How do street-level bureaucrats manage the existential needs of older people when making decisions regarding home care? – On the significance and use of neglective restrictiveness

Abstract

Reduced resources in the public sector, combined with an ageing population and increasing existential needs, mean that social service caseworkers need strategies to manage and limit their workload. Social service caseworkers consequently need to develop new ways to manage the population’s increased existential needs. The purpose of the study is therefore to analyse and understand how social workers handle existential issues during the needs assessment process for home care services. Data have been collected through semi-structured interviews with social service caseworkers (N = 15) (2022–2024). The results show that shifting responsibility (e.g. delegation and integration) and professional sensitivity (e.g. tacit knowledge, empathy and adaptation) were two prevalent strategies. The study uses the term neglective restrictiveness to further explain how social service caseworkers combine the two strategies in order to consciously disregard and transform existential needs into a non-issue. A hard-to-manage area is dealt with through actions including delay, omission, disregard and delegation. The study develops the SLB theory, particularly in relation to situations that require an emotional stance.

The authors' abstract, as published at the source. Nordic Social Work Research, 2026 · DOI ↗