Patching Up the Holes: Analyzing the Work of Home Care
OBJECTIVE: Through close, critical readings of everyday practice of homecare case managers in Canada and Iceland, we demonstrate how contemporary neo-liberal policy that focuses on enhancing efficiency in the health care system has the effect of undermining forms of flexibility that previously enabl...
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ftpubmed:oai:pubmedcentral.nih.gov:6975827 2023-05-15T16:48:09+02:00 Patching Up the Holes: Analyzing the Work of Home Care Purkis, Mary Ellen Ceci, Christine Bjornsdottir, Kristin 2008-11-01 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6975827/ https://doi.org/10.1007/BF03403801 en eng Springer International Publishing http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6975827/ http://dx.doi.org/10.1007/BF03403801 © The Canadian Public Health Association 2008 Article Text 2008 ftpubmed https://doi.org/10.1007/BF03403801 2020-02-09T01:22:28Z OBJECTIVE: Through close, critical readings of everyday practice of homecare case managers in Canada and Iceland, we demonstrate how contemporary neo-liberal policy that focuses on enhancing efficiency in the health care system has the effect of undermining forms of flexibility that previously enabled the delivery of home-based care and respected the unique needs of older adults. METHOD: A case study method is used, drawing on a single case from Canada and another from Iceland to undertake an ethnomethodological analysis of how assessments of older adults’ needs for homecare support that is largely performed by women are accomplished. RESULTS: The interpretation of data illustrates both individual and collective strategies for the conduct of care in homes and communities. The effects of such strategies in terms of their effects in diminishing resistance to further shifts of responsibility for care over to individuals are demonstrated. Professional imperatives are shown to be effective in repairing and even extending the effects of responsibilization. DISCUSSION: This paper explores the effects of a variety of strategies employed by health care organizations as they both shape and respond to a changing care provision landscape. We illustrate how gendered organizational policies and professional practices support wider political interests in performance management and efficiency and, in so doing, further the effects of individualization in what could otherwise be mobilized collective responses to aging, poverty, illness and isolation. Text Iceland PubMed Central (PMC) Canada Canadian Journal of Public Health 99 S2 27 32 |
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Article Purkis, Mary Ellen Ceci, Christine Bjornsdottir, Kristin Patching Up the Holes: Analyzing the Work of Home Care |
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Article |
description |
OBJECTIVE: Through close, critical readings of everyday practice of homecare case managers in Canada and Iceland, we demonstrate how contemporary neo-liberal policy that focuses on enhancing efficiency in the health care system has the effect of undermining forms of flexibility that previously enabled the delivery of home-based care and respected the unique needs of older adults. METHOD: A case study method is used, drawing on a single case from Canada and another from Iceland to undertake an ethnomethodological analysis of how assessments of older adults’ needs for homecare support that is largely performed by women are accomplished. RESULTS: The interpretation of data illustrates both individual and collective strategies for the conduct of care in homes and communities. The effects of such strategies in terms of their effects in diminishing resistance to further shifts of responsibility for care over to individuals are demonstrated. Professional imperatives are shown to be effective in repairing and even extending the effects of responsibilization. DISCUSSION: This paper explores the effects of a variety of strategies employed by health care organizations as they both shape and respond to a changing care provision landscape. We illustrate how gendered organizational policies and professional practices support wider political interests in performance management and efficiency and, in so doing, further the effects of individualization in what could otherwise be mobilized collective responses to aging, poverty, illness and isolation. |
format |
Text |
author |
Purkis, Mary Ellen Ceci, Christine Bjornsdottir, Kristin |
author_facet |
Purkis, Mary Ellen Ceci, Christine Bjornsdottir, Kristin |
author_sort |
Purkis, Mary Ellen |
title |
Patching Up the Holes: Analyzing the Work of Home Care |
title_short |
Patching Up the Holes: Analyzing the Work of Home Care |
title_full |
Patching Up the Holes: Analyzing the Work of Home Care |
title_fullStr |
Patching Up the Holes: Analyzing the Work of Home Care |
title_full_unstemmed |
Patching Up the Holes: Analyzing the Work of Home Care |
title_sort |
patching up the holes: analyzing the work of home care |
publisher |
Springer International Publishing |
publishDate |
2008 |
url |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6975827/ https://doi.org/10.1007/BF03403801 |
geographic |
Canada |
geographic_facet |
Canada |
genre |
Iceland |
genre_facet |
Iceland |
op_relation |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6975827/ http://dx.doi.org/10.1007/BF03403801 |
op_rights |
© The Canadian Public Health Association 2008 |
op_doi |
https://doi.org/10.1007/BF03403801 |
container_title |
Canadian Journal of Public Health |
container_volume |
99 |
container_issue |
S2 |
container_start_page |
27 |
op_container_end_page |
32 |
_version_ |
1766038268739059712 |