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What does client ‘engagement’ mean in aged care? An analysis of practice

Published online by Cambridge University Press:  07 March 2017

ANDREA PETRIWSKYJ ,
ALEXANDRA GIBSON  and
GLENYS WEBBY
ANDREA PETRIWSKYJ*
Affiliation:
School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Australia.
ALEXANDRA GIBSON
Affiliation:
School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Australia.
GLENYS WEBBY
Affiliation:
Blue Care, Brisbane, Australia.
*
Address for correspondence: Andrea Petriwskyj, The University of Queensland, School of Nursing, Midwifery and Social Work, Brisbane, Qld 4072, Australia E-mail: [email protected]
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Abstract

Client engagement is an important part of contemporary aged care. However, the extent to which decisions are delegated to the older person, and the scope of issues about which decision making occurs, vary. The types of engagement that are offered to, and taken up by, aged-care clients have implications for the extent of power and influence older people hold. This paper reports on a qualitative study conducted in a large Australian service provider. It identifies the forms that client engagement takes in the aged-care context, the roles for staff and older people that are enacted through these activities, and the implications these have for power relationships and older people's influence. An inverse relationship was seen between the depth and scope of client influence, but a desire to address this suggested potential spaces for greater empowerment. A relationship was evident between the retention of control by staff and the perceived effectiveness of existing engagement strategies, highlighting the limitations of traditional power dynamics in engagement practice. An expanded model of engagement in aged care is proposed that recognises the foundational role of connection building as a facilitator of greater empowerment for older people. Implications for theory regarding engagement in aged care, and the practice of engagement in aged-care organisations, are discussed.

Keywords

aged careengagementparticipationpower
Type
Article
Information
Ageing & Society , Volume 38 , Issue 7 , July 2018 , pp. 1350 - 1376
Copyright
Copyright © Cambridge University Press 2017 

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References

Abma, T. A. and Baur, V. 2014. Seeking connections, creating movement: the power of altruistic action. Health Care Analysis, 22, 4, 366–84.Google Scholar
Abma, T. A. and Baur, V. E. 2015. User involvement in long-term care. Towards a relational care-ethics approach. Health Expectations, 18, 6, 2328–39.Google Scholar
Abma, T. A. and Widershoven, G. 2014. Dialogical ethics and responsive evaluation as a framework for patient participation. American Journal of Bioethics, 14, 6, 27–9.Google Scholar
Arnstein, S. 1969. A ladder of citizen participation. Journal of the American Institute of Planners, 35, 4, 216–24.Google Scholar
Bailey, C., Clarke, C., Gibb, C., Haining, S., Wilkinson, H. and Tiplady, S. 2013. Risky and resilient life with dementia: review of and reflections on the literature. Health, Risk & Society, 15, 5, 390–401.Google Scholar
Barnes, M. 2005. The same old process? Older people, participation and deliberation. Ageing & Society, 25, 2, 245–59.Google Scholar
Barnes, M. 2008. Deliberating with care: ethics and knowledge in the making of social policies. Inaugural lecture, 24 April, University of Brighton, Brighton, UK.Google Scholar
Baur, V. and Abma, T. 2011 a. ‘The Taste Buddies’: participation and empowerment in a residential home for older people. Ageing & Society, 32, 6, 1055–78.Google Scholar
Baur, V. E. and Abma, T. A. 2011 b. Resident councils between lifeworld and system: is there room for communicative action? Journal of Aging Studies, 25, 4, 390–6.Google Scholar
Baur, V., Abma, T. and Baart, I. 2012. ‘I Stand Alone.’ An ethnodrama about the (dis)connections between a client and professionals in a residential care home. Health Care Analysis, 22, 3, 272–91.Google Scholar
Baur, V., Abma, T., Boelsma, F. and Woelders, S. 2013. Pioneering partnerships: resident involvement from multiple perspectives. Journal of Aging Studies, 27, 4, 358–67.Google Scholar
Bonifas, R. P., Hedgpeth, J. and Kramer, C. 2013. Evidence of empowerment in resident council groups: an examination of two leadership models in assisted living. Journal of Gerontological Social Work, 56, 4, 281–98.Google Scholar
DeForge, R., van Wyk, P., Hall, J. and Salmoni, A. 2011. Afraid to care; unable to care: a critical ethnography within a long-term care home. Journal of Aging Studies, 25, 4, 415–26.Google Scholar
Department of Health and Human Services Tasmania 2009. Your Care, Your Say: Consumer and Community Engagement. Department of Health and Human Services Tasmania, Hobart, Australia.Google Scholar
Dialogue by Design 2012. A Handbook of Public and Stakeholder Engagement. Dialogue by Design, London.Google Scholar
Gregory, J. 2007. Conceptualising Consumer Engagement: A Review of the Literature. Australian Institute of Health Policy Studies, Melbourne.Google Scholar
Health Canada 2000. Health Canada Policy Toolkit for Public Involvement in Decision Making. Minister of Public Works and Government Services Canada, Ottawa.Google Scholar
Huby, G., Stewart, J., Tierney, A. and Rogers, W. 2004. Planning older people's discharge from acute hospital care: linking risk management and patient participation in decision-making. Health, Risk and Society, 6, 2, 115–32.CrossRefGoogle Scholar
Knight, C., Haslam, A. and Haslam, C. 2010. In home or at home? How collective decision making in a new care facility enhances social interaction and wellbeing amongst older adults. Ageing & Society, 30, 8, 1393–418.Google Scholar
MacKenzie, C. and Stoljar, N. (eds) 2000. Relational Autonomy: Feminist Perspectives on Autonomy, Agency, and the Social Self. Oxford University Press, Oxford.Google Scholar
McLaughlin, H. 2009. What's in a name: client, patient, customer, consumer, expert by experience, service user: what's next? British Journal of Social Work, 19, 6, 1101–17.Google Scholar
Mitchell, W. and Glendinning, C. 2007. A review of the research evidence surrounding risk perceptions, risk management strategies and their consequences in adult social care for different groups of service users. Working Paper DHR 2180 01.07, Social Policy Research Unit, University of York, York, UK.Google Scholar
O'Dwyer, C. and Timonen, V. 2010. Rethinking the value of residents’ councils: observations and lessons from an exploratory study. Journal of Applied Gerontology, 29, 6, 762–71.Google Scholar
Petriwskyj, A. M., Gibson, A. and Webby, G. 2014. Participation and power in care: exploring the ‘client’ in client engagement. Journal of Aging Studies, 31, 119–31.Google Scholar
Petriwskyj, A. M., Gibson, A. and Webby, G. 2015 a. Staff members’ negotiation of power in client engagement: analysis of practice within an Australian aged care service. Journal of Aging Studies, 33, 37–46.Google Scholar
Petriwskyj, A. M., Gibson, A. and Webby, G. 2015 b. ‘We're in the sandwich’: aged care staff members’ negotiation of constraints and the role of the organisation in enacting and supporting an ethic of care. Journal of Aging Studies, 35, 84–94.Google Scholar
QSR International 2012. NVivo Qualitative Data Analysis Software. QSR International, Melbourne.Google Scholar
Queensland Health 2010. Consumer and Community Engagement and Patient Involvement and Participation in Health Service Planning, Delivery and Evaluation. Queensland Health, Brisbane.Google Scholar
Strauss, A. L. and Corbin, J. M. 1998. Basics of Qualitative Research: Grounded Theory Procedures and Techniques. Sage, Thousand Oaks, California.Google Scholar
Timonen, V. 2016. Beyond Successful and Active Ageing: A Theory of Model Ageing. Policy Press, Bristol, UK.Google Scholar
Tritter, J. Q. and McCallum, A. 2006. The snakes and ladders of user involvement: moving beyond Arnstein. Health Policy, 76, 2, 156–68.Google Scholar
Tronto, J. C. 1993. Moral Boundaries: A Political Argument for an Ethic of Care. Routledge, New York.Google Scholar
van Hees, S., Horstman, K., Jansen, M. and Ruwaard, D. 2015. Conflicting notions of citizenship in old age: an analysis of an activation practice. Journal of Aging Studies, 35, 178–89.Google Scholar
van Malderen, L., Vriendt, P., Mets, T. and Gorus, E. 2016. Active ageing in the nursing home: could participatory action research provide the answer? Action Research. Published online March 9, 2016, DOI: 10.1177/1476750316636668.Google Scholar
Wikstrom, E. and Emilsson, U. M. 2014. Autonomy and control in everyday life in care of older people in nursing homes. Journal of Housing for the Elderly, 28, 1, 41–62.Google Scholar
Young, I. M. 2000. Inclusion and Democracy. Oxford University Press, New York.Google Scholar