Distribution of leadership across organizational and system levels: prevalence, forms and conditions for attractive and sustainable work in elderly care

Research project
Active research
Project size
4 520 000
Project period
2020 - 2023
Project owner
Institutionen för sociologi och arbetsvetenskap

Short description

In the nearest 10 years, citizens aged 80 years and over (the majority of those who utilize eldercare) will increase with 50%. There is a growing concern about the future of the health and elder care service due to this expected rise in life-span, which in turn is expected to lead to both a reduction of resources (tax-incomes) and an increased need for workers within the welfare sector (SKL 2018). The sector suffers from high prevalence of occupational disorders (AFA, 2017) and increased turnover among employees, as well as high numbers of sick-leave (SCB 2017). The later, according to professionals, due to a lack of attractive employers (DN 2018). Thus, decent organizational improvements needs to mobilize engagement and job attractiveness among employees, while also promoting job sustainability (SDG goal 8).

Today, many initiatives have been tried but few have managed to get any noticeable impact in practice. Organizational gaps, managers’ work-overload and poor functional support have been identified as important hinders for improvements [4,5]. Moreover, the implementation of over-controlled top-down initiatives has spurred decreased engagement, frustration, stress and health problems among both operative employees and managers [8,10]. A few recent studies show that a more thorough distribution of leadership in everyday work processes can better meet the needs of the older through more committed and knowledgeable staff who takes responsibility for the care and want to stay [12,14]. The forms of distributed leadership comprise delegation of responsibilities, improvement work and prioritizing of the “close-to-care” tasks and concerns.  Nevertheless, deeper knowledge about proximal processes (the reasons, forms, pre-conditions) and implications for groups are less known, as well as the prevalence of distributed leadership conditions.

The overall objective is to contribute to knowledge about pathways of development of sustainable and attractive work among older workers by the means of distributing control and leadership to employees working close to care. This study will identify forms of distributed leadership in eldercare and its covariation and implication for job attractiveness (motivation to apply, stay and work despite higher age and/or health status, employment, turnover), health-related sustainability (self-rated health, sick-leave) and engagement. Hypothesis: organizational and leadership practices of distributed power over everyday decisions will increase job attractiveness and sustainability; that learning climate and employee centered support across system levels (in opposite to over-controlled jobs and work-overload) are important preconditions. The study focuses on eldercare organizations and on the jobs: assistant nurses, nurses and first line managers.



Lotta Dellve, project leader

Monika Andersson Bäck
Gunnar Gillberg
Caroline Hasselgren
Daniel Seldén
Mikael Stattin, Umeå University, Department of Sociology
Andrea Eriksson, KTH Royal Institute of Technology, Division of Ergonomics