Moral stress and moral agency in Swedish eldercare

Ageing populations, high levels of sickleave 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 is 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 wellbeing, our focus is on the connection between moral stress and moral agency. Moral agency encompasses a cognitive capacity, feelings, skills and actions.

Thus, central questions are: how, if and when moral agency can be mobilized in a sector where ethical dilemmas and moral stress are constantly present?

In our view, moral stress and moral agency has to be understood in the light of the political and structural context in each given situation. 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 3 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.