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Project: Moral stress and moral agency in Swedish eldercare

This project investigates how and when moral agency can be mobilized in eldercare, where ethical dilemmas and moral stress are constantly present. The study is carried out in collaboration with three professional categories: care workers, needs assessors and first line managers.

Project information

Project manager
Sara Hultqvist
Other project members
Katarina Hollertz, University of Gothenburg, Sweden; Magdalena Elmersjö, Södertörn University, Sweden
Participating organizations
Linnaeus University, University of Gothenburg, Södertörn University, the municipalities of Helsingborg, Kalmar and Vänersborg, Grimslöv's folk high school, Sweden
1 July 2021–30 June 2024
Social work (Department of Social Work, Faculty of Social Sciences)

More about the project

Ageing populations, high levels of sick leave among eldercare personnel and financial constraints on municipal budgets impact eldercare. The Covid-19 pandemic has shed light on many of the structural problems facing eldercare, and it is well known that working conditions in this sector are poor. Older people with care needs are primarily offered care in their own homes. Only the very frail elderly with extensive care needs are granted places in institutional settings. Needs assessments to determine the right to care for the elderly, and the daily care work, are both complex and demanding; ethical dilemmas are constantly present for eldercare personnel.

The underlying argument underpinning this research procect is that ethical dilemmas in the work cause moral stress among staff in eldercare. While much research on moral stress highlights the connection between moral stress and negative effects on health and well-being, our focus is on the connection between moral stress and moral agency.

Moral agency encompasses a cognitive capacity, feelings, skills and actions that take place in a given situation. Taking responsibility comprises acting on what is believed to be the right thing to do, and being able to justify these actions in moral terminology. Thus, a central question is: How can moral stress generate moral agency rather than passivity and tacit acceptance? In our view, moral stress and the moral agency that possibly follows from it, must be understood in the light of the political and structural context of the current ethical dilemma (cf. Kälvemark et al 2004).

This project aims to identify situations that give rise to moral stress. Under which circumstances can moral stress become a catalyst for moral agency within eldercare? How can moral agency be fostered in eldercare? The project is unique as the research is performed in collaboration with three vocational groups, local politicians and trade unions in tree municipalities, as well two educational settings. The project will lead to increased knowledge about how to support moral agency for those working in eldercare and thereby improving the quality of eldercare.

The project is part of the research in the research group Social Work, Disability and Ageing (SODA).