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Understanding Aging and Disability Perspectives on Home Care: Uncovering Facts and Values in Public-Policy Narratives and Discourse*
Published online by Cambridge University Press: 31 March 2010
Abstract
Every public-policy problem can be defined in terms of its empirical (“facts”) and normative (“values”) dimensions and the interrelationship between them. An understanding of the connection between facts and values at the foundation of the home care policy debate in the Canadian health-care system is developed through the application of an analytical framework based on the concept of “narrative frame” analysis. The literature on home care policy reports and recommendations is examined within this conceptual structure – including especially publications and reports from the federal government, national organizations, and the aging and disability communities. Finally, observations and conclusions about the significance of home care policy discourse, and of the differences between the aging and disability constituencies in this debate, are offered as a guide for deconstructing the public-policy process.
Résumé
Tous les problèmes ayant trait aux politiques gouvernementales peuvent être délimités par leur dimension empirique (les faits) et leur dimension normative (les valeurs), et par l'interrelation entre ces deux dimensions. Le lien entre les faits et les valeurs sur lesquels repose le débat politique sur les soins à domicile dans le système de santé canadien est examiné par la lorgnette d'un schéma analytique fondé sur la «narration». La documentation formée de rapports et de recommandations sur la politique concernant les soins à domicile est examinée en vertu de cette structure conceptuelle – en particulier, les publications et les rapports du gouvernement fédéral, d'organisations canadiennes et des milieux du vieillissement et de l'incapacité. Enfin, des observations et une conclusion sur la portée du discours politique sur les soins à domicile, et sur les différences entre les sphères du vieillissement et de l'invalidité dans ce débat, sont proposées pour guider le lecteur dans le dédale de l'élaboration des politiques publiques.
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- Copyright © Canadian Association on Gerontology 2007
Footnotes
Earlier versions of this paper were presented at a symposium titled “Interdisciplinary Perspectives on the Costs and Contributions of Care” as part of the Hidden Costs/Invisible Contributions (HCIC) Project, Trent University, Peterborough, ON, June 8–10, 2005, and at the 34th Annual Scientific and Educational Meeting of the Canadian Association on Gerontology, Halifax, NS, October 20–22, 2005.
The author would like to thank Isabel Sousa of York University and Maggie Quirt of Trent University for their assistance in researching the sources and references used in this paper; and Cameron Crawford of the Roeher Institute, Janis Douglas of the Canadian Association for Community Living, Anne Martin-Matthews of the University of British Columbia, and Louise Plouffe of Health Canada for their help in identifying issues and resources related to this topic and their comments on an earlier draft. This research was funded by grant no. G124130363 to the University of Alberta through the Major Collaborative Research Initiatives (MCRI) program of the Social Sciences and Humanities Research Council of Canada (SSHRC).
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