**4. Background**

### **4.1 Eldercare in Sweden**

In Sweden, eldercare work is professionalised because it is a profession that is tax-financed and publicly organised for the most part. Care research moves between philosophical discussions about care as a concept and empirical studies that include everyday life experiences. It is about understanding quality and competence in care work, discussing the consequences of different ways of organizing care work, implementing social policy interventions and conducting comparative welfare state research [20]. However, to understand the complexity of care work, it is crucial to understand what the word care in eldercare work means. This is more important than focusing on the words: care or nursing. One problem is that these latter concepts are of great importance for the work of care staff. Nursing provides stronger medical associations than care. Implicit in the idea of nursing lies the wish to cure the patient. Eldercare is not expected to make the old young again. In the same way, care for the older adults does not involve a change for the recipient [6].

The work in eldercare services often involves conditions that pressure the staff members in many ways. The relatively brief training, combined with demanding tasks, frequently results in physical strain and emotional stress among the care workers [21]. This emotional dimension is a crucial aspect and significantly impacts working situations. One essential element is that the healthcare personnel expect to use their empathic skills and common sense when encountering older clients [22, 23]. The staff work closely with the older adults in their daily activities and are also responsible for providing medical care delegated by licensed healthcare personnel. These are complex work tasks, and the care workers must correspondingly ensure that the older adults experience dignity in their daily lives, which is also regulated by the Swedish Social Services Act requirements. To promote dignity in eldercare services, are they expected to maintain a perspective based of the individual right to self-determination, individual adaptation, privacy, bodily integrity, proper treatment, good quality and older adults' individual right to participation [24]. The requirements for facilitating a life of dignity for the older adults assume the personnel's respect for the individual, and older persons must feel that they are safe and that their lives have meaning when receiving eldercare services. These are consequently highly ranked demands for an eldercare workforce, at the same time characterised by low wages and low status, often in combination with unfavourable working conditions.

#### **4.2 Care work and the female virtue**

A great majority of employees in eldercare services are women ([25], p. 280), making eldercare one of Sweden's most female-dominated occupations. This feminisation has consequences for how the work is perceived and valued, not least by the older adults. The working conditions in eldercare are primarily based on women's responsible and caring, rational actions. Caring rationality stands for compassion, closeness, treatment and an ability to see every person from a holistic perspective [26]. However, care actions' rationality can contain different spheres, and Franssén [27] divides the care work content into an instrumental (physical) and an emotional sphere.

#### *The Challenge of Migration in Swedish Eldercare: Experiences of Everyday Racism DOI: http://dx.doi.org/10.5772/intechopen.106609*

There is a significant risk of distinguishing between physical and emotional care work being determined too one-sidedly. A common notion about the care work is that the instrumental/physical part is an oppressive practice of women filled with repetitive and alienating tasks, such as cleaning, laundry, shopping, and washing. However, the emotional care work accounts for the positive and more gratifying and meaningful dimensions of the work. The danger lies in that the distinction does not give the physical aspects an emotional scope. Instead, the care profession contains both emotional and instrumental components. Both parts require an emotional commitment while the work is physically strenuous. The dynamic perspective risks idealising the care and ignoring the workload [28].

A notion of female virtue dominates the care work. Like feminine virtue, the care work performs in unpretentiousness and silence. This work fell on the woman's lot is sonically explained because the care corresponds to her nature [29]. Care has, therefore, been linked to 'femininity' and thus to women [30]. The dominance of women in the professional field consequently has a solid historical foundation, which can be traced to notions that women have an inherent ability to provide care.

To be a reliable employee in eldercare services, individuals must first and foremost conduct themselves by the common conceptions of gender and femininity and live up to the meaning of these conceptions. The sociologist Beverly Skeggs studied British working-class women in nursing schools and how the education shaped them into respectable healthcare workers. She considers that professional schooling has primarily focused on making women respectable by conveying typical 'female' characteristics [31]. According to Skeggs, there is a connection between the concept of female respectability and behaving in a caring, responsible and selfless manner.

Given these requisite circumstances, employment in eldercare services is less attractive than in many other professions. The striding working conditions concern everything from working conditions to wages [32]. There are, however, also other factors that could generate complications in this work. One such aspect is being a migrant. One explanation for why so many people with migrant backgrounds work in eldercare is that people with migrant backgrounds often take jobs in areas of labour shortage [33].

Therefore, Sweden has developed an increasingly 'ethnically coded' labour market. But also because migrant nursing assistants consider possessing more genuinely caring qualities [34]. There is, however, research indicating that ethnic discrimination and racism have a significant impact on working conditions in the health and care sector [30, 35–39]. The most common form of racism in the workplace is verbal racism [40]. Ethnic diversity in the workplace produces ethnic discrimination and racism ([41], p. 34). The Swedish Research Council [42] survey highlighted the scarcity of research on racism in the Swedish labour market. Since many people with migrant backgrounds work in eldercare services, it is necessary to ask about racism and discrimination in the workplace.

Much of the eldercare research on migration-related problem areas is based on a client/user perspective [43–45]. When research emphasises the staff's perspective, the dominant area has touched on how they can become culturally competent and work in a culturally congruent way in the encounter with the older migrant person. There are examples of research that concern migrant people's work in eldercare. Still, research is needed to highlight the migrants' own stories and experiences to create new knowledge more accurately.
