Older People's “Voices”—On Paper: Obstacles to Influence in Welfare States—A Case Study of Sweden

Abstract

The official rhetoric of welfare states unconditionally pays tribute to older people's right to express dissatisfaction. In practice, users of older services in welfare states may be deprived of their "exit" options and face considerable constraints when it comes to raising their "voices." For example, when older people in nursing homes would like to lodge a complaint, they may well be referred to the very staff members they depend on in their everyday lives. This article analyzes a national case study in which these contradictory tendencies are especially explicit: formal influence channels for older people in Sweden. Using data from structured interviews with 100 representatives of Swedish municipalities and drawing on Hirschman's (1970) theory on exit and voice, the article analyzes obstacles to older service users' influence in Sweden and develops explanations for these obstacles in terms of social contexts.