persons at high risk of complex medical care or hospitalisation is used, followed by proactive medical and social care, in comparison with usual care. The study started in April 2017 with a run-in period until December 2017, followed by a 2-year continued intervention phase that will continue until the end of December 2019. The intervention includes several tools (multiprofessional team for rehabilitation, social support, medical care home visits and telephone support). Primary outcome measures are healthcare cost, number of hospital care episodes, hospital care days and mortality. Secondary outcome measures are number of outpatient visits, cost of social care and informal care, number of prescribed drugs, health-related quality of life, cost-effectiveness, sense of security, functional status and ability. We also study the care of elderly persons in a broader sense, by covering the perspectives of the patients, the professional staff and the management, and on a political level, by using semistructured interviews, qualitative methods and a questionnaire. Ethics and dissemination Approved by the regional ethical review board in Linköping (Dnr 2016/347-31). The results will be presented in scientific journals and scientific meetings during 2019–2022 and are planned to be used for the development of future care models. ; Funding Agencies|County Council of Ostergotland; Linkoping University [2016186-14]