An institutional ethnography of elder care: Understanding access from the standpoint of ethnic and "racial" minority women

grantor: University of TorontoThe current study addresses the problematic of access for ethnic and "racial" minority elderly women through an examination of the working processes of a publicly-funded organization which provides elder care services in Ontario, from the standpoint of these women. Using Institutional Ethnography methodology, the study explicates how state ideologies become infused into the operating policies and guidelines of elder care ideologies become infused into the operating policies and guidelines of elder care organizations, shaping the actual way access is both conceptualized and operationalized and the subsequent interactions between workers and their elderly clients. Interviews conducted with 43 participants (elderly women, agency staff, community agency and institutional staff) explicate how actors both reproduce relations of oppression and counter or resist those relations. Several problematic constructions have been identified which highlight the disjunctures between older women's expressed desires regarding access and the way access to services are operationalized in elder care agencies. These include: family involvement in care; prolonged engagement as a means of facilitating access; the influence of acute health care models on eligibility for and delivery of care; and, a focus on cultural competence and language in the delivery of ethno-specific services. Program and practice implications are highlighted in order to shift the dominance of state-orchestrated ideologies which operate to shape the experience of women who are multiply situated on the margins and who have been and continue to be oppressed within elder care institutions.Ph.D