Everyday Knowledge in Elder Care

This dissertation is about how knowledge is constructed in interactions and what knowledge entails in practical social work. It is about how a collective can provide a foundation for the construction and development of knowledge through the interactions contextualized in this study on Swedish elder care, organized by the municipality. This study follows a research tradition that recognizes knowledge as socially constructed, and focuses on the practice of knowledge within an organizational context of care. This is an ethnographic study. The empirical material consists primarily of field notes from participant observations at two elder care units in a midsized city in Sweden. Moreover, the collected materials include national and municipal policy documents, local policy documents and guidelines, and notes from observations in staff meetings and interviews with care workers and managers. This thesis uses Institutional Ethnography as a departure point for analyzing the contextual factors for workers in elder care, mainly women, and the situational factors for acquiring knowledge. The overall aim of this dissertation was to explore knowledge in elder care practice by analyzing the construction and application of knowledge for and by staff in elder care. This sheds light to the Mystery of Knowledge in Elder Care Practice: Locally Enabled and Disabled. In order to pursue this aim, two questions were addressed in the study: 1. How and what kind of knowledge is expressed and made visible in daily elder care practice? 2. How is knowledge shared interactively in the context of elder care? The findings shed light to the situation for care workers in elder care and the conditions for using and gaining knowledge. This situation is problematic as the local conditions both enables and disables knowledge use and sharing of knowledge. Contributing challenging factors are lack of recognition and equal valuing of various forms of knowledge; the organizational cultures and a limiting reflective work to the individual. The main findings in this thesis are presented in three areas: a way of understanding tacit knowledge, which refers to knowledge gained by care workers through working in elder care; the connection between an organizational culture and the knowledge shared within the organizational culture; reflective practice in elder care work and the imbalance between individual and collective reflectivity. These findings have implications for specific knowledge in social work practice and the need for education linked to this knowledge. Formal knowledge alone is insufficient for effective elder care practice; however, informal knowledge is also insufficient alone. Both are needed, and they should be linked to create synergy between the two types of knowledge.