Assessing individual needs in Swedish elderly home care services: care managers' argumentation in relation to the needs of migrant customers

The aim of the article is to analyse and problematize care managers' argumentation of individual needs when assessing migrant customers within Swedish public elderly home care services. According to legislation, need for assistance should always be assessed individually. In recent decades of service decline, standardization of needs has been part of the distribution of elderly care services. Simultaneously, the stratum of older people has become more diverse, which means that a wider spectrum of needs is presented to the care managers. Ten interviews with care managers were analysed with a focus on their arguments regarding the care needs of elderly people with migrant backgrounds seeking assistance. The theoretical conceptions of the two perspectives of care and services were used to analyse the understanding of care managers' arguments. Our analysis shows that the service perspective with assistance and support that are standardized for Swedes is poorly suited to people born outside Sweden and socialized into other expectations of family and society. The meaning of individual needs was imprecise and contradictory when confronted with diverse cultural codes. When general standards were used in the arguments by referring to regulations and local guidelines, immigrants' individual needs were not prioritized. Our analysis suggests that the tension between national standards, local guidelines and individual needs has to be discussed further, where theoretical tools related to care and services may be useful in guiding care managers' professional arguments of individual needs and cultural sensitivity in the needs assessment.