ABSTRACT
This chapter explores how nursing home managers grapple with local manifestations of the wicked problems that plague elderly care. It shows the tension between managers' lofty ideals of high-quality, individualized care and their continuous struggle to handle very basic troubles that ultimately appear to be grounded in a lack of resources, such as high personnel turnover and staff complaints about inconvenient work times. The chapter explains and illustrates the gap between lofty ideals and lowly troubles among managers which it found at most investigated nursing homes but which was more or less absent from one of them, a private non-profit home with relatively ample resources and a strong focus on concrete quality work. In the nursing homes, wicked problems take the form of constant pressures to keep costs down and at the same time improve care for increasingly vulnerable residents.
