"Det är ju vi som ska vara skyddsnätet, men vi får inte göra nåt!" - En studie av yrkesverksammas handlingsutrymme i arbetet med våld i nära relationer inom demensvården

Care recipients living with dementia face an increased risk of being subjected to domestic violence. However, a 2024 report by the Swedish Agency for Gender Equality indicates that this issue is insufficiently recognized within health and care services. In light of this, our study examines how professionals in these services identify and respond to domestic violence against individuals with dementia, as well as how they view a recent legislative proposal to introduce mandatory reporting in such cases. The study is based on qualitative interviews with assistant nurses and managers in home care services, as well as health care counselors at memory clinics. Empirical material was analysed using Lipsky’s theory on street-level bureaucracy, with a particular focus on professional discretion. Our findings show that professionals across all groups face similar and significant challenges in addressing domestic violence; challenges often caused by dementia-related symptoms as well as intergenerational norms. Furthermore, the use of discretionary power varies between professional groups; with assistant nurses in particular having substantial knowledge gaps, thus limiting their ability to act. Across all professions, however, intervening in specific cases of domestic violence appeared to be an individual rather than an organisational responsibility. Finally, while the introduction of mandatory reporting was viewed positively, it was considered to be insufficient without further organisational support and clearer guidelines.