Foundations of caring in Fagerberg & Engström (2012), “Care of the old: A matter of ethics, organization and relationships”

In Fagerberg and Engström (2012), caring for older people is presented as more than completing tasks. Its meaning lies in an ethical, person-centered relationship in which carers try to understand and respond to the older person’s needs, wishes, pace, and vulnerability. Care becomes meaningful when the older person is met as a unique person and when the carer is truly present in the encounter.

Attentiveness to needs

A central meaning of caring in Fagerberg and Engström’s study is attentiveness. Carers try to notice what the older person needs, not only what is formally scheduled. This attentiveness includes seeing signs that something is wrong, understanding wishes, and using professional knowledge to judge what kind of help is needed. The study connects this to an ethic of care through attentiveness, responsibility, competence, and responsiveness.

• Carers pay attention to both expressed and unspoken needs.
• They take responsibility for responding to those needs.
• They use competence to decide how best to help.
• The older person’s response helps confirm whether the care is right.

In this view, caring means being observant and morally engaged, not simply following routines.

Respect for individuality

Fagerberg and Engström show that caring for older people requires respect for individuality. Older persons are not treated as a category but as distinct individuals with different personalities, histories, preferences, and ways of living. Ethical care means trying to find out what is best for this particular person.

This respect may involve making room for what matters in the person’s everyday life, such as familiar music, companionship, a walk, or contact with friends and former neighbors. Such actions show that good care is not only bodily assistance but support for the person’s identity and meaningful life.

Pliability toward pace and vulnerability

A key phrase in the study is that carers are pliable toward the older person. This means adapting care to the person’s reduced strength, slower pace, and vulnerable situation. Rather than forcing care into rigid routines, carers try to take time and adjust themselves to the older person.

• Pliability means respecting that ageing may bring diminished energy and slower movement.
• It means allowing time to understand individual needs.
• It means recognizing vulnerability and responding gently and ethically.

According to the study, this pliability is part of acting ethically and morally. The carer does not dominate the situation but bends toward the older person’s condition and tempo.

Relational presence as the ethical core of care

The study also shows that the meaning of care is deeply relational. Care is not only what is done, but how the older person is met. Presence, eye contact, companionship, and shared time can be what matters most. One example in the study shows that simply being present in a meeting and truly seeing the older person had great significance.

This relational presence gives care its ethical meaning because it affirms the older person as someone worthy of attention, dignity, and response. When carers walk with an older person, talk with them, or make space for their wishes, the relationship itself becomes caring.

Why this meaning of care matters

Fagerberg and Engström also show that this ideal of caring can come into conflict with organizational demands and co-worker expectations. Carers may know what the older person needs but lack time or support to provide it. Even so, the study makes clear that the ethical meaning of caring remains grounded in:

• attentiveness to needs,
• respect for individuality,
• pliability toward pace and vulnerability, and
• relational presence.

Together, these elements describe caring for older people as an ethical practice of responsive relationship rather than a set of tasks alone.