Old Overnight: Experiences of Age-Based Recommendations in Response to the COVID-19 Pandemic in Sweden.

The Swedish response to the COVID-19 pandemic included age-based recommendations of voluntary quarantine specifically for those 70 years of age or older. This paper investigates the experiences of a sudden change of policy in the form of an age restriction that trumped the contemporary active aging ideal. A web-based qualitative survey was conducted in April 2020. Through manual coding of a total of 851 responses, six different ways of relating to the age-based recommendations were identified. The results show that age is not an unproblematic governing principle. Instead, in addition to protecting a vulnerable group, the age-based recommendation meant deprivation of previously assigned individual responsibility and, consequently, autonomy. It is shown how respondents handled this tension through varying degrees of compliance and resistance. Findings highlight the importance of continuously tracking the long-term consequences of age-based policy to avoid negative self-image and poorer health among older adults.

Pushing for miracles, pulling away from risk: An ethnographic analysis of the force dynamics at Senior Summer Camps in Sweden.

With an ageing population and a discourse of active ageing guiding welfare policies, initiatives to engage older people in health promoting activities have been established. One growing phenomenon is Senior Summer Camps, arranged all over Sweden in beautiful natural environments close to water. Their main purpose is to enable older people to participate in outdoor activities in an institutionalized setting. Although many professionals consider acts of infantilization as highly inappropriate, research has shown that still this is frequently done in institutional settings targeting older people. This paper wish to contribute to this field of research. The objective is to study how the camp leaders handle the dilemma of on the one hand, wanting to push senior campers into participating in challenging activities, and on the other, needing to pull them away, to reduce risk and ensure their safety, as well as how senior campers experience alternately being pushed into and pulled away from activities. What strategies are used by the camp leaders to push the campers to challenge themselves without taking unnecessary risks, and what consequences do these strategies have for the campers? The study was conducted in the form of ethnographic observations at two different camps. During one week at each camp we stayed with the participants, alternately being a silent observer and listener in the background, and an active participant in conversations and activities. Narratives, direct quotes, descriptions and reflections were written down in a field diary that forms the empirical basis for the analysis. Various modes of pushing and pulling were identified and defined as cheering, tricking, compelling, monitoring and restricting. These different modes of pushing and pulling were analyzed as manifestations of force, exerted by the camp leaders within a certain age-based force dynamic that resulted in different responses among the campers, especially in terms of how they "did age" in relation to notions on autonomy and vulnerability. It is shown that manifestations of force involve the risk of putting the campers in a position of vulnerability, regardless of whether or not they are actually vulnerable. The main argument in this paper is that initiatives that in an institutionalized context aim to promote a prolonged health and well-being, targeting "older people" in a general sense, run the risk of getting the exact opposite result, namely instead learned vulnerability is implicitly promoted by removing or downplaying the agency and autonomy of the campers.

How dislocation and professional anxiety influence readiness for change during the implementation of hospital-based home care for children newly diagnosed with diabetes - an ethnographic analysis of the logic of workplace change.

BACKGROUND: In 2013-14, the evidence based care model Hospital-based Home Care for children newly diagnosed with diabetes was implemented at a large paediatric diabetes care facility in the south of Sweden. The first step of the implementation was to promote readiness for change among the professionals within the diabetes team through regular meetings. The aim was to analyse the implicit facilitators and barriers evident on a cultural micro level in discussions during the course of these meetings. What conceptions, ideals and identities might complicate, or facilitate, implementation? METHODS: A case study was conducted during the implementation process. This article draw on ethnographic observations carried out at team meetings (n = 6) during the introductory element of implementation. From a discourse theoretical perspective, the verbal negotiations during these meetings were analysed. RESULTS: Three aspects were significant in order to understand the dislocation during this element of implementation: an epistemological disagreement that challenged the function of information within care practice; a paradoxical understanding of the time-knowledge intersection; and expressions of professional anxiety. More concretely, the professionals exhibited an unwillingness to give up the opportunity to provide structured, age-independent information; a resistance against allowing early discharge; and a professional identity formed both by altruistic concern and occupational guardiancy. The findings suggest the necessity of increased awareness of the conceptions and ideals that constitute the basis of a certain professional practice; a deeper understanding of the cultural meaning that influences care practice within a specific logic in order to predict in what way these ideals might be challenged by the implemented evidence. CONCLUSIONS: Our main contribution is the argument that the implemented evidence in itself needs to be examined and problematized from a cultural analytical perspective before initiation in order to be able to actively counter negative connotations and resistance.