"Hvem hjælper mor og far?" - En kvalitativ undersøgelse af voksne børns omsorgsfortællinger som pårørende til ældre skrø-belige borgere

Abstract

Indledning Om voksne børn som pårørende til ældre skrøbelige borgere Specialet undersøger voksne børn som pårørende til ældre skrøbelige borgere (65+). De voksne børn er centralt placerede i den sundhedspolitiske dagsorden, når der tales om et borgernært og sammenhæn- gende sundhedsvæsen med hjælp fra inddragelse af patienter og pårørende (Sundheds- og Ældremini- steriet 2017 Ministeriet for sundhed og forebyggelse, Sundhedsaftalen 2019:5). Undersøgelser af Ældre- sagen (2017) og Vive (2017, 2019) har vist, at det især er denne gruppe, der hjælper til hos de ældre skrøbelige borgere, som er en demografisk stigende gruppe i samfundet (Sundhedsstyrelsen 2017:2018). Borgergruppen er desuden central i en række af regioner og kommuners tværsektorielle organisatoriske modeller, hvis formål er at forebygge uhensigtsmæssige indlæggelser og genindlæggelser ved at skabe en sammenhæng i ældre skrøbelige borgeres sygdomsforløb. Her fremhæves de pårørende som en res- source, der bør involveres mere i patientforløbet og i hverdagslivet hos de ældre borgere (Ældresagen 2018: Sundhed- og Ældreministeriet 2017). Alligevel har beskrivelser af de pårørende traditionelt set væ- ret både unuancerede og ensidig i sundhedsdebatten (Timm 2016: Oute 2016a, 2016b: Ågård et al.2017:51:Guldager 2018), og der mangler imidlertid systematisk, dybdegående og pårørendenær viden om, hvordan voksne børn udøver ældreomsorg og oplever sådanne tværsektoriel indsats. Derfor under- søger jeg i dette speciale, hvilken betydning køn, lokalitet vidensformer og livshistoriske erfaringer har for de voksne børns ældreomsorgspraksis og meningstilskrivning hertil. Jeg tager i specialet udgangs- punkt i en igangværende indsats i Region Midtjylland. Specialet tilrettelægges som en kvalitativt under- søgelse, og metoderne, der anvendes, er især biografiske narrative interviews suppleret med et feltar- bejde.

English summary This master thesis "Helping mom and dad" - A qualitative study of Adult children carestories as caregivers to frail, elderly patients was conducted during the spring of 2019. In it, I examine the care practices and its at- tributed meaning of adult relatives to frail, elderly patients in Denmark by focusing on two social differ- entiations, gender and locality. Moreover this study is important for two reasons. First, relatives in Den- mark have become increasingly responsible for the care of the elderly and sick as the population of el- derly has grown disproportionately and health policy agendas have shifted towards increased involve- ment of relatives in the frail elderly patients trajectory and everyday life. Secondly, reports by Danish research institutions show that relatives experience that their voices are not getting heard when talking to healthcare worker about their role and involvement in the care of for the elderly. In the thesis, I make three main contributions. First, I contribute to theory development within sociol- ogy of health and illness and the elder studies, terming a category of ‘healthcare support’ that has been theoretically overlooked. Secondly, I develop and examine empirical on forms of elderly care and how relatives experience elderly care. Descriptions like the ‘laissez-faire-relative’ and ‘healthcare-guardian’ express a preconception that certain forms relative positions are associated with ‘involvement’, ‘activ- ity’, ‘responsibility’ and others are associated with ‘passivity’ in their parents healthcare situation. Fi- nally, I examine how social categories such as gender and locality, formerly understudied in a Danish context of relatives to elderly frail patient, affects the relatives elderly care practices by itself and by in- teraction with each other. The findings are based on qualitative study, using the following methods: • Eight biographic narrative interviews conducted with adult children who live in the Central Jut- land region. • Ethnographic field studies at a regional hospital and a discharge intervention The qualitative analysis of the adult relatives care for their elders shows that social category such as gen- der and locality offers new dynamics ways to analyze the relatives caregiving practice. However, the qualitative analysis also reveals a complex relation between adult caregivers’ knowledge and elderly practice. It is to understand this category of care that I develop the term ‘healthcare support’. On the one hand, the relatives draw on resources (i.e. knowledge of the healthcare system or life experiences) which often functions as resources in navigating and demanding healthcare services or treatment. On -4- the other hand, the relatives without this knowledge, life experiences, and understanding assign a differ- ent meaning to involvement. A potential result of these interactions in health-care, is relatives dismiss- ing opportunities to influence and demand better health care solutions for their elderly. Moreover, the study suggest that the interplay between elderly care, gender and locality should be seen as a dynamic process that is constantly created and recreated in relation to the specific context of which the practices is conducted. Finally the analysis shows that elderly care is central to most of the relatives as a part of their self-perception. As such relatives attached meanings to their care practice in relation to life experi- ences, as an anchor for their care practices. The qualitative study in this thesis in summary shows that the social differentiations (locality, gender, healthcare knowledge, and life experience) dynamically affects the relatives elder care and their experi- enced meaning of caregiving tasks. A result of this is differences in care for the elderly, is the potential for differential health outcomes of the frail, elderly parents.

A master thesis from Aalborg University

"Hvem hjælper mor og far?" - En kvalitativ undersøgelse af voksne børns omsorgsfortællinger som pårørende til ældre skrø-belige borgere

["Helping mom and dad" - A qualitative study of Adult children carestories as caregivers to frail, elderly patients]