Home care as a family matter? Discursive positioning, storylines and decision-making in assessment talk

Authors

  • Anna Olaison National Institute for the Study of Ageing and Later Life (NISAL), Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden
  • Elisabet Cedersund Department of Behavioural Science and Social Work, School of Health Sciences, Jönköping University, Jönköping, Sweden

DOI:

https://doi.org/10.1558/cam.v5i2.145

Keywords:

Assessment interviews, aged care, storylines, positioning, discourse analysis, decision making

Abstract

Home care arrangements for older people are coordinated via a client-centred assessment process. This article describes how storylines and discursive positioning are used among older people and their relatives when divergent opinions of care needs are expressed. Eleven assessment interviews were studied using discourse analysis. The results show that relatives and older people advanced three major storylines, and positioned themselves within them with respect to the need for help. These storylines were based on whether the persons viewed home care as an intrusion into daily routines and relationships, or as a complement and support in everyday life, or as a right. The content of the storylines and the ways in which positions were shaped within them illustrate how positioning is incorporated as part of the ongoing reflexive process in interaction in which participants form an image of the older person’s needs. Assessments clarify the views of the participants on home care, but they also reflect the discourses that are prevalent in the aged care community and in society in general. The article raises questions about strengthening older people’s participation in the decision making process and also whether a new communicative practice is needed for assessments, i.e., one that proceeds on the basis of a broader family perspective.

Author Biographies

Anna Olaison, National Institute for the Study of Ageing and Later Life (NISAL), Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden

Anna Olaison is currently undertaking doctoral research on communication and interaction in aged care with a focus on older people and family members’ participation in home care assessments, documentation and case files. Her interests also include categorization processes of talk and text and questions concerning the client’s perspective in social work practices.

Elisabet Cedersund, Department of Behavioural Science and Social Work, School of Health Sciences, Jönköping University, Jönköping, Sweden

Elisabet Cedersund is professor of social work at the School of Health Sciences, Jönköping University. She has conducted research on and written about institutional discourse, construction of financial problems in social welfare interviews, narratives in social work and communication in educational settings. Address for correspondence: E-mail:

Published

2009-03-14

How to Cite

Olaison, A., & Cedersund, E. (2009). Home care as a family matter? Discursive positioning, storylines and decision-making in assessment talk. Communication and Medicine, 5(2), 145–158. https://doi.org/10.1558/cam.v5i2.145

Issue

Section

Articles