Satu Jokitulppo, Sini Eloranta, Erja Rappe, Outi Jolanki

Kehittämispuheiden takana talouskeskeisyyttä ja hiljaisuutta ‒ Ikäihmisten perhehoito vanhushoivapoliittisten asiakirjojen näkökulmasta

Introduction

Kehittämispuheiden takana talouskeskeisyyttä ja hiljaisuutta ‒ ikäihmisten perhehoito vanhushoivapoliittisten asiakirjojen näkökulmasta . Miten ikäihmisten perhehoitoa kuvataan vanhushoivapolitiikassa? Tutkimus analysoi talouskeskeisyyttä ja ikääntyvien näkökulman jäämistä varjoon.

Abstract

Tutkimuksen tavoitteena oli selvittää millä tavalla vanhushoivapolitiikkaa ohjaavissa asiakirjoissa kuvataan ikääntyvien henkilöiden perhehoitoa ja kuinka perhehoidon palvelumallia niissä perustellaan. Dokumenttiaineiston muodostivat vanhushoivapolitiikkaa ohjaavat asiakirjat vuosilta 2014–2024. Induktiivisen teema-analyysin avulla analysoitiin ikääntyvien henkilöiden perhehoitoa kuvaavia asiakirjoja (n=31). Teemoittelua ohjasi tulkitseva politiikka-analyysi. Perhehoitoon liittyvät teemat olivat: perhehoidon jatkuvuuden turvaaminen, taloudellistettu perhehoito, perhehoitajien hyvinvointia tukeva toiminta ja ikääntyvien henkilöiden hyvinvointi. Aineistossa kuvattiin perhehoitoa palvelumallina, jota on tarpeen kehittää ja laajentaa. Kehittämis- ja laajenemistarve liittyy huoleen yhteiskunnan palvelurakenteen kestävyydestä tarjota riittävästi hoiva- ja asumispalveluita ikäihmisille. Yksi kehittämisen näkökulma on, että sosiaali- ja terveydenhuollon henkilöstön ja perhehoitajan välisen yhteistyön ajatellaan tukevan paikallaan ikääntymisen politiikkatavoitetta. Perhehoidon tarpeellisuutta perusteltiin erityisesti taloudellisilla syillä: perhehoito tuottaa ikääntyville ihmisille monipuolisia ja edullisempia ratkaisuja kuin muut vaihtoehdot. Analyysi osoitti, että perhehoidon tarvitsijoiden eli ikääntyvien henkilöiden näkökulma jää vähäiselle huomiolle. Tarvitaan lisää tietoa perhehoidon vaikuttavuudesta ja erityisesti siitä, miten ikäihmisten yksilölliset tarpeet tulevat huomioiduksi. Behind the development talk, economic emphasis and silences ‒ Foster care for older people from the perspective of elder care policy The aim of the study was to examine how foster care for older people is described in the elder care policy documents as well as how the service model of foster care is justified in these documents. The documentary material consisted of elder care policy documents for older people published between 2014 and 2024. These 31 documents about foster care for older people were analysed using inductive thematic analysis, which was guided by interpretative policy analysis. The themes that were identified from the data included ensuring the continuity of foster care, financing foster care, activities supporting the well-being of foster carers, and the well-being of older people. Foster care was portrayed as a service model that requires further development and expansion. This need for development was attributed to concerns about how to ensure the sustainability of societal services, such as care and housing services for older people. One aspect of development highlighted was the importance of fostering co-operation between social and health care staff and foster carers. This collaboration is considered to support the objective of the ageing-in-place policy. Foster care was described as a service that offered older people more varied and cost-effective solutions compared to other options. The analysis revealed limited attention to the perspective of older people who require foster care services. However, more information is needed regarding the effectiveness of foster care, particularly in terms of addressing the individual needs of elderly people.

Review

This paper provides a timely and insightful analysis into the portrayal and justification of foster care for older people within elder care policy documents in Finland. Employing an inductive thematic analysis guided by an interpretative policy analysis of 31 policy documents from 2014 to 2024, the study meticulously uncovers the prevailing narratives surrounding this crucial service model. The research successfully identifies key themes such as the continuity and financing of foster care, the well-being of foster carers, and the well-being of older people. A central finding is the consistent framing of foster care as a service requiring development and expansion, primarily driven by concerns for the sustainability of public care and housing services and its perceived cost-effectiveness compared to alternative options. The strength of this research lies in its rigorous approach to policy document analysis, effectively discerning the underlying rationales behind the "development talk" surrounding elder care. The methodological choice of interpretative policy analysis is well-suited to uncover not just what is explicitly stated, but also the implicit assumptions and priorities guiding policy. The study's most salient contribution is its powerful observation that while policy documents advocate for foster care development, this advocacy is largely rooted in economic considerations and concerns about system sustainability. This exposes a significant "silence" in the policy discourse regarding the direct perspectives and individual needs of the older people who are the ultimate recipients of these services, a critical finding captured aptly by the paper's title. While offering a valuable macroscopic view of policy directives, the paper itself acknowledges the limitation regarding the minimal attention paid to the voice of older people. This highlights a crucial area for future research. To complement these policy-level insights, subsequent studies could incorporate qualitative methodologies such as interviews or ethnographic approaches to explore the lived experiences of older people in foster care, as well as the experiences and challenges faced by foster carers themselves. Such research would provide a more holistic understanding of the impact and effectiveness of foster care, moving beyond policy rhetoric to illuminate how individual needs are (or are not) met. This paper serves as an important foundation, prompting critical reflection on how elder care policy can better align economic imperatives with person-centred approaches.

Full Text

Comments

You need to be logged in to post a comment.