Upskilling, reskilling and deskilling when using welfare technologies in Swedish older adults' care: A vignette-based qualitative study across four municipalities.

Background: In Swedish older adults' care, welfare technology is often introduced to help address the pressures of population ageing and ongoing difficulties in recruiting and retaining staff. By welfare technology, we mean digital and technical solutions used in everyday care work with older adults, such as mobile documentation systems, digital door access, alarms and social robots. Earlier research suggests that opportunities for skills development are important for job satisfaction and organisational commitment. In this study, we examine how welfare technology reshapes care workers' everyday care work and under what conditions those changes can be understood as upskilling, reskilling or deskilling. Objectives: To explore how welfare technology reconfigures working conditions and skill demands in home care and nursing homes. Methods: This qualitative study draws on eight vignette-based workshops with care workers ( Results: Across the workshops, care workers described three pathways in which the use of welfare technology shaped their work. In one home care team, an integrated mobile system, coordinated alarm handling and app-based support for planning, documentation, medication sign-off and door access helped staff organise their work and maintain continuity in care. We read this as an example of upskilling. More often, however, care workers described fragmented documentation, parallel systems, frequent alarms and repeated interruptions. These conditions added administrative work, increased stress and reduced the time available for relational care, which we interpret as deskilling. Across both home care and nursing homes, care workers also described taking on new informal tasks such as troubleshooting devices, supporting older adults' use of technology and helping colleagues manage digital systems. We see these added responsibilities as a form of reskilling, but when this extra work went unrecognised or unsupported, it often added pressure rather than skills development. Conclusions: Our findings show how care workers' accounts of everyday work with welfare technology point to upskilling, reskilling and deskilling, depending on how welfare technologies are embedded in care work. For practice, our results point towards looking at what welfare technology requires from care workers in practice, not only whether different kinds of welfare technologies have been implemented.