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Translating person-centered care into homecare practice: challenges and innovations in implementing dementia policy in Sweden
Politecn Milan, Design Dept, Milan, Italy.
Mälardalen University, Faculty of Engineering and Health Sciences, Department of Health Sciences, Innovation and Design.ORCID iD: 0009-0005-2682-0212
Politecn Milan, Design Dept, Milan, Italy.
Mälardalen University, Faculty of Engineering and Health Sciences, Department of Health Sciences, Innovation and Design.ORCID iD: 0000-0003-2511-9502
2026 (English)In: Frontiers in Dementia, E-ISSN 2813-3919, Vol. 5, article id 1814577Article in journal (Refereed) Published
Abstract [en]

Introduction Despite strong commitments, translating person-centered and dementia care principles into practice remains challenging in homecare settings. In Sweden, national and regional frameworks such as N & auml;ra V & aring;rd (Good and Close Care) and the S & ouml;rmland Dementia Strategy promote autonomy, participation, and collaboration. Yet, their enactment unfolds within layered institutional systems characterized by multiple logics, documentation demands, and fragmented responsibilities, which often dilute the intent of person-centered policies. The study applied a policy enactment perspective to examine how person-centered and dementia-related policies are interpreted, negotiated, and translated into municipal homecare services. It further explores how participatory, design-driven methods can support policy enactment by providing structured arenas for collective sensemaking and resource negotiation across system levels.Methods A qualitative design was employed in the county of S & ouml;rmland, Sweden, combining 17 semi-structured interviews with policymakers, municipal managers, and homecare staff, and two participatory workshops (n = 14-18) involving actors ranging from frontline staff to managerial levels. Interview data was analyzed using inductive and abductive thematic analysis, while workshop data were examined using the framework method to identify shared interpretations and enactment conditions. Patient and Public Involvement (PPI) activities with people living with dementia and unpaid carers informed the design and validated the findings.Results Findings show that policy enactment is constrained by fragmented organizational structures, limited prioritization of dementia, uneven (dementia-specific) knowledge across roles, workforce instability, time pressures, and weak feedback mechanisms. Documentation-heavy routines often reinforce biomedical notions of "good care," limiting the mobilization of relational, person- centered practices. Participatory workshops facilitated the development of provisional, middle-level interpretations that can help bridge abstract policy ideals and situated care practices.Discussion Our study contributes by extending policy enactment frameworks into dementia homecare, and by illustrating how participatory approaches can strengthen bottom-up translation mechanisms within complex public care systems.

Place, publisher, year, edition, pages
Frontiers Media SA , 2026. Vol. 5, article id 1814577
Keywords [en]
dementia, home care, participatory design, person-centered care, policy enactment
National Category
Health Sciences
Identifiers
URN: urn:nbn:se:mdh:diva-77161DOI: 10.3389/frdem.2026.1814577ISI: 001777494700001PubMedID: 42222750OAI: oai:DiVA.org:mdh-77161DiVA, id: diva2:2065572
Available from: 2026-06-03 Created: 2026-06-03 Last updated: 2026-06-03Bibliographically approved

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Löyttynen, JennyMarmstål Hammar, Lena

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1112131415161714 of 111
CiteExportLink to record
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