Vi gör så gott vi kan men i praktiken är det ibland omöjligt -En studie om vårdpersonals syn på gråzoner inom demensvård

Sammanfattning: The purpose of this study was to explore medically trained care givers’ views on their work with people with dementia, focusing on their professional discretion and the standardized tools they use in their daily work. The aim was to gain a deeper understanding of aspects of their work that overlap with social work. The method used was qualitative semi-structured interviews with six caregivers, working in five Swedish nursing homes specialized in dementia. All six interviewees had training in the use of the BPSD-register. The BPSD-register is a national quality register and a standardized tool to be used working with individuals with dementia who are suffering from Behavioral and Psychological Symptoms of Dementia (BPSD). For the analysis, the Neo-Institutional theoretical concepts of moral work and individuals vs. organizations were applied together with a Theory of Professional Discretion, with a focus on kinds of knowledge in Social Work. The analysis highlights that the interviewed caregivers pay great attention to how to best approach a person with dementia, and that they use tacit knowledge to read the person and interpret their needs and mood. Moreover, the caregivers’ professional discretion was described as charged with contradictions between laws and regulations, the clients’ needs and a more general moral conceptions of coercion, and that such tensions were often resolved in the team, rather than individually The study concludes that care work with people with dementia involves certain grey zones, which can be understood as meeting points both between the organisation and the individual, and between such care as medical and social work. The BPSD-register confirms this by opening up for different kinds of knowledges to interact.