Vaihtoehtolääkinnän oikeutus : Diskurssianalyyttinen tutkimus vaihtoehtolääkintään kohdistuvasta argumentaatiosta Suomessa.

Suomessa terveydenhuollon perustaksi on hyväksytty yksi legitiimi oppi, lääketiede. Lisäksi käytetään vaihtoehtolääkintää, jolla tarkoitetaan kaikkia lääketieteen ulkopuolisia hoitomuotoja. Keskustelua vaihtoehtolääkinnän oikeutuksesta on esiintynyt julkisessa mediassa ainakin 1970-luvun loppupuolelta alkaen. Julkisuudessa vaihtoehtolääkintää ovat vastustaneet erityisesti lääkärit. Puolustajia ovat olleet vaihtoehtolääkinnän elinkeinonharjoittajat, mutta myös muut kansalaiset. Tutkimuksessa tarkastellaan ja analysoidaan Suomessa vaihtoehtolääkinnästä käytyä julkista debattia. Analyysin kohteena ovat argumentaation diskurssit ja niihin vaikuttavat uskomukset. Tulkinta pohjautuu diskurssianalyysin sosiaalista konstruktionismia korostavaan teoriaan ja argumentaatiota tarkastellaan kiinteästi osana kulttuurista ja intertekstuaalista kontekstiaan medikaaliantropologisessa viitekehyksessä. Tutkimuksen aineisto koostuu julkisista tekstilähteistä ja painottuu ajallisesti 2000-luvulle. Aineistona ovat päivälehtien, vaihtoehtolääkinnän lehtien ja lääkärien ammattilehtien artikkelit ja mielipidekirjoitukset, Hengen ja Tiedon Messuilta vuosina 2000 ja 2003 koottu laaja markkinointiaineisto sekä vaihtoehtolääkintää käsittelevää tietokirjallisuutta. Analyysissä keskustelun havaittiin lokalisoituvan kovien ja pehmeiden arvojen diskursseihin sekä tulkinnallisesti eriytyneeksi uskodiskurssisiksi. Kovien arvojen diskurssin sisään rakentuvat tieteellisyyden, vaarallisuuden, tehokkuuden, kaupallisuuden ja huijauksen diskurssit. Pehmeiden arvojen diskursseja ovat kokonaisvaltaisuuden, ennaltaehkäisyn, syynhoidon ja luonnollisuuden diskurssit. Uskodiskurssin muodostavat uskon, uskonnon ja uskomuksellisuuden käsitteiden ympärille kietoutuvat diskurssit. Tutkimuksessa analysoidaan kunkin diskurssin keskeistä sisältöä ja kuhunkin diskurssiin liittyviä uskomuksia ja argumentaatioperusteita. Kukin diskurssi muodostaa oman merkityskontekstinsa, jossa puolustetaan ja vastustetaan vaihtoehtolääkintää sekä kritisoidaan lääketiedettä. Lääketieteen asema koetaan keskustelussa esisopimuksellisesti niin vahvana, etteivät keskustelijat katso tarpeelliseksi puolustaa sitä näkyvästi. Vaihtoehtolääkinnästä on vähän tutkittua tietoa, joten keskusteluun osallistuvat rakentavat argumentaationsa usein yksipuolisiin uskomuksiin perustuen. Keskustelussa osallistujat ymmärtävät useiden keskeisten käsitteiden sisällöt toisistaan poikkeavasti, mutta huomaavat vain harvoin näin tapahtuvan. Käsiteproblematiikan lisäksi debatin keskeisiä ongelmia ovat uskon ja tieteen kielten sekoittuminen ja lääkintään ja hoitoon liittyvien kysymysten erilainen merkityksellistäminen. Tulkinnan reflektiona käytettiin aiempien tutkimusten pohjalta saatua tietoa vaihtoehtolääkinnästä ja toisaalta vasta-argumentaatiota, joka kuhunkin diskurssiin peilautuu. Diskurssien ja taustalla olevien uskomusten näkyväksi tekeminen lisää osapuolten keskinäisen ymmärryksen mahdollisuutta ja tarjoaa välineitä keskustelun lukkiutuneen asetelman avaamiseen ja uusien näkökulmien mukaan tuomiseen. Diskurssianalyysin avulla päästään irtautumaan positiivisesti ja negatiivisesti latautuneiden kannanottojen mustavalkoisesta asetelmasta, ja voidaan tarkastella asemoitumisen keskeisiä syitä. Vaihtoehtolääkintään suhtautuminen on sidoksissa maailmankuvaan ja maailmankatsomukseen, mutta se merkityksellistyy myös suhteessa lakeihin ja päätöksentekoon. EU:n myötä jäsenmaiden lakeja ja säädöksiä pyritään harmonisoimaan. Vaihtoehtolääkinnästä on vain vähän tutkittua tietoa ja vaarana on, että lainsäätäjät joutuvat tekemään päätöksiä yksipuoliseen lobbaukseen perustuen. Yksipuoliset näkemykset vaihtoehtolääkinnän taloudellisten resurssien kasvattamisen tarpeesta tai vaihtoehtolääkintään kohdistuvien rajoitusten lisäämisestä sisältävät ongelmia, joita voidaan ymmärtää vastustamisen ja puolustamisen perustelut tuntemalla. Avainsanat: Vaihtoehtolääkintä, diskurssianalyysi, diskurssi, argumentointi, uskomukset

Venäjän politiikka ja perustuslaki : Tutkimus Venäjän perustuslakikäsitteistön kehityksestä 1900-luvulla

Constitutional politics in Russia, a conceptual history study of the constitutional rhetoric in the 20th century In April 2006 the Russian Constitution had its 100th anniversary. Following its late start, five constitutions have been adopted. The great number of constitutions is partly explained in my work by the fact that Russia s political system has changed many times, from one state system to another. From a monarchical state power, it changed first, with the October revolution, into the Russian Socialist Federal Soviet Republic, and after that, in 1924, into the Union of Soviet Socialist Republics. In 1991, the Russian Federation was established. The great number of constitutions can also be explained by the fact that in a one-party system, constitutional concepts became one of the most important instruments for introducing political programmes. When the political unity of the state was not only restricted by the Constitution, but also by the party ideology, the political debates concerning constitutional concepts were the key discussions for all the reformative pursuits of Soviet politics. It can be said that, in the Soviet Union, almost all political discourses dealt with constitutional concepts. In the context of restricted unity, the constitutional concepts were the most important tools to argue and create a basis for a new presentation and new political programmes. Thus, the basic feature of the Soviet political discourses has been a continuous competition regarding the constitutional concepts. By defining the constitutional concepts, a new, the political elites wanted especially to redefine, their own way, the traditional meanings of the October 1917 Revolution, and to differentiate them from those of the preceding period of power. From a methodological point of view, I argue that the Russian constitutional concepts make a conceptual historical approach very suitable, and change the focus on history. This approach studies history in contemporary contexts which follow after each other, and whose texts are the main research target. The picture of history is created through the interpretation of the original sources of contemporary contexts. Focusing on the dynamic and traditional characteristic of Russian constitutional concepts, I refer to a certain kind of value and the task of these concepts to justify and define the political and societal unity in every situation. This is done by combining the pursued future orientation of constitutional unity with the new acts of preservation of the traditional principles of the revolution. The different time layers of the constitutional concepts, the past, the present and the future, are the key aspects of storytelling in justifying the continuity and redefining the constitutional unity for the sake of reform. These aspects of constitutional concepts, in addition to all the other functions, have been the main elements of the argumentative structure of acting against opponents.

Tasa-arvo ja muutoksen rajat : Sukupuolten tasa-arvo poliittisena ongelmana Ranskan parité- ja Suomen kiintiökeskusteluissa

The study looks at the debates on gender equality in political decision-making in Finland and France in the 1990s and 2000s by analysing the argumentation for parité and quotas and the ways in which gender equality was constructed as a political problem. The focus of the study is on the parliamentary debates on the amendment of the electoral law in France in 2000 and the introduction of quota regulations into the Act on Equality in Finland in 1994 - 1995. The debates ended in the adoption of quota regulations in the electoral lists (France) and in the executive and preparatory bodies at the national and the local level (Finland). Apart from the analysis of the parliamentary debates, the study explores the political processes preceding the adoption of legislation as well as the debates on quotas and parity in Finnish and French societies in the 1980s and 1990s. The debates on gender equality are analysed as the sites of struggle and change with regard to the normative boundaries of gender equality, as well as of politics and citizenship. The cross-cultural perspective gives room to explore the ways in which gender equality and change can be imagined in different national contexts, and which kinds of discursive resources are available for the politicization of gender equality. Specific attention is paid to the discursive frames and agenda settings in the debates and how these set the limits of the imaginable and the possible in the promotion of gender equality. In both Finland and France, the promotion of equality was constructed as a national project, in which the main beneficiary was the society or the nation as a whole. In France, gender equality was an inherent part of the promotion of French democracy; in Finland, gender equality was regarded as a means to bring the expertise of both women and men to the benefit of the whole society. Furthermore, in both countries the promotion of gender equality was based on the harmonious cooperation of women and men and the temporal dimension of "nearly achieved" gender equality. In this kind of a context, gender equality served as a means towards the wider national ends, and there was little room to discuss the aspects of power and agency with regard to gender equality. However, the internationalisation of equality politics, as well as the conflicting interpretations of gender equality in the national political arenas, calls into question the existence of clearly defined and immutable boundaries of "Finnish" and "French" gender equality. At the same time, the rules of the game in politics, including the meaning of French republicanism and Finnish "expert oriented" politics were contested. In this way, the new equality legislation and the preceding political processes played a part in the transformation of the limits of gender equality, politics and citizenship.

Lähellä, mutta niin kaukana : Tutkimus naisten muuttoliikkeestä Suomen ja uudelleen itsenäistyneen Viron välillä

Immigration is one of the most topical international issues of our time. Worldwide, the number of immigrants has doubled over the last twenty years, and migration patterns have become so diversified that they now constitute a kind of “chaos”. The number and significance of women as migrants has also increased, which is earning women growing attention among scholars. This study looks at the migration of women, in particular mothers of small children, in both directions between Finland and Estonia, following the latter’s re- independence. The data consists of in-depth interviews conducted in 2005 with 24 Finnish and 24 Estonian immigrant women. The focus was on the women’s expectations and experiences of their new country of residence, acculturation – i.e. adjusting to a new environment, social networks in the country of origin and the new country, and models of motherhood following immigration. The primary research question was formulated as follows: Which factors have influenced the formation of female immigrants’ social ties, thus contributing to the formation of motherhood strategies and afecting internal family dynamics in the new country? The research consists of four previously published independent articles as well as a summary chapter. The study’s findings indicate that Finnish and Estonian women migrated for diferent reasons and at diferent times, and that their migration patterns also difered. Estonian migration occurred mainly in the 1990s, and most immigrants intended to return later to their country of origin. Regardless of the reason for migrating that they gave to immigration officials, other key reasons often included the desire for a more stable living environment and better income. Only four of the Estonian women had immigrated together with an Estonian husband, while two- thirds came because of marriage to a Finnish man. Most of the Finnish women, on the other hand, migrated after 2000 and either came with their family as a result of a spouse’s job transfer, or came by themselves to further their studies. In most cases, the migration was a temporary solution intended to promote one’s own or one’s spouse’s career advancement. Because the reasons for migrating were diferent between Finnish and Estonian women, their expectations of the new country and their status in it were also diferent. In terms of both social and economic standing, the position of Finnish immigrants was categorically better. The reason for migrating had an impact on one’s orientation toward the receiving society. Estonian women and Finns who migrated for marriage or edu cational reasons became immediately active in forming institutional and social ties in the new society. Conversely, the women had migrated because of work had little contact with Estonian society, and their social networks consisted of other Finnish immigrants. Furthermore, they maintained strong institutional and social ties to Finland and therefore felt no need to anchor themselves to Estonian society. The Finnish and Estonian women who were better integrated into the receiving country also maintained strong social ties to their country of origin. Women who became integrated into the receiving country as a result of giving birth to children utilized various services directed at families with children. In part, such services conveyed to the women the conceptions that were prevalent in the surrounding society concerning the treatment of children and the expectations on mothers, both of which difer to some extent in Finland and Estonia. had an impact on strategies of motherhood, internal family dynamics, and gender Regardless of the reason for migrating, or the country of origin, immigration equality. Most Estonian women had to do without the child-care help provided by relatives; before immigrating, some women had even had daily child-care assistance from family members. However, Estonian women who were married to Finns did receive help from the spouse and sometimes also the spouse’s relatives. Conversely, Finnish women who had immigrated because of a spouse’s job transfer were faced with the opposite situation, in which they bore the main responsibility for domestic work and child care. They were, however, in a position to pay for domestic help. Hence, the women who had integrated into a new society had to construct their own perceptions of motherhood by reconciling the motherhood models of both the cause of a spouse’s job transfer found that being a stay-at-home mother challenged previously self-evident behaviors. Receiving country and the country of origin, whereas women who had migrated because of a spouse’s job transfer found that being a stay-at-home mother challenged previously self-evident behaviors.

Toiminta, valta ja kokemus organisaation muutoksessa : Tutkimus kolmesta suuryrityksestä

Action, Power and Experience in Organizational Change - A Study of Three Major Corporations This study explores change management and resistance to change as social activities and power displays through worker experiences in three major Finnish corporations. Two important sensitizing concepts were applied. Firstly, Richard Sennett's perspective on work in the new form of capitalism, and its shortcomings - the lack of commitment and freedom accompanied by the disruption to lifelong career planning and the feeling of job insecurity - offered a fruitful starting point for a critical study. Secondly, Michel Foucault's classical concept of power, treated as anecdotal, interactive and nonmeasurable, provided tools for analyzing change-enabling and resisting acts. The study bridges the gap between management and social sciences. The former have usually concentrated on leadership issues, best practices and goal attainment, while the latter have covered worker experiences, power relations and political conflicts. The study was motivated by three research questions. Firstly, why people resist or support changes in their work, work environment or organization, and the kind of analyses these behavioural choices are based on. Secondly, the kind of practical forms which support for, and resistance to change take, and how people choose the different ways of acting. Thirdly, how the people involved experience and describe their own subject position and actions in changing environments. The examination focuses on practical interpretations and action descriptions given by the members of three major Finnish business organizations. The empirical data was collected during a two-year period in the Finnish Post Corporation, the Finnish branch of Vattenfal Group, one of the leading European energy companies, and the Mehiläinen Group, the leading private medical service provider in Finland. It includes 154 non-structured thematic interviews and 309 biographies concentrating on personal experiences of change. All positions and organizational levels were represented. The analysis was conducted using the grounded theory method introduced by Straus and Corbin in three sequential phases, including open, axial and selective coding processes. As a result, there is a hierarchical structure of categories, which is summarized in the process model of change behaviour patterns. Key ingredients are past experiences and future expectations which lead to different change relations and behavioural roles. Ultimately, they contribute to strategic and tactical choices realized as both public and hidden forms of action. The same forms of action can be used in both supporting and resisting change, and there are no specific dividing lines either between employer and employee roles or between different hierarchical positions. In general, however, it is possible to conclude that strategic choices lead more often to public forms of action, whereas tactical choices result in hidden forms. The primary goal of the study was to provide knowledge which has practical applications in everyday business life, HR and change management. The results, therefore, are highly applicable to other organizations as well as to less change-dominated situations, whenever power relations and conflicting interests are present. A sociological thesis on classical business management issues can be of considerable value in revealing the crucial social processes behind behavioural patterns. Keywords: change management, organizational development, organizational resistance, resistance to change, change management, labor relations, organization, leadership

Kahdestaan kotona : Tutkimus vanhoista pariskunnista

In this study, which pertains to the field of social gerontology and family research, I analyse the meaning of everyday life as perceived by elderly couples living at home. I use the ethnographic approach, with the aim of interpreting meanings from the elderly people s personal point of view and to increase understanding of their way of life. The study deepens our conception of what gives purpose to the everyday life of elderly people. The number of elderly couples is growing and, to an increasing extent, a couple will live and cope together to a ripe old age. Such coping can also be viewed as an important resource for society. Ethnography tries to get close to people's life practices. I examine the day-to-day life of elderly couples based on textual data, which I obtained by visiting the homes of 16 couples in a total of five small municipalities in Southern Finland. The couples had married soon after the war or in the early 1950s. I found that the aspiration towards continuity, which unites the concepts of place and home, housework and a long marriage, is the most important notion connecting the discussion themes. The results show that in the opinion of the elderly, the concept of a good life is intertwined with a long marriage spent at home, as well as its values. Old people find that they lead an independent life if they feel that they can hold on to the key features of their way of life. Elderly couples ability to cope with everyday life involves taking care of housework and other tasks around the home together. This means that they support one another and have common goals and aspirations. Daily tasks provide substance in the lives of elderly couples. Each day has its rhythm, and the pace of this rhythm is set by routine and habits. Satisfaction stems from the fact that you can do something you are good at. The couples have also revised the division of housework. Men have learned to perform new tasks around the house when their wives can no longer manage them by themselves. Some tasks are given up. Day-to-day life at home and around the house provides room for men s participation. Mutual support and care between husband and wife can also protect them from having to resort to outside or official help. Old couples integrate their life experiences and memories, as well as present and future risks and opportunities. They wish to carry on their lives as before, and still think that their present life corresponds with their idea of a good life. Key words: elderly couples, continuity theory of aging, everyday life, social gerontology, family research

Kuntoutusosallisuuden diagnoosi : Tutkimus entisten rappiokäyttäjien kuntoutumisen muodoista, mekanismeista ja mahdollisuuksista

The main theme of the research centres on the idea that social inclusion can be analysed as inclusions and exclusions. The research is focused on the phenomenon of inclusion that is defined as widely understood social relationships and social binds emerging in a rehabilitation process. Information was gathered from 13 ex substance abusers, who had a background of heavy substance abuse for appr. 15 years and who have been sober for about 7 years. Also 34 persons who helped them to rehabilitate by the helped persons’ perspectives, were interviewed. The speciality of the research is that 5 of the ex abusers were also physically or mentally disabled. A Simmelian interaction process analysis was applied for the narrative analysis of the collected data. The aim of the analysis was to define different kinds of configurations of social relations and social binds. According to the research 3 different forms of inclusion are emerged in rehabilitation. At the early stage rehabilitation leans towards controlling the new sober life style (inclusion of life control). When people begin to rely on their temperance, they begin to make decisions about an own way of living (life political inclusion) and can also dissociate from the institutional thought patterns. People must also find a way into the circles of social relationships to develop own esteemed individual settings of codes for their action (inclusion of life orientation). The main result of the research represents the ‘mechanism of the social’ of rehabilitation. It is composed of the forms of inclusion mentioned above, their contents and the specific reflection mechanism of inclusion. It consists of the heavy structure of the disciplines of the rehabilitation system and the light structure of social worlds. Finally rehabilitation in the long run seems to lean on aesthetic of social relationships – how the person is connected to the circle of social relationships in this reflection. The conclusions are the following. The role of institutional disciplines is an important social resource for controlling life. Other institutions, i.e. the institutions of adult education offer opportunities to organize the abuser’s life. Unfortunately, the institutional rehabilitation seems to offer feeble help, especially to those who are actualising a kind of life orientation that does not comply with legitimated institutional thought patterns. If the helpers cannot define the need for aid in this situation, the helped easily becomes perversely socially excluded. In a discreet way the institutional rehabilitation is shaping subjectivities of the ex abusers by transferring responsibilities for them. This incident already increases the uncertainty of life of ex abuser, who is disposed towards feeling shame and inferiority. It is more secure to strengthen social binds with the institutional rehabilitation and its membership. Thus, getting individually responsible increases addictive behaviours.

Työkykyarviokokous moniammatillisen työryhmän päätöksentekotilanteena : Tutkimus vuorovaikutuksesta ja potilaan osallisuudesta

Work capacity assessment meeting as a decision-making situation of a multi-professional team a study on interaction and patient participation Multi-professional working has become an increasingly popular method of work in social and health care. The introduction of the viewpoints of several professionals is seen as a way to enhance the openness and quality of decision-making. However, so far relatively few study results are available on the implementation of this method in actual operations. This study examines one work method, a work capacity assessment meeting, along with medical certificates B and their enclosures written by the doctor to the patient after a meeting. After the theoretical and methodological chapter, providing background information, the study describes the structure of the meeting and the medical certificate as a constructive factor. This is followed by a discussion on the manner of assessing the various domains of the patient s functional capacity and the decision-making based on the assessed factors. Next, the study moves on to examine the effect of patient involvements on the conclusions and decisions that professionals make at the meeting. In conclusion, the study looks into how the voices of the professionals and the customer are transferred to the medical certificate. The material of the study consists of 11 meetings recorded on video, of which eight are work capacity assessment meetings and three are rehabilitation examination meetings. The first type of meeting is attended by a patient and a number of professionals, while the latter is attended only by the professionals. All the patients, whose cases are discussed in the work capacity assessment meetings, have a musculoskeletal disorder, while the rehabilitation meetings are related to patients who all also have some additional problem. The study material also consists of seven medical certificates B, written after a work capacity assessment meeting. For the most part, the material has been collected by the conversation analysis method. Moreover, also discourse analysis and a rhetorical approach were used. By using conversation analysis, it is possible to study closely how interaction is built up at the meeting and to examine how the actors implement their institutional assessment tasks in a co-operation that takes its form turn by turn. The four main findings of the study are as follows: firstly, the meeting is structured to a great extent on the basis of the medical certificate form to various phases of the meeting and the headings of the certificate are seen as communicative affordances at the meeting, directed primarily to the professionals that have assessed the patient s work capacity with various tests. The medical certificate is the ethno-method of the doctor acting as the chairman of the meeting that functions in two directions: it constructs the meeting and constitutes the task of the professionals as they produce contents for it. Secondly, the study describes the ways that are used to assess the different domains of the patient s work capacity, how they are described at the meeting and how a decision is taken when the assessment information has been saturated in the opinion of the team. Thirdly, the study brings up ways, with which the patient can influence the conclusions and decisions made by the professionals at the meeting. The study showed that the patient can affect the preconditions of his or her own future and wellbeing. Fourthly, the study describes how the wealth of expressions at the meeting is transferred to the certificate as an argumentative micro-cosmos, where the patient is classified to be recommended for rehabilitation or disability pension. An important finding is also how objective and subjective information and the voices of actors at the meeting are transferred to the statement in a strategic and intentional manner, with an orientation to the decision that will be taken at the insurance institution. The study results can be utilized in the training of professionals and in developing the operations of organisations performing the assessment of the work capacity of people suffering from musculoskeletal disorders.

Sinusta kiinni : Tutkimus puolisohoivan arjen toimijuuksista

Depending on you – A study of spousal care, everyday life and agency The present aim of the aging policy is to promote old peoples´ possibilities to live at their own home. It is also many elderly couples´ own wish. At home a persons spouse is the most natural care giver, if she or he is able to give care. Spousal care means living together, giving and receiving care and interdependency between the spouses. The aim of the policy is to support spousal care by paying financial support to a carer and arrang-ing formal home care services. The purpose of this research is to study the agency of care giving and receiving spouses as care givers and receivers and also as home care service users. The data of the study consist of the interviews of 21 elderly couples. Both spouses were interviewed seper-ately, with the exception of five couples who were interviewed together. In these inter-views a care receiver had difficulties in communicating by speaking and a spouse was her or his interpreter. The study is based on a social constructionistic and a discourse analytical view of con-struction of meanings in human communication. Talking is a social action: people achieve identities, realities, social order and social relationship through talking. In inter-pretating the spouses agency I have used of Harvey Sack´s method of Membership Categorization Device (MCD). The spouses construct social categories which made the meaning of their agency visible. Care changes the routines and actions of everyday life. The couples have to negotiate their duties and rights between each other. Care giving and receiving are both physical and emotional actions. In the end it becomes a part of the couples´ normal life. The pur-pose of couples´ action is to live together as long as possible. They want to strengthen both their own agency and their spouses´ agency. The living together depends on both of them. The spouses decided together what home care services they would like to use and on which conditions they have to use services. Spouses have different kind of agencies as service users which describe their relationship and confidency on formal home care support and services. Services must support the elderly couples´ shared life at home. They cannot be against the conditions on the spousal care. When you want to arrange services to elderly care giving and receiving couples, you have to consider their own wishes and the meanings of their own relationship and shared life.

Vapaaehtoiset vuodeosastolla : Etnografinen tutkimus vanhusten ja vapaaehtoisten kohtaamisesta

This ethnographic study investigates encounters between volunteers and older people at the Kerava Municipal Health Centre inpatient ward for chronic care. Volunteer activities have been under development, in cooperation with the Voluntary Work Center (Talkoorengas), since the start of the 1990s. When my research began in 2003, nine of the volunteers came to the ward on set days per week or visited the ward according to their own timetables. The volunteers ranged in age from 54 to 78 years. With one exception, all of them were on pension. Nearly all of them had been volunteers for more than ten years. My study is research on ageing, the focal point being older people, whether volunteers or those receiving assistance. The research questions are: How is volunteer work implemented in daily routines at the ward? How is interaction created in encounters between the older people and the volunteers? What meanings does volunteer work create for the older people and the volunteers? The core material of my research is observation material, which is supplemented by interviews, documentation and photographs. The materials have been analysed by using theme analysis and ethnomethodological discussion analysis. In the presentation of the research findings, I have structured the materials into three main chapters: space and time; hands and touch; and words and tones. The chapter on space and time examines time and space paths, privacy and publicness, and celebrations as part of daily life. The volunteers open and create social arenas for the older people through chatting and singing together, celebrations in the dayroom or poetry readings at the bedside. The supporting theme of the chapter on hands and touch is bodily closeness in care and the associated concrete physical presence. The chapter highlights the importance of everyday routines, such as meals and rituals, as elements that bring security. Stimuli in daily life, such as handicrafts in groups, pass time but also give older people the experience of meaningful activity and bring back positive memories of their own life. The chapter on words and tones focuses on the social interaction and identity. The volunteers’ identity is built up into the identity of a helper and caregiver. The older people’s identity is built up into a care recipient’s identity, which in different situations is shaped into, among others, the identity of one who listens, remembers, does not remember, defends, composes poetry or is dying. The cornerstones of voluntary social care are participation, activity, trust and presence. Successful volunteer work calls for mutual trust between the older people, volunteers and the health care personnel, and for clear agreements on questions of responsibility, the status of volunteers and their role alongside professional personnel. This study indicates that volunteer work is a meaningful resource in work with older people.