Journal Article

Helping Older People in Residential Care Remain Full Citizens

Peter Scourfield

in The British Journal of Social Work

Published on behalf of British Association of Social Workers

Volume 37, issue 7, pages 1135-1152
Published in print October 2007 | ISSN: 0045-3102
Published online September 2006 | e-ISSN: 1468-263X | DOI: http://dx.doi.org/10.1093/bjsw/bcl086
Helping Older People in Residential Care Remain Full Citizens

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New Labour’s project of modernization has involved the promotion of interlocking ideas about active citizenship and new modes of democratic engagement combining to produce what has described as ‘participative governance’. Concerns about legitimacy, a ‘democratic deficit’ and the need to shift power and responsibility to the ‘citizen’ have led to the emergence of a range of new deliberative fora and democratic processes. This has led to debates about how to ensure that social diversity can be represented in the decision-making process. A challenge has been how to engage with the issues of an ageing population and represent older people in all their diversity. In recent years, there have been growing calls to extend advocacy rights to older people living in residential care. Mostly, this has been to ensure that as consumers, they have a fuller say in how their service is run. Older care home residents are service users but, as persons, should not be reduced to this role only; they are also citizens in the broadest sense and should not be cut adrift from debates at the national, local and community levels on issues that concern them. This paper examines how the moves to bring older people into deliberative democratic processes have tended to focus on those in their ‘Third Age’. Those in institutional settings, being in the ‘Fourth Age’, occupy a much more marginal position. This effective disenfranchisement is yet another reason why, for many, the move into residential care—a difficult transition for a variety of reasons—becomes regarded as the ‘last refuge’. It contributes to the sense of loss of identity, lowering of self-esteem and a reduced sense of personhood. This article accepts that there should be more effective involvement of care home residents in decision making about their personal care. However, there are dangers in adopting a too narrowly consumerist approach. This can reinforce a reductionist view of care home residents simply as ‘service users’—a form of ‘othering’ in itself. As citizens and members of a wider community, they should be included in consultations about any community and wider political debates that affect them. Such a proposal implies a widening and deepening of advocacy services available to this group. As most older people in residential care are there following the intervention of a social care professional, then ensuring that they have access to advocacy must surely be a key task. This paper argues that this is frustrated by the lack of suitable services. Without a significant investment by the Government in independent advocacy services, not only is the social work task with one of social care’s core client groups rendered impossible, but the Government cannot deliver on its own agenda of empowerment, active citizenship and inclusion.

Keywords: advocacy; citizenship; older people; residential care

Journal Article.  7879 words. 

Subjects: Social Work

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