Contested involvement of family members in service allocation processes in long-term care: a qualitative study

Population ageing, as the predominant demographic trend in many Western countries, has prompted governments to seek novel approaches to long-term care provision. Increased collaboration between formal and informal caregivers in service planning and provision is one solution advocated by governments across Europe and other regions. This qualitative study explored service allocators' experiences with involving family members in the assessment and allocation of long-term care services for older adults in Norway.

Using content analysis, we analysed data from semi-structured individual interviews (n = 9), focus group interviews (n = 2), and hours of direct observation (n = 165), all with or of service allocators tasked with assessing needs and assigning long-term care services to older adults.

The overarching theme identified was Balancing Family Involvement: Legal Rights, Efficiency, and Welfare. The themes identified were (i) Conflict in Involving Family Members in Caring, (ii) Efficient Involvement of Family Carers in Needs Assessment, and (iii) Support: Preserving the Family Caregiver Role.

By prioritising system efficiency over family members' values, New Public Management principles influence and obstruct the dynamics and effectiveness of family members' involvement in the long-term care allocation process. To improve and enhance the involvement of family members, a paradigm shift towards a more family-oriented approach within the long-term care system is needed.

Not applicable.