Table of Contents

About the authors * 9 1. Introduction: Elderly care in transition * 13 ANNETTE KAMP AND HELGE HVID Three types of criticism of modernisation * 15 Objectives and background of the book * 20 Introduction to the chapters of the book * 21 References * 26 2. Paradoxes in Elderly Care: The Nordic Model * 29 HANNE MARLENE DAHL AND BENTE RASMUSSEN Introduction * 29 A Nordic model in elderly care? * 31 State engineered professionalisation * 33 New Public Management: Context and ambiguity * 35 New Public Management as quality: Standardisation and free choice * 38 Quality, meaning and resistance * 39 Paradoxes * 41 Conclusion * 42 References * 45 3. The quest for the meaning of work: Competing concepts of meaning * 51 ANNETTE KAMP Introduction * 51 The classic conceptions: Controversies on meaning, motivation and work * 54 Meaning of work: a critical perspective * 59 A management perspective on meaning * 63 Meaning from a transformation perspective * 69 Conclusion and perspectives * 73 References * 76 4. Knowledge at play: Positioning care workers as professionals through scientific rationality and caring dispositions * 83 ANDREAS FEJES Introduction * 83 Background * 85 Method * 89 Policy discourse on professionalisation * 90 Constituting a caring self: caring for and caring about * 92 Acknowledging caring dispositions * 95 Discussion * 100 References * 103 5. Meaning of work in elderly care in Denmark: Fragile reconstructions * 107 ANNETTE KAMP Introduction * 107 Meaning of work - a dynamic approach * 110 The emergence of professional identities * 113 Home helpers at a crossroads * 116 Different perspectives - the meaning of work * 117 Meaning and identity in transition * 125 Concluding discussion * 128 References * 130 6. The meaning of work from subjective and intersubjective perspectives - a daily conflict of creating and losing meaning in elderly care * 133 BETINA DYBBROE Acknowledgement of workers' subjective meaning in elderly care * 136 Subjective meaning * 140 The meeting * 142 A case of intersubjective and subjective meaning * 145 Meaning in the meeting of a care worker, a dying patient and relatives * 146 Subjective meaning in care work * 148 Subjective meaning in the meeting with societal structures * 150 Meaning from a managerial perspective * 153 Concluding remarks * 159 References * 160 7. New Public Management: Constructing a new management identity in care for the elderly * 165 BENTE RASMUSSEN Introduction * 165 Power, freedom and self-discipline * 167 Managing public services * 169 Method and data * 172 Power and freedom to manage in nursing homes * 174 Boundless work in home-based care * 177 Power and freedom to manage? * 182 References * 186 8. Creating meaning in dementia care work - a story of (re) professionalisation? * 189 PERNILLE BOTTRUP AND PER BRUHN Introduction * 189 A brief glance into the world of a dementia care centre * 191 Dementia care work - a historical perspective * 193 Creation of meaning as a learning process * 201 Meaning in dementia care - case analysis * 204 Summary and conclusion * 222 References * 227 9. The future of elderly care - beyond New Public Management? * 231 HELGE HVID AND ANNETTE KAMP The external perspective: Scandinavian elderly care as an object lesson * 231 The internal perspective: Scandinavian elderly care as a maltreatment sector * 233 New Public Management and the quality of elderly care * 234 New outlook? * 236 Innovation in elderly care daily practice * 237 Gradual professionalisation * 239 Changes in local management? * 241 Changes in management systems? * 242 Beyond New Public Management? * 243 References * 244