Guidelines effect on care managers aid assessments : A qualitative study of how municipal guidelines affect care managers aid assessment process

The aim of this study was to examine in what way municipal guidelines affect care managers aid assessments process. The study also examined if it is possible for care managers to make aid assessment decisions that exceed references in municipal guidelines and whether there was a resistance from colleagues or managers when care managers make those decisions. The method used for this study was a qualitative method and the empirical data was obtained by semistructured interviews with 5 care managers. The interviews were conducted in Sweden in a medium sized municipality in Skåne. The results from the study were then analyzed with the help of Michel Foucault's concept of Governmentality. The results were also analyzed with Michel Foucault's concept of the normalization process as well as power and knowledge with the help of Magnus Hörnqvists (2012) elaboration of Michel Foucault's original concepts. The results of the study showed that there is a possibility for care managers to make aid decisions that exceed references in municipal guidelines because of their full delegation which results in autonomy. Furthermore, an individual assessment may result in an aid decision which requires the care managers to exceed references in municipal guidelines in order to meet the individual needs. The results also showed that municipal guidelines affect the care managers work in several ways. The guidelines can be just that, a guide for care managers in their aid decisions in both what the municipality can offer and at what frequency. The results show that municipal guidelines can be both beneficial and inhibitory for care managers. They can be used as support in cases that are complicated for the care managers and they can be used in a way to strengthen the customers position and their rights. Guidelines are also a way for the municipality to organise their organisation. But they can also be inhibitory if they are diffuse and doesn’t clearly describe the meaning of what is stated in the guidelines, which results in the aid officer having to define the guidelines themselves. Guidelines are also inhibitory if they don't correspond to customers specific needs. Lastly, the result of the essay shows that there is no resistance from colleagues or managers if care managers make aid decisions that exceed references in municipal guidelines, however there is resistance from the aid providers if they have to execute an aid decision which exceeds references in guidelines.