For many years there has been an emphasis on increasing efficiency and productivity in the Danish public sector, linked to discussions about how we can preserve the Danish welfare model. The average life expectancy is growing, and at the same time more and more elderly people are afflicted by chronic illnesses. This development poses a challenge to the healthcare sector and public spending. As a consequence of this, rehabilitation has been an important issue, and as of 2015 the intentions in this respect have been embedded in relevant legislation. The aim of this dissertation is to investigate how the intention of a rehabilitation-centered approach to care of the elderly is mediated through the system, and how it is understood and implemented by healthcare staff. Another goal is to identify possible barriers to the implementation. As the study primarily seeks to understand the mechanisms that influence the implementation of the rehabilitation approach, it has been carried out as a case study using qualitative methods: documents analysis, interviews and participative observation. In total, 4 frontline health care staff from the home care division and 3 coordinators have been interviewed, and 4 observation studies have been carried out. All informants are employees of the Department of Home Care at the municipality of Gladsaxe. Qualitative data has been analysed using a hermeneutical approach, and subsequently discussed using relevant input from theory involving concepts of translation, self-directed work and motivation. The main finding of the dissertation is that the home care services generally carry out the stipulated concrete tasks and services that have been listed by the coordinators. However, they do not do this in a rehabilitation perspective as intended in both municipal and national policy. This is at least partly explained by the identified barriers. The goals of rehabilitation for the single elderly citizen are not mediated and explained to front-line staff. They carry out their work mainly according to their own perceptions of standards and motivation, rather than according to organizational policies of a rehabilitating approach to homecare services. The insights into the way staff approach their tasks and how they direct their own work, provides a good point of departure for the future organization of the sector with a focus on the management of self-directed work. At the same time, the study has also opened up for new perspectives on different ways of involving citizens and their capacities in health care work.
|Educations||Master of Public Governance, (Executive Master Programme) Final Thesis|
|Number of pages||132|