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Bridging gaps in risk discourse: home care case management and client choices
Author(s) -
Ceci Christine,
Purkis Mary Ellen
Publication year - 2009
Publication title -
sociology of health and illness
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.146
H-Index - 97
eISSN - 1467-9566
pISSN - 0141-9889
DOI - 10.1111/j.1467-9566.2008.01127.x
Subject(s) - conceptualization , negotiation , bridging (networking) , public relations , sociology , discourse analysis , business , nursing , medicine , political science , computer science , computer network , social science , linguistics , philosophy , artificial intelligence
This paper examines, and problematises, a well‐entrenched conceptualisation of how home care case management practice works – that is, that case managers offer alternatives, and clients make choices. This understanding of practice is reinforced by organisational policy that states that clients have the right to live at risk if that is their choice. Analysis of data from a field study of home care practice in a western Canadian city, drawing predominantly on case managers’ accounts of actual practice situations, underscores the limitations of such a view, and suggests that conceptualising such practices as ongoing and fragile negotiations between freedom and security offers a more useful frame for thinking through the distance and difference between current home care policy and practice and what people might actually need.