Purpose: The aim is to explore how family relations are affected by societal
changes in relation to informal and formal caregiving and self-determination
of older adults.
Design/methodology/approach: Care managers (CMs)/social workers (SWs)
(N = 124) participated in a comparative vignette study including Japan, South
Korea, and Sweden. Systems theory was used.
Findings: Japanese CMs/SWs clearly describe their efforts to create networks
in a relational way between formal and informal actors in the community. South
Korean CMs/SWs balance between suggesting interventions to support daily
life at home or a move to a nursing home, often acknowledging the family as the
main caregiver. In Sweden, CMs/SWs highlight the juridical element in meeting
the older adult and the interventions offered, and families primarily give social
support. Regarding self-determination, the Japanese priority is for CMs/SWs
to harmonize within the family and the community. South Korean CMs/SWs
express ambivalent attitudes to older adults’ capability for self-determination in
the intersection between formal and family care. Swedish CMs/SWs adhere to
the older adult’s self-determination, while acknowledging the role of the family
in persuading the older adult to accept interventions. The results suggest emerging
defamilialization in South Korea, while tendencies to refamilialization are
noticed in Japan and Sweden, albeit in different ways.
Research limitations/implications: In translation, nuances may be lost. A
focus on changing families shows that country-specific details in care services
have been reduced. For future research, perspectives of “care” need to be studied
on different levels.
Originality/value: Using one vignette in three countries with different welfare
regimes, discussing changing views on families’, communities’ and societal caregiving
is unique. This captures changes in policy, influencing re- and defamilialization.
Bingley, UK: Emerald Group Publishing Limited, 2021, 1. p. 1-38