Valfrihet -makt eller maktlöshet? : En intervjustudie om äldres val- och påverkansmöjligheter i en konkurrensutsatt äldreomsorg

Sammanfattning: In recent decades, the Swedish welfare system has been characterized by the increasing occurrence of market solutions. One example of this development is the introduction of voucher systems in the elderly care. With the purpose to contribute empirically based knowledge about elderly caretaker’s ability to act in a voucher system, interviews have been conducted with eleven relatives to someone who lives in a residential home. By further focusing on the unique features of the elderly care and putting these in relation to Albert O. Hirschman's concept of exit and voice, several conclusions have been made about the individuals strategies towards the voucher system. The study shows that the individuals relation to the voucher system is characterized by emotions and social relations witch complicates the ability to act rationally towards the market.  The unique character of the elderly care also means that the possibilities for exit (to change residential home when not content) are limited, as it implies a heavy burden for both relatives and caretakers to change residential home. Lack of information about what other options are available also limits the individuals ability to exit. The possibilities of voice (to protest and try to improve the quality of the care) are also limited to the individual as this is an option that takes a lot of energy and dedication. The study shows that protracted voice without improvement ultimately makes the individual give up his attempts to influence the quality of the care. The only option that remains when neither voice or exit is available is for the relative to personally take over the care of the caretaker.