Unpacking the Welfare Technology Solution Discourse: An analysis of society’s perceptions of formal and informal care of older people

Abstract

The overarching aim of this thesis is to examine how the welfare technology solution discourse can provide insights into society’s views of formal and informal care for older people.   The thesis employs a qualitative inductive design based on social constructionism and discourse analysis. The studies illuminated the welfare technology solution discourse from the angle of international research (Study I), Swedish local policy (Study II), local politicians (Study III) and older adults represented by pensioners’ organisations (Study IV). The temporal demarcations were from 2013-2022. The studies made use of the following research methods: scoping review (I), poststructural policy analysis (II), poststructural interview analysis (III) and focus group interviews (IV). The findings were derived from narrative descriptions and interpretations of the empirical data supported by previous empirical, theoretical and grey literature in the field.  The findings highlighted that the welfare technology solution discourse focused on prevention in order to keep older people active and independent and thereby avoid further increases in demands for formal care. Health was positioned as a means to achieve that goal and as an individual responsibility for the older person her/himself. Passive remote monitoring, gaming and digital leisure activities were considered to be part of “good” care, while participation and inclusion were downplayed. Informal carers were positioned as part of the older person’s social sphere, a position that ignores the help, support and/or care they provide to their elder family member or friend on a weekly or even daily basis. The discourse did not include any welfare technology to support or facilitate participation by informal carers. The reviewed empirical literature (I) and policy documents (II) did not take up the issue of health inequalities among older people and their informal carers to any great extent.  The pensioners’ organisations viewed the discourse with concern, cautioning about an increased gap between those digitally included and those excluded in what they perceived as a “harsh and impersonal society”. They positioned informal carers as crucial for the older person’s security and wellbeing.  The thesis challenges the conceptualisation of health in old age as an individual enterprise and argues that interventions using welfare technology for older people need to be targeted towards participation and facilitate reciprocal relationships between all parties involved. Further, informal care needs to be further lifted on the political agenda to illuminate informal carers’ role in the provision of informal care of older people within the modern welfare state in Sweden.