Growing old is not for sissies: a critical ethnography

Abstract

This thesis investigates the elderly health care recipient and their family carer(s)' perceptions of the health care services within the Southland region. This research was predicated on an increasing awareness of changes to the delivery and quality of health care offered to older people within this region since the implementation of the 1991 health reforms. Using critical ethnography as a methodology exposes the way in which socio-political influences have shaped the health policies and the delivery of the health care to the frail, disabled and /or ill elderly population. The participants included three elderly health care recipients and their family carer(s). Each was asked to reflect on the health care they had received and their response to that care. Although the data was collected over a three month period while they were receiving health care services in their own home environments, the participants were asked to reflect on the services they had encountered prior to and during that time period. Data was collected during unstructured interviews with each individual participant initially and then with both the elderly health care recipient and their family carer jointly. Critical analysis of the participants' perceptions illustrate the ways in which the dominant ideologies of the economic rationalisation have influenced the delivery of the health care services, and in turn, their health and wellbeing. The study showed the participants rely heavily on the health care services but in doing so have experienced an almost overwhelming sense of vulnerability related to the delivery of those services. The perceptions of the participants indicate that the rationing and allocation of health care services have discriminated against them in terms of being able to access health care, and in relation to the knowledge, skill and attitudes of those providing the care to this diverse and complex population group.