Disrupting the problematization of 'safety' in the care of older people in New Zealand: A Foucauldian discourse analysis

Abstract

In New Zealand, older people and their care have been made into various problems with the use of rest homes to provide this care, and surveillance techniques to monitor and regulate the care, used as default solutions. As we are governed through such policy, Carol Bacchi’s framework “What’s the problem represented to be?” was used to uncover how older people and their safety have been problematized through policy resulting in current problematizations. A Foucauldian genealogy and discourse analysis uncovered how throughout three eras, the State and medicine created the older person as housing, economic and security problems. Within each era, these problems determined the types of problems older people, and their care, would be made into with redefined solutions dependent on the dynamics of changing problem representations. First made a social problem through problematizations of hygiene, resource use, and destitution. The medicalization of the older body created them as dependent, making the older person burdensome to their family. The use of institutions as a solution reframed the problem to be about problem homes. Today, the use of the Health and Disability Services (Safety) Act 2001 and other health and disability legislation has reframed the problem of older people and their care to be about problems of safety in care, allowing for problems and their solutions to focus on the care rather than the older person. This research shows how these redefined problems, and their solutions, played an integral role in the shaping of the current Act used to govern safety, older people, and staff and the implications. The main implication being the removal of the older person from the abstract to complete disappearance. However, being problematized in the first place means they remain represented in the problems they cause for the people providing the care and the State. It is the intentions of this research to disrupt these problematizations and to show what the doing does.