How do older people negotiate social care support? A study of the perspectives of older people, their families and other stakeholders

Abstract

Current English social care policy advocates ‘active ageing’, ‘ageing‐in‐place’ and ‘independence’, whilst promoting ‘choice and control’. Yet research has shown that these competing policy agendas relay mixed messages to older people. Latest figures show that over half of older people aged 65+ live with two or more health conditions, which affect their ability to carry out activities of daily living (ADLs) and instrumental activities of daily living (IADLs) in and around their home environment. Older people face an increasing risk of being left unsupported, owing to ongoing consequences of austerity measures affecting formal social care provision in recent years.

Many studies have focused on who provides support, but little is known about how older people arrange support. This thesis aims to understand how older people who are living in the community negotiate arrangements for support and assistance with ADLs and IADLs from formal and informal sources, using a qualitative research approach. Semi‐structured interviews were conducted with older people aged 65+ (n=8) and members of their formal and informal support network (n=19). Data were analysed by combining thematic analysis with a symbolic interactionist approach. The findings indicate that older people tend not to adopt a direct approach for help with ADLs and IADLs from informal members, preferring to adopt ‘hinting’ to highlight unmet need. Older people usually adopt a direct approach when negotiating with formal members, or with informal members if recent reciprocity is evident. Importantly, older people accept help if it is offered. The findings have two main policy implications: First, to highlight awareness to formal support members about the language used by older people to draw attention to unmet need. Second, to ensure that older Personal Budget holders receive advice and support to make contingency support arrangements in emergency situations.

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ORCID for Maria Evandrou: orcid.org/0000-0002-2115-9358

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