PurposeMedia reporting is one of many circumstances that nursing homes have to relate to, because of the reputational risks. The aim of this article is to investigate media representations of Swedish nursing homes in relation to reports on an annual national user survey.Design/methodology/approachThe empirical data consist of 381 Swedish newspaper articles about the survey results. The questions guiding the analysis were: what messages on nursing homes are communicated, and how are claims organized in order to appear factual?FindingsThe data show that press reports focus on comparisons of care units' survey results, eldercare representatives' explanations of the results, and what improvements will be made in order to do better in the next year's survey. With their use of truth-making rhetoric, press articles construct survey results as credible and valid, thus mirroring user perceptions and ultimately nursing home quality. The selection of nursing home representatives' comments equally reinforces the validity of claims.Originality/valueGiven nursing homes' problems with demonstrating success, the authors argue that media reports on the user survey is a way for eldercare organizations to achieve results in an otherwise resultless field, and while media reports might be seen as prompting change in nursing home care, what is ultimately achieved is the legitimation of a costly survey with low response rate.
Swedish nursing homes' use of Instagram has increased vastly in the past few years. Instagram is understood as a means to manage the image they wish to mediate to the public. This article examines what is displayed in the nursing homes' Instagram accounts, and what kind of reality is thereby constructed. The data consist of Instagram images from four nursing homes' Instagram accounts. It is found that nursing home life is primarily depicted on Instagram as active, sociable and fun, with informal, friendly relations between staff and residents, and residents able to continue to live as before, if not better, and to interact with surrounding society. Frailty, boredom, loneliness and death were absent from the data, as were mundane care activities. The article concludes that the presentations in the Instagram accounts challenge the traditional idea of nursing homes as total institutions, and the decline and loss associated with living in such institutions; however, there is a risk that these idyllic presentations conceal the inherent problems of nursing home life.
Swedish nursing home residents are very frail, but a new trend is for nursing homes to adopt a lifestyle profile. Based on interviews with 16 representatives of care organisations, this study investigates the reasons for adopting profiles in this way. The analysis shows that the existence of lifestyle profiles is strongly linked to a market discourse centred on freedom of choice. It is concluded that lifestyle profiles are used as a differentiation strategy in order to justify marketisation, exposing the Swedish eldercare system – which does not permit competition on the basis of price or standards of care – to market forces.
The article is based on a study of how social media and other types of online representations of nursing homes are described by staff. The study proceeds from a qualitative thematic analysis of 14 interviews with nursing-home representatives. The article addresses a key finding that was apparent in the interviews: the online representations’ form and content were adjusted to fit the demands of residents’ relatives. Given the peripheral role attributed to relatives in official Swedish eldercare policies, the motives for the online representations are systematically examined. Two motives are found to be central: marketing and assurance. Residents’ relatives, specified as adult children, were perceived pre-admission as customers in charge of the process of choice and placement; post-admission, relatives requested proof that social activities were provided for their parents. The article discusses how online representations strategically construct a version of ‘reality’ by adjusting to relatives’ unrealistic expectations, only showing residents as involved in social activities. Finally, the need to examine the actual role of relatives in Swedish eldercare is discussed.
Public sector services are audited, measured and ranked in order to improve quality and transparency and to prompt organizations to conform to normative definitions of quality. In Swedish eldercare, a nationwide user survey distributed by the public authorities to all eldercare users, designed to gauge user satisfaction, is a prominent example of this form of soft governance. The aim of the present study is to investigate nursing home representatives' meaning making of the user survey and its function. The findings from 24 qualitative interviews suggest that despite professional scepticism about flawed measurement procedures and tools and thus the validity of the survey results, organizations adjust the care they offer in order to improve low scores. External pressure and the risk of shame and a bad reputation may explain their willingness to let survey results guide their organizational improvements. The article concludes that practitioners may rely on their professional knowledge to dismiss the validity of normative external demands on one level but still manage such demands by making organizational changes on another level for the sake of good reviews. Moving between these levels makes it possible for respondents to be simultaneously critical and compliant. As an organization will need to appeal to external assessors of quality if it is to manage its reputation by achieving high scores, the audience's perceptions risk overriding care users' voices—the very voices the survey is intended to listen to.
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