Empathetic Attuning: 'How Would i Feel if i Had to Expose Myself All the Time?'-Strategies for Managing Personal and Intimate Care in Swedish Formal Home Care

Abstract

Sweden, as a welfare state, has a long tradition of providing formal home care and support to their citizens in their own homes, either through home care services or personal assistance. A large percentage of frail elderly and persons with disability who receive formal home care require personal and intimate care, such as help with eating, showering, getting dressed and personal hygiene. Managing intimacy and safeguarding the care recipient's integrity pose particular challenges for staff. The aim of this qualitative interview study is to describe and analyse care workers' (CWs) and personal assistants' (PAs) strategies for managing situations and challenges related to provision of personal and intimate care in the context of formal home care. Semi-structured interviews with eleven CWs and nine PAs were conducted. Our analysis reveals a complex repertoire of relational and communicative strategies, within an overall approach-which we labelled 'empathetic attuning'-of relating to the current situation and task at hand whilst safeguarding integrity. These strategies were intertwined with dimensions of time. The possibility to accomplish satisfactory personal and intimate care rests on structural and organisational conditions that promote sustainable working conditions, where relations characterised by continuity, integrity and respect can be realised.