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Some limits and political implications of participation within health and social care for older adults

Published online by Cambridge University Press:  14 March 2018

MALCOLM CAREY
MALCOLM CAREY*
Affiliation:
Faculty of Health and Social Care, University of Chester, Warrington, UK.
*
Address for correspondence: Malcolm Carey, Faculty of Health and Social Care, University of Chester, Martin Building, Crab Lane, Fearnhead, Warrington WA2 0DB, UK E-mail: [email protected]
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Abstract

This paper critically examines service user participation and involvement for older adults. It concentrates on research and community-led engagement for older people, and maintains that despite extensive support and expansion, participation offers a complex form of governance and ideological control, as well as a means by which local governments and some welfare professions seek to legitimise or extend their activities. Some of the paradoxes of participation are discussed, including tensions that persist between rhetorical claims of empowerment, active citizenship and democratic engagement, on one hand, despite tendencies towards risk-aversion, welfare retrenchment and participant ambivalence, on the other. The paper also highlights practical problems in relation to participative research and community involvement, and questions arguments that participation may challenge the authority of welfare professionals. Critical theory is drawn upon to contextualise the role of participative narratives within wider welfare, including its role in moving debate away from ownership or redistribution while masking and validating policy-related goals which can counter many older people's needs. Tension is also noted between participation projects represented as resources to support ageing identities as opposed to those representing technologies for social regulation and conformity.

Keywords

participationideologyrisk-aversionempowermentcommunity
Type
Article
Information
Ageing & Society , Volume 39 , Issue 8 , August 2019 , pp. 1691 - 1708
Copyright
Copyright © Cambridge University Press 2018 

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References

Althusser, L. 1971. Essays on Ideology. Verso, London.Google Scholar
Althusser, L. 2003. The Humanist Controversy and Other Writings. Verso, London.Google Scholar
Andrews, R., Cowell, R. and Downe, J. 2008. Support for active citizenship and public service performance: an empirical analysis of English local authorities. Policy and Politics, 36, 2, 225–43.Google Scholar
Bacon, J. 2015. An exploration of child voice and its use in care planning. Unpublished PhD thesis, University of Chester, UK.Google Scholar
Barnes, M. 2005. The same old process? Older people, participation and deliberation. Ageing & Society, 25, 2, 245–59.Google Scholar
Bartlett, R., Hick, C., Houston, A., Gardiner, L. and Wallace, D. 2015. Privileging place: reflections on involving people with dementia in a residency. Dementia: The International Journal of Social Research and Practice, 14, 6, 788–99.Google Scholar
Begum, N. 2006. Doing it for themselves: participation and Black and Ethnic Minority service users. Participation Report 14, Social Care Institute for Excellence, London.Google Scholar
Beresford, P. 2016. All Our Welfare. Policy Press, Bristol, UK.Google Scholar
Blair, T. and Minkler, M. 2009. Participatory action research with older adults: key principles in practice. The Gerontologist, 49, 5, 651–62.Google Scholar
Brett, J. 2014. Mapping the impact of patient and public involvement on health and social care research: a systematic review. Health Expect, 17, 5, 637–50.Google Scholar
Brett, J., Staniszewska, S., Mockford, C., Seers, K., Herron-Marx, S. and Bayliss, H. 2010. A systematic review of the conceptualization, measurement, impact and outcomes of patients and public involvement in health and social care research. UK Clinical Research Collaboration, London.Google Scholar
Carey, M. 2010. Should I stay or should I go? Practical, ethical and political challenges to service user participation within social work research. Qualitative Social Work, 10, 2, 224–43.Google Scholar
Carey, M. 2013. Some ethical doubts and possibilities regarding service users participation within social work. In Carey, M. and Green, L. (eds), Practical Social Work Ethics. Aldershot, Ashgate, UK, pp. 199–227.Google Scholar
Carey, M. 2016. Journey's end? From residual service to newer forms of pathology, risk aversion and abandonment in social work with older people. Journal of Social Work, 16, 3, 344–61.Google Scholar
Carr, S. 2004. Has service user participation made a difference to social care services? Position Paper 3, Social Care Institute for Excellence, London.Google Scholar
Clarke, J. 2004. Dissolving the public realm? The logics and limits of neo-liberalism. Journal of Social Policy, 33, 1, 27–48.Google Scholar
Clough, R., Green, A., Hawkes, B., Raymond, G. and Bright, L. 2006. Older People as Researchers: Evaluating a Participative Project. Joseph Rowntree Foundation, York, UK.Google Scholar
Cooke, B. and Kathari, U. (eds) 2001. Participation – The New Tyranny? Zed Books, London.Google Scholar
Cowden, S. and Singh, G. 2007. The ‘user’: friend, foe or fetish? A critical exploration of user involvement in health and social care. Critical Social Policy, 27, 1, 5–23.Google Scholar
Cruickshank, B. 1999. The Will to Empower: Democratic Citizens and Other Subjects. Cornell University Press, London.Google Scholar
Daly, M. and Westwood, S. 2017. Asset-based approaches, older people and social care: an analysis and critique. Ageing & Society. Published online 28 March, doi:10.1017/S0144686X17000071.Google Scholar
Drakeford, M. 2000. Privatisation and Social Policy. Pearson, Harlow, UK.Google Scholar
Fenwick, J. and McMillan, J. 2012. Public participation and public service modernisation: learning from New Labour? International Journal of Public Administration, 35, 6, 367–78.Google Scholar
Ferguson, I. 2007. Increasing user choice or privitizing risk? The antimonies of personalisation. British Journal of Social Work, 37, 3, 387–403.Google Scholar
Furedi, F. 2004. Therapy Culture: Cultivating Vulnerability in an Uncertain Age. Continuum, London.Google Scholar
Furedi, F. 2011. On Tolerance: A Defence of Moral Independence. Continuum, London.Google Scholar
Gilbert, T. and Powell, J. L. 2012. The place that social policy plays in shaping the social context of older people. In Davies, M. (ed.), Social Work with Adults. Basingstoke, Palgrave Macmillan, UK.Google Scholar
Grover, S. 2004. Why won't they listen to us? On giving power and voice to children participating in social research. Childhood, 11, 1, 81–93.Google Scholar
Hafford-Letchford, P. 2010. The age of opportunity? Revisiting assumptions about the life-long learning opportunities of older people using social care services. British Journal of Social Work, 40, 2, 496–512.Google Scholar
Hafford-Letchford, P. and Formosa, M. 2016. Mind the gap! An exploration of the role of lifelong learning in promoting co-production and citizenship within social care for older people. European Journal for Research on the Education and Learning of Adults, 7, 2, 237–54.Google Scholar
Harrison, S. and Mort, M. 1998. Which champions, which people? Public and user involvement in health care as a technology of legitimation. Social Policy and Administration, 32, 1, 60–70.Google Scholar
Hernandez, L., Robson, P. and Sampson, A. 2010. Towards integrated participation: involving seldom heard users of social care services. British Journal of Social Work, 40, 3, 714–36.Google Scholar
Higgs, P. 1997. Citizenship theory and old age: from social rights to surveillance. In Jamieson, A., Harper, S. and Victor, C. (eds), Critical Approaches to Ageing and Later Life. Open University Press, Buckingham, UK, pp. 118–31.Google Scholar
Hodgeson, P. and Canvin, K. 2005. Translating health policy into research practice. In Lowes, L. and Hulatt, I. (eds), Involving Service Users in Health and Social Care Research. Routledge, London, pp. 48–65.Google Scholar
Jackson, S. 2006. Learning to live: the relationship between lifelong learning and lifelong illness. International Journal of Lifelong Education, 25, 1, 51–73.Google Scholar
Jones, C. and Novak, T. 1999. Poverty, Welfare and the Disciplinary State. Routledge, London.Google Scholar
Jordan, B. and Jordan, C. 2000. Social Work and the Third Way: Tough Love as Social Policy. Sage, London.Google Scholar
Kemshall, H. 2010. Risk rationalities in contemporary social work policy and practice. British Journal of Social Work, 40, 4, 1247–62.Google Scholar
Lacan, J. 1977. The Four Fundamental Concepts of Psychoanalysis. Hoghart Press, London.Google Scholar
Levitas, R. 2005. The Inclusive Society? Social Exclusion and New Labour. Second edition, Palgrave Macmillan, Basingstoke, UK.Google Scholar
Levitas, R. 2013. Utopia as Method: The Imaginary Reconstitution of Society. Palgrave Macmillan, Basingstoke, UK.Google Scholar
Lewis, G. 1998. Coming apart at the seams: the crisis of the welfare state. In Hughes, G. and Lewis, G. (eds), Unsettling Welfare: The Reconstruction of Social Policy. Routledge/Open University, London, 38–79.Google Scholar
Littlechild, R., Tanner, D. and Hall, K. 2015. Co-research with older people: perspectives on impact. Qualitative Social Work, 14, 1, 18–35.Google Scholar
Local Government Association (LGA) 2012. Ageing Well: An Asset Approach. OPM, London.Google Scholar
Lowndes, V., Stoker, G. and Pratchett, L. 1998. Enhancing public participation in local government. London: Department for Transport, Local Government and the Regions. (DTLR).Google Scholar
Lymbery, M. 2010. A new vision for adult social care? Continuities and change in the care of older people. Critical Social Policy, 30, 1, 5–26.Google Scholar
Martin, W. 2011. Visualizing risk: health, gender and the ageing body. Critical Social Policy, 32, 1, 51–68.Google Scholar
Morrow, V. and Richards, M. 1996. The ethics of social research with children: an overview. Children and Society, 10, 2, 90–105.Google Scholar
Ong, B. N. and Hooper, H. 2003. Involving users in low back pain research. Health Expectations, 6, 4, 332–41.Google Scholar
Rawls, J. 1996. Political Liberalism. Columbia University Press, New York.Google Scholar
Ray, M. 2007. Readdressing the balance? The participation of older people in research. In Bernard, M. and Scharf, T. (eds), Critical Perspectives on Ageing Societies. Policy Press, Bristol, UK, pp. 73–88.Google Scholar
Ray, M. 2014. Critical perspectives on social work with older people. In Baars, J., Dohmen, J., Grenier, A. and Phillipson, C. (eds), Ageing, Meaning and Social Structure: Connecting Critical and Humanistic Gerontology. Policy Press, Bristol, UK, pp. 139–156.Google Scholar
Scott-Samuel, A. and Smith, K. E. 2015. Fantasy paradigms of health inequalities: utopian thinking? Social Theory and Health 13, 3/4, 418–36.Google Scholar
Scourfield, P. 2007. Social care and the modern citizen: Client, consumer, service user, manager and entrepreneur, British Journal of Social Work, 37, 1, 107–22.Google Scholar
Shaw, V. N. 2005. Research with participants in problem experience: challenges and strategies. Qualitative Health Research, 15, 6, 841–54.Google Scholar
Stevenson, M. and Taylor, B. J. 2017. Involving individuals with dementia as co-researchers in analysis of findings from a qualitative study. Dementia. Published online 29 January. http://journals.sagepub.com/doi/pdf/10.1177/1471301217690904.Google Scholar
Swain, J., French, S. and Cameron, C. (eds) 2003. Controversial Issues in a Disabling Society. Buckingham: Oxford University Press, Maidenhead, UK.Google Scholar
Taylor, D. 2005. Governing through evidence: participation and power in policy evaluation Journal of Social Policy, 34, 4, 601–18.Google Scholar
Tutton, E. M. M. 2005. Patient participation on a ward for frail older people. Journal of Advanced Nursing, 50, 2, 143–52.Google Scholar
Vincent, J. A. 1999. Politics, Power and Old Age. Open University Press, Buckingham, UK.Google Scholar
Webb, S. A. 2006. Social Work in a Risk Society. Palgrave Macmillan, Basingstoke, UK.Google Scholar
Williams, S. J. 2003. Medicine and the Body. Sage, London.Google Scholar
Whittington, C. 2016. The promised liberation of adult social work under England's 2014 Care Act: genuine prospect or false prospectus? British Journal of Social Work, 46, 7, 1942–61.Google Scholar
Woolham, J. and Benton, C. 2013. The costs and benefits of personal budgets for older people: evidence from a single local authority. British Journal of Work, 43, 8, 1472–91.Google Scholar
Ziegler, F. and Scharf, T. 2014. Community based participatory action research: opportunities and challenges for critical gerontology. In Baars, J., Dohmen, J., Grenier, A. and Phillipson, C. (eds), Ageing, Meaning and Social Structure: Connecting Critical and Humanistic Gerontology. Policy Press, Bristol, UK, pp. 157–80.Google Scholar