Organizational narratives in rehabilitation-focused dementia care: Negotiating identities, interventions and personhood

Lea Graff, Helle Timm, Jette Thuesen

Publikation: Bidrag til tidsskriftTidsskriftsartikelForskningpeer review

Abstract

Background:Rehabilitation is increasingly being introduced in dementia care but studies highlightextensive heterogeneity in practices, conceptual confusion and divergent perceptions of its rele-vance across care organizations and national contexts. As this have implications for development ofdementia care as well as for people with dementia’s access to care it is important to study theorganizational narratives and practices in rehabilitation-oriented dementia care organizations.Methods:The study build on qualitative interviews (individual and group interviews) with healthprofessionals (N = 26) engaged with dementia care and rehabilitation in two Danish municipalities.The interviews were conducted in 2018–2019. The empirical data was analyzed using abductiveanalysis and theory-based narrative analysis, using Loseke’s conceptualizations of and approach toanalyzing formula stories.Findings:Four dominant organizational narratives were constructed from the data. Each narrativeproduced a specific organizational narrative of client identity: the active participant in individualized rehabilitation the inactive individual benefitting from enhanced social environments, the disengagingself and the vulnerable self.Conclusion:Introducing rehabilitation in dementia care may amplify the organizational polyphonicand provide a plurality of organizational identities each expressing different perceptions of per-sonhood and agency for people with dementia. The organizational narratives were negotiated withina specific structural context where national regulation and dominant discourses on economicchallenges and ageing gave precedence to some narratives more than others. In Danish elder care,thefirst narrative is the most influential but risks excluding people with dementia. Instead, re-habilitation in dementia care is positioned within a social and relational perspective, which maysilence important discussion of agency and resistance.
OriginalsprogEngelsk
TidsskriftDementia
Vol/bind22
Udgave nummer4
Sider (fra-til)709-726
Antal sider18
ISSN1471-3012
DOI
StatusUdgivet - maj 2023

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