Regulating Elderly Care And Struggles



The regulation of elderly care is transformed. Three aspects of the changing regulation are identified: its hybrid nature, its multilevel character and its gendered aspects. Regulation has intensified, characterized by new logics and moving toward a multilevel governmentality, including among others, the increasing role of international institutions. More tensions arise in the hybridity of regulation and new logics. Simultaneously we witness the swift traveling of new buzzwords across the globe such as ‘active aging’ and marketization in this form of multilevel regulation. Noticeable also is how the struggles about the regulation of elderly care are still gendered concerning the discourses on work, knowledge and the professional, for example, when struggles about professionalizing and de-professionalizing are played out in relation to different ideals of care.


Regulation Hybridity Neo-liberalizing Struggles about logics Multilevel governmentality and gendered regulation 


  1. Aristotle. (1987). Ethics. London: Penguin Books.Google Scholar
  2. Ældrekommissionen. (1980–82). Ældrekommissionens delrapporter: 1. delrapport (1980), 2. delrapport (1981) og 3. delrapport (1982).Google Scholar
  3. Alasuutari, P., & Rasimus, A. (2009). Use of OECD in justifying policy reforms: The case of Finland. Journal of Power, 2(1), 89–109.CrossRefGoogle Scholar
  4. Allen, D. (2012). Bringing it all back home—The (re)domestication and de(medicalization) of care in the UK. In C. Ceci, K. Björnsdottir, & M. E. Purkis (Eds.), Perspective on care at home for older people (pp. 101–120). New York: Routhledge.Google Scholar
  5. Andersen, N. Å. (1997). Udlicitering—strategi og historie. Copenhagen: Nyt fra Samfundsvidenskaberne.Google Scholar
  6. Andersen, K., & Kvist, E. (2015). The neo-liberal turn and the marketization of care: The transformation of eldercare in Sweden. European Journal of Women’s Studies, 22(3), 274–287.CrossRefGoogle Scholar
  7. Bacchi, C. (2005). Discourse, discourse everywhere: Subject ‘agency’ in feminist discourse methodology. Nordic Journal of Women’s Studies, 13(3), 198–209.CrossRefGoogle Scholar
  8. Bacchi, C. (2009). Analysing policy: What’s the problem represented to be? Sydney: Pearson Education.Google Scholar
  9. Bache, I., & Flinders, M. (2004). Multilevel governance. Oxford Scholarship Online: 2004 doi:10.1093/0199259259.001.0001Google Scholar
  10. Bertilsson, M. (1990). The welfare state, the professions and citizens. In R. Torstendal & M. Burrage (Eds.), The formation of professions (pp. 114–133). London: Sage.Google Scholar
  11. Blaakilde, A. L. (2012). Døde mænd og syge kvinder—køn, alder og ulighed i sundhed. Kvinder, Køn & Forskning, 21(4), 56–63.Google Scholar
  12. Borras, S., & Greve, B. (2004). Preface. Journal of European Public Policy, 11(2), 181–184.CrossRefGoogle Scholar
  13. Brante, T. (2005). Staten og professionerne. In T. R. Eriksen & A. M. Jørgensen (Eds.), Professionsidentitet i forandring (pp. 16–35). Copenhagen: Akademisk forlag.Google Scholar
  14. Bröckling, U., Krasman, S., & Lemke, T. (2010). From Foucault’s lectures at the Collège de France to studies of governmentality—An introduction. In U. Bröckling, S. Krasmann, & T. Lemke (Eds.), Governmentality—Current issues and future challenges (pp. 1–33). London: Routhledge.Google Scholar
  15. Brodin, H. (2005). Does anybody care? Public and private responsibilities in Swedish eldercare 1940–2000. Umeå: Ekonomisk historia.Google Scholar
  16. Brown, W. (2003). Neo-liberalism and the end of liberal democracy. Theory and Event, 7(1). Accessed 1 Aug 2014.
  17. Brush, L. D. (2003). Gender and governance. Oxford: Alta Mira Press.Google Scholar
  18. Bubeck, D. (1995). Care, gender and justice. Oxford: Clarendon Press.CrossRefGoogle Scholar
  19. Burau, V., & Dahl, H. M. (2013). Trajectories of change in Danish long-term care policies: Reproduction by adaptation through top-down and bottom-up reforms. In C. Ranci & E. Pavolini (Eds.), Reforms in long-term care policies – Investigating institutional change and social impacts (pp. 79–96). New York: Springer.Google Scholar
  20. Burau, V., Zechner, M., Dahl, H. M., & Ranci, C. (2016). The political construction of elder care markets: Comparing Denmark, Finland and Italy, Social Policy and Administration (e-publication ahead of print). Accessed 21 Dec 2016.
  21. Christensen, T. (2012). Post-NPM and changing public governance. Meiji Journal of Political Science and Economics, 1(2), 1–11.Google Scholar
  22. Churchill, J., & Giraldi, M. (2013). Theoretically informed case study accompanying the film European care certificate. Accessed 23 Sept 2016.
  23. Cixous, H. (1980). Sorties. In E. Marks & L. Courtivron (Eds.), New French Feminisms (pp. 90–98). Amherst: The University of Massachusetts Press.Google Scholar
  24. Clarke, J., & Newman, J. (1997). The managerial state. London: Sage.Google Scholar
  25. Conrad, C. (2011). Social policy history after the transnational turn. In P. Kettunen & K. Petersen (Eds.), Beyond welfare state models (pp. 218–240). Cheltenham: Edward Elgar.Google Scholar
  26. Dahl, H. M. (2000). Fra kitler til eget tøj—Diskurser om professionalisme, omsorg og køn, Ph.D. thesis. Aarhus: Politica.Google Scholar
  27. Dahl, H. M. (2005). A changing ideal of care in Denmark: A different form of retrenchment? In H. M. Dahl & T. R. Eriksen (Eds.), Dilemmas of care in the Nordic welfare state: Continuity and change (pp. 47–61). Aldershot: Ashgate.Google Scholar
  28. Dahl, H. M. (2009). New public management, care and struggles about recognition. Critical Social Policy, 29(4), 634–654.CrossRefGoogle Scholar
  29. Dahl, H. M. (2010). An old map of state feminism and an insufficient recognition of care. NORA—Nordic Journal of Feminist and Gender Research, 18(3), 152–166.CrossRefGoogle Scholar
  30. Dahl, H. M. (2012a). Neoliberalism meets the Nordic welfare state—Gaps and silences. NORA, 20(4), 283–288.Google Scholar
  31. Dahl, H. M. (2012b). Who can be against quality? A new story about home-based care: NPM and governmentality. In C. Ceci, K. Björnsdottir, & M. E. Purkis (Eds.), Perspectives on care at home for older people (pp. 139–157). London: Routledge.Google Scholar
  32. Dahl, H. M. (2015). Regulering og velfærdsprofessionelle identitet(er). In B. Greve (Ed.), Grundbog i socialvidenskab—5 perspektiver (pp. 109–125). Frederiksberg: Nyt fra Samfundsvidenskaberne.Google Scholar
  33. Dahl, H. M., Eurich, J., Fahnøe, K., Hawker, C., Krlev, G., Langer, A., Mildenberger, G., & Pieper, M. (2014). Promoting innovation in social services. Heidelberg: Heidelberg University.Google Scholar
  34. Dahl, H. M., Hansen, A. E., Hansen, C. S., & Kristensen, J. E. (2015a). Kamp og status—De lange linjer I børnehaveinstitutionens og pædagogprofessionens historie fra 1820 til 2015. Copenhagen: U Press.Google Scholar
  35. Dahl, H. M., Eskelinen, L., & Hansen, E. B. (2015b). Coexisting principles and logics of elder care: Help to self-help and consumer-oriented service. International Journal of Social Welfare, 24(3), 287–295.CrossRefGoogle Scholar
  36. Dahle, R. (2005). Dirty work in Norwegian health context (The case of Norway). In H. M. Dahl & T. R. Eriksen (Eds.), Dilemmas of care in the Nordic welfare state – Continuity and change (pp. 101–111). Aldershot: Ashgate.Google Scholar
  37. Dale, H. M. (2004). Forms of governance, governmentality and the EU open method of coordination. In W. Larner & W. Walters (Eds.), Global governmentality (pp. 174–194). London: Routledge.Google Scholar
  38. Dean, M. (1999). Governmentality: Power and rule in modern society. London: Sage.Google Scholar
  39. Ertner, M. (2016). Hvem bestemmer hvad en gangstav skal bruges til? Et etnografisk studie af velfærdsteknologi og deres brugere. Gerontologi, 32(1), 8–11.Google Scholar
  40. Feldman, L. (2008). Status injustice: The role of the state. In K. Olson (Ed.), Adding insult to injury—Nancy Fraser debates her critics (pp. 221–245). London: Verso.Google Scholar
  41. Finansministeriet. (2005). Processregularing af amter og kommuner. Albertslund: Schultz.Google Scholar
  42. Foucault, M. (1978). The history of sexuality—An introduction. (R. Hurley, Trans.). London: Penguin Books.Google Scholar
  43. Foucault, M. (1991). Governmentality. In G. Burchell, C. Gordon, & P. Miller (Eds.), The Foucault effect (pp. 87–104). Chicago: The University of Chicago Press.Google Scholar
  44. Foucault, M. (1996). The ethics in the concern of the self as a practice of freedom. In S. Lotringer (Ed.), Foucault live (pp. 433–449). New York: Semiotext(e).Google Scholar
  45. Foucault, M. (1997). What is critique. In S. Lotringer & L. Hochroth (Eds.), The politics of truth (pp. 23–82). New York: Semiotext(e).Google Scholar
  46. Fraser, N. (2008). Scales of justice—Reimagining political space in a globalizing world. Cambridge: Polity.Google Scholar
  47. Fraser, N., & Gordon, L. (1994). A genealogy of dependency: Tracing a keyword of the U.S. welfare state. Signs, 19(2), 309–336.CrossRefGoogle Scholar
  48. Freidson, E. (2001). Professionalism: The third logic. Cambridge: Polity.Google Scholar
  49. Haahr, J. H. (2004). Governing Europe—Discourse, governmentality and European integration. London: Routledge.Google Scholar
  50. Hänsel, D. (1992). Wer ist der Professionelle? Zeitschrift für Pädagogik, 38(6), 873–893.Google Scholar
  51. Hansen, A. M., & Kamp, A. (2016). From carers to trainers: Professional identity and body work in rehabilitative eldercare. Gender, Work & Organization (e-publication ahead of print). Accessed 21 Dec 2016.
  52. Hansen, M. B., & Vedung, E. (2005). Fælles sprog i ældreplejens organisering. Odense: Syddansk Universitetsforlag.Google Scholar
  53. Hansen, E. B., Eskelinen, L., & Dahl, H. M. (2011). Hjælp til selvhjælp eller service i hjemmeplejen—Hvordan er praksis, og er der en virkning? Copenhagen: AKF report.Google Scholar
  54. Harrington, C. (2013). Governmentality and the power of the transnational women’s movement. Studies in Social Justice, 7(1), 47–63.CrossRefGoogle Scholar
  55. Hartman, H. (1979). The unhappy marriage of marxism and feminism. Capital & Class, 8, 1–33.CrossRefGoogle Scholar
  56. Hernes, H. (1987). Welfare state and woman power—Essays in state feminism. Oslo: Universitetsforlaget.Google Scholar
  57. Højlund, H. (2004). Markedets politiske fornuft. Et studie af velfærdens organisering i perioden 1990–2003, PhD series 17. København: CBS.Google Scholar
  58. Hoppania, H. (2015a). In a response to my question at her oral defense held on November, 2015.Google Scholar
  59. Hoppania, H. (2015b). Care as a site of political struggle, Ph.D. thesis. Helsinki: Department of Political Science and Economic Studies.Google Scholar
  60. Interview. (2013, April 24). Focus group interview with experts conducted in Copenhagen.Google Scholar
  61. Irigaray, L. (1979). Das Geschlecht, das nicht eins ist. Berlin: Merve Verlag.Google Scholar
  62. Irigaray, L. (1994). Könskillnadens etik och andra texter (C. Angelfors, Trans.). Stockholm: Brutus Östlings Bokforlag.Google Scholar
  63. Johnson, T. (1995). Governmentality and the institutionalization of expertise. In T. Johnsson (Ed.), Health professions and the state in Europe (pp. 7–24). London: Routledge.Google Scholar
  64. Kildal, N., & Nilssen, E. (2013). Ageing policy ideas in the field of health and long-term care, comparing the EU, the OECD and the WHO. In R. Ervik & T. S. Lindén (Eds.), The making of ageing policy—Theory and practice in Europe (pp. 53–77). Cheltenham: Edward Elgar.Google Scholar
  65. Kirk, H. (1995). Da alderen blev en diagnose. Copenhagen: Munksgaard.Google Scholar
  66. Kjær, P., & Pedersen, O. K. (2001). Translating liberalization: Neoliberalism in the Danish negotiated economy. In J. L. Campbell & O. K. Pedersen (Eds.), The rise of neoliberalism and institutional analysis (pp. 219–248). Princeton: Princeton University Press.Google Scholar
  67. Kjellberg, R., Ibsen, R., & Kjellberg, J. (2011). Fra pleje og omsorg til rehabilitering—viden og anbefalinger. København: Dansk sygehus institut.Google Scholar
  68. Kofod, J. (2012). hold hænderne i lommerne Om hjælp til selvhjælp på plejecentre. In M. Järvinen & N. Mik-Meyer (Ed.), At skabe en professionel—Ansvar og autonomi i velfærdsstaten (pp. 211–230). Copenhagen: Hans Reitzels Publishers.Google Scholar
  69. Larner, W. (2000). Neo-liberalism: Policy, ideology, governmentality. Studies in Political Economy, 63, 5–25.CrossRefGoogle Scholar
  70. Larner, W., & Walters, W. (2004). Introduction: Global governmentality—governing international spaces. In W. Larner & W. Walters (Eds.), Global governmentality (pp. 1–20). London: Routledge.Google Scholar
  71. Lemke, T. (2007). An indigestible meal? Foucault, governmentality and state theory. Distinktion: Scandinavian Journal of Social Theory, 8(2), 43–64.CrossRefGoogle Scholar
  72. Lewis, J. (Ed.). (1997). Lone mothers in European welfare regimes. London: Jessica Kingsley Publishers.Google Scholar
  73. Lukes, S. (1974). Power—A radical view. Basingstoke: Macmillan.Google Scholar
  74. Macleod, P., & Duurheim, K. (2002). Foucauldian feminism: The implications of governmentality. Journal for the Theory of Social Behavior, 32(1), 41–60.Google Scholar
  75. Mahon, R. (2013). Social investment according to the OECD/DELSA: A discourse in the making. Global Social Policy, 4(2), 150–159.CrossRefGoogle Scholar
  76. Marcussen, M. (2002). OECD og idespillet—Game over? Copenhagen: Hans Reitzels publishers.Google Scholar
  77. Martinsen, K. (1994). Fra Marx til Løgstrup—om etik og sanselighed i sygeplejen. Copenhagen: Munksgaard.Google Scholar
  78. Muehlebach, A. (2012). The moral neoliberal—Welfare and citizenship in Italy. Chicago: University of Chicago Press.Google Scholar
  79. Newman, J., & Tonkens, E. (2011). Introduction. In J. Newman & E. Tonkens (Eds.), Participation, responsibility and choice: Summoning the active citizen in Western European welfare states (pp. 9–28). Amsterdam: Amsterdam University Press.Google Scholar
  80. Nousiainen, K. (2011). Double subsidiarity, double trouble? Allocating care responsibilities in the EU through social dialogue. In H. M. Dahl, M. Keränen, & A. Kovalainen (Eds.), Europeanizaton, care and gender: Global complexities (pp. 21–40). Basingstoke: Palgrave Macmillan.CrossRefGoogle Scholar
  81. Obling, A. R. (2012). Kunsten at skabe en medfølende og engageret hospitalslæge. In M. Järvinen & N. Mik-Meyer (Eds.), At skabe en professionel—Ansvar og autonomi i velfærdsstaten (pp. 142–164). Copenhagen: Hans Reitzels Publishers.Google Scholar
  82. OECD. (2005). Long-term care for older people? Paris: OECD.CrossRefGoogle Scholar
  83. OECD. (2011). Help wanted? Providing and paying for long term care. Paris: OECD.Google Scholar
  84. OECD. (2013). A good life in old age? Monitoring and improving quality in long-term care. Paris: OECD.Google Scholar
  85. Oksala, J. (2013). Feminism and neoliberal governmentality. Foucault Studies, 16, 32–53.Google Scholar
  86. Ong, A. (2007). Neoliberalism as a mobile technology. Transactions of the Institute of British Geographers, 32(1), 3–8.CrossRefGoogle Scholar
  87. Outshoorn, J., & Kantola, J. (Eds.). (2007). Changing state feminism. Basingstoke: Palgrave Macmillan.Google Scholar
  88. Pedersen, O. K. (2011). Konkurrencestaten. Copenhagen: Hans Reitzels Publishers.Google Scholar
  89. Poulantzas, N. (1978). State, power and socialism. London: Verso.Google Scholar
  90. Prado, C. G. (1995). Starting with Foucault—An introduction to genealogy. Boulders: Westview Press.Google Scholar
  91. Rasmussen, L. D. (2012). (H)vide verden—om relationer mellem professionsidentiteter og kvalitetssikring, Ph.D. thesis. Roskilde: Institut for samfund og globalisering.Google Scholar
  92. Rönnblom, M. (2014, July 3–5). From governance to governmentality—The need for more elaborate methodologies when studying power and politics. Paper presented at the 9th IPA Conference, Wageningen, The Netherlands.Google Scholar
  93. Sahlin-Andersson, K. (2002). National, international and transnational constructions of new public management. In T. Christensen & P. Lægreid (Eds.), The transformation of ideas and practice (pp. 43–72). Aldershot: Ashgate.Google Scholar
  94. Sanchez, M., & Hatton-Yeo, A. (2012). Active aging and intergenerational solidarity in Europe: A conceptual reappraisal from a critical perspective. Journal of Intergenerational Relationships, 10(3), 276–293.CrossRefGoogle Scholar
  95. Serviceloven. (2015). Lovbekendtgørelse number 1284 from 17/11/2015. Social- og Indenrigsministeriet.Google Scholar
  96. Søndergaard, D. M. (1994). Køn i formidlingsprocessen mellem kultur og individ: nogle analytiske greb. Psyke & Logos, 15, 47–68.Google Scholar
  97. Soss, Fording and Schram. (2011). The organization of discipline: From performance management to perversity and punishment. Journal of Public Administration Research and Theory, 21(suppl. 2), 203–232.Google Scholar
  98. Spanger, H. M., Dahl, H. M., & Petterson, E. (manuscript). How do states condition care chains? Discursive framings, heterogeneous states and multilevel governance.Google Scholar
  99. Szebehely, M., & Meagher, G. (2013). Four Nordic countries—Four responses to the international trend of marketisation. In G. Meagher & M. Szebehely (Eds.), Marketisation in Nordic eldercare (pp. 241–288). Stockholm: Department of Social Work.Google Scholar
  100. Tronto, J. (1993). Moral boundaries: A political argument for an ethic of care. New York: Routledge.Google Scholar
  101. Thomas, T., & Davies, A. (2005). Theorizing the micro-politics of resistance: The new public management and managerial identities in the UK public service. Organization Studies, 26(5), 683–706.CrossRefGoogle Scholar
  102. Ulmanen, P. (2012). Working daughters: A blind spot in Swedish eldercare policy. Social Politics, 20(1), 65–87.CrossRefGoogle Scholar
  103. Vabö, M. (2006). Caring for people or caring for proxy consumers? European Societies, 8(3), 403–422.CrossRefGoogle Scholar
  104. Venogopal, R. (2015). Neoliberalism as a concept. Economy and Society, 22(2), 165–187.CrossRefGoogle Scholar
  105. Wærness, K. (1987). On the rationality of caring. In A. Showstack-Sassoon (Ed.), Women and the state (pp. 207–234). London: Hutchinson.Google Scholar
  106. Walby, S. (1990). Theorizing patriarchy. Oxford: Basil Blackwell.Google Scholar
  107. Weber, M. (1921 [1980]). Wirtschaft und Gesellschaft. Tübingen: Mohr Siebeck.Google Scholar
  108. Witz, A. (1992). Professions and patriarchy. London: Routledge.CrossRefGoogle Scholar
  109. Yuval-Davis, N. (2011). The politics of belonging – Intersectional contestations. London: Sage.CrossRefGoogle Scholar

Copyright information

© The Author(s) 2017

Authors and Affiliations

  1. 1.Department of Social Sciences and BusinessRoskilde UniversityRoskildeDenmark

Personalised recommendations