An exploration of 'choice' in relation to social care for older people in a rural area

Bell, Audrey (2010) An exploration of 'choice' in relation to social care for older people in a rural area. Doctoral thesis, Northumbria University.

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Abstract

Social care is currently undergoing a transformation, driven by Government policy, and key to this transformation is giving greater choice to service users. This vision of choice is based on a market model of competing service providers; such a model can be difficult to implement in rural areas where problems of space, time and access hamper service delivery. This raises the question of whether policy is biased towards urban areas and highlights the important role that geographical gerontology can play in developing more person-centred social care policy and practice. This consumerist vision of social care has also fuelled a theoretical debate which underpins this research. The market model of choice has been located within a wider discourse which regards the self as a rational, self-sufficient individual. An alternative discourse has been posited from a feminist ontology in which interdependence and co-responsibility come to the fore; such a discourse emphasises the personal dimension to social care practice. This project forms the research component of a professional doctorate in occupational therapy and is concerned with the self-expressed views of rural older people in relation to the above social care theory and policy. Taking a phenomenological approach, a narrative methodology was used to interview 11 older people who live in rural West Northumberland. Participants? narratives concerning social care re-affirm findings from previous gerontological research which assert low expectations, self-sufficiency and the crucial role of human relationships. Although at a superficial level, „choice? is not a term participants relate to social care, it is revealed that they do make choices on a daily basis both in relation to social care and their home situation, but choice is a complex and ongoing process rather than a one off event. It is suggested that the way participants situate themselves within their network of care and their geographic location helps them to maintain coherence in their personal identity. The concepts identified above are used to develop theory from a postmodern and feminist perspective in the areas of social care and geographical gerontology, forming an original contribution at the interface of these two domains.

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