Title:
|
Older people, personalisation and personhood : towards user informed theory
|
Personalisation of social care for adults is a key policy objective in the UK having
gained wide acceptance as essential for the empowerment of service users and as a
means of making the system sustainable in the face of the increasing population
demand. However, despite huge investment in 'transformational change' over the
past decade there is little evidence of its effectiveness. This is particularly true of
personalisation policy and practice applied to older people. Evaluative studies show
poorer outcomes compared with other user groups and question effectiveness in
terms of actual empowerment experienced and value for money achieved. The
conditions required for what is essentially a consumerist model of personalisation are
frequently stated but rarely, if ever, wholly achieved. A qualitative study of eight
cases in two local authority areas in England explored older people's experience of
using (or refusing) a direct payment with the aim of obtaining user perspectives to
inform future policy and practice. The study was concerned with understanding the
relationship between participants' personhood, or experience of 'Self , and
personalised services. The locus of personalisation was found to reside within the
interpersonal dynamics of helping relationships rather than control over the means of
procuring services. Participants experienced personalisation when carers perceived
and accommodated their 'special requirements of Self'. This was achieved in most
cases despite the consumerist model of personalisation rather than because of it. In
a number of cases participants and their front line carers were exposed to
considerable risk and dilemma in the process. These user perspectives provide a
valuable starting point for the development of an alternative theoretical framework
within which existing policy and practice might be reviewed and redeveloped.
Key words: Older people, personalisation, personhood, Self, direct payments.
|