Handling the Dilemma of Self-Determination and Dementia: A Study of Case Managers’ Discursive Strategies in Assessment Meetings

Abstract

In assessment meetings concerning care services for people with dementia, Swedish case managers face a dilemma. On the one hand, according to the law, the right to self-determination of every adult citizen must be respected, but on the other hand cognitive disabilities make it difficult to fulfill obligations of being a full-fledged citizen. In this article, we examine 15 assessment meetings to identify discursive strategies used by case managers to handle this dilemma. We also examine how these affect the participation of persons with dementia, and indicate implications of our study for social work practice and research.

KEYWORDS:

• assessment
• decision-making
• needs assessment
• social services
• social work