The
institutionalisation of community care
The social construction of
community care
Contents
"Institutionalised
care for people with disability is alive and well in
Western Australia"
Community Care:
(
Top)
Is about community members getting together to support or provide a
service within that community.
... About the
members supporting each other.
... A value in being a part of the
community.
... Having something to contribute to the
community.
... Parents may rely on
family
members or relatives to look after young children or toddlers..
... A car pool allows the members of a group to share resources
within a group.
... A group may get together to help out a neighbour.
... Book clubs are a way to share books.
... A community may use goods and services as a form of monetary
exchange rather than cash (barter)
... Is dependent on the skills and resources of the members within
the community.
... Relies on community members to provide
the service.
Characteristicts of
community care:
(
Top)
Informal ...
... there are no defined
roles,
structures or hierarchies in the provision of the care.
... care is centered around the skills and resources of the othres
providing the care.
... the care is provided in an informal setting that is not designed
around a particular model of care.
Spontaneous ...
... care is provided as
needed and
relies on the availability of others,
... care is improvised and relies on available skills and resources.
Adaptable ....
... the care provided can
be easily
changed or modified according to the person's/groups needs.
(
Top)
Where a
community can not
provide for the needs of it's members the care needs to come from
somewhere else. As a result specialised services have evolved to
fulfill those needs. People that have a physical or intellectual
condition, the aged and other groups are supported by an organisation
or service that can provide for the specific needs of each group. These
organisations or services have their own institutions that are not the
same as the institutions of the wider communities that they are a part
of.
We see
institutions
such as Activ, Identity, TCCP, Rocky bay etc take
over the role of the
institutions
that they replaced in society.
While the outcomes are different to the services that were provided 100
yeqrs ago, they still provide the support, the skills and resources
that are not available in the wider community.
The various policies, practices and
institutions
of
government,
disability services and organisations provide the community behaviours
towards these groups, and expectations of the way these groups are
treated within the community.
The shift from community care to institutional (social) care
The dependence on social structures in providing the care
Institutional practices ...
Profiling as a social
policy.
Actively supporting people with high needs in the community: the
community provides a supportive role.
Service industries become dependent on these
institutions.
New communities are built that have the skills and resources to provide
for the needs of people with high support needs.
Legatimises the roles of
institutionalised
care in the community.
In Gerard Goggin, Christopher Newell, Disability in Australia: exposing
a social apartheid,
University of New South Wales Press LTD Sydney, First published 2005
Characteristicts of
institutional
care: (See
Characteristics
of
an
institution) (
Top)
Formal ...
... there are defined
roles, structures
or hierarchies in the provision of the care.
... care is centered around trained staff that have spicific tasks and
duties.
... the care is provided in an informal setting that is designed around
a particular model of care.
Organised ...
... care is provided in an
orderly,
planned and structured setting,
... care is planned and relies on professional skills and resources.
Fixed....
... the care provided can
not be easily
changed or modified according to the person's/groups needs.
The roles of
the carer:
(
Top)
Non-professional:
Provides personal care for a person
that can not look after him/her self
Privides for the physical and social needs of the person
Has limited skills and resources in providing for the person
Is often helped by family, friends,
or a community support
network/group,
or
institutional
support that is provided by a government or community service,
that has the skills and resources to help.
Is the best person to
provide the
support;
Knows the person.
Is often trained by a medical service that has some knowledge about the
condition that the person sufferes from.
May support the person in a setting that most suits the persons needs
The care is provided in a non-
institutional
way,
in a non-
institutional
setting.
The carer may have other roles such as mother, father, son or daughter,
brother or sister, or worker, student etc.
The carer may also recieve financial support: child support, carers
support or pension.
The amount of financial or social support provided by government or
community service is dependent on some criteria that allows access to
that financial or social support.
(
Top)
The roles of the carer
Professional:
Paid support by way of government subsidies, pensions etc
New government policy and practice mean that a carer needs professional
support in providing the care.
Hew technology, equipment, drugs and knowledge means that the carer
needs to have a more professional approach to service delivery.
Provides personal care for a person
that can not look after him/her self
Privides for the physical and social needs of the person
The amount of financial or social support provided by government or
community service is dependent on some criteria that allows access to
that financial or social support.
The roles of the volunteer
Provides a service that is
not
available in the wider community.
Usually not paid for services, but compensated for expenses.
Provides a
non-professional approach to
service delivery within a service or organisation.
Is bound by the policies, proceedures and other mechanisms of the
service or organisation.
Is bound by the
institutions
of the service or organisation.
Acts as an aid or support to the service or organisation in providing
non essential services that supplement or assist service delivery.
The roles of the support worker
Provides a service that is
not
available in the wider community.
Paid for services provided.
Provides a professional approach to service delivery within a
service or organisation.
Is bound by the policies, proceedures and other mechanisms of the
service or organisation.
Is bound by the
institutions
of the service or organisation.
Provides the essential services of the service or organisation
The above shows that while individuals are looking for a local service
to provide the skills and resources, so they can better fulfil their
own needs, these supports are less likely to be found in the community.
There is a growth in the human service industry that is taking over
from the traditional roles of the community in providing these
supports. Local Rotary, Lions, Apex groups are getting smaller. Church
and school groups have less participation as we knew it in the
community.
In many ways I see this as the community opting out in providing these
roles ...
A lack of community skills
and
resources.
Communities are more diverse and
fragmented these days. They are different places to what they were 100
years ago;
New generations have more things to think about these days. They expect
everything to be given to them.
Everything is reduced to a personal cost. My time is more valuable in
doing something else.
Permissions, insurance and liability issues, legal implications, and
council regulations all make it more difficult for community groups to
get together.
The idea of
"placing
a person into institutional care" is so institutionalised
and
normalised into the culture of the society through government policy
and practice, the medical arena, schools and universities, as well as
the media, that there really is no choice these days. A person that can
not be supported in the community is placed in institutional care that
has the skills and resources that can provide for his/her needs.
Institutionalised care is also about the community not having the
skills
and resources in providing the care. Sometimes institutional care is
important in, and integral to, the way a community functions. These
institutions (Organisations and services) complement communities in
allowing communities to better
manage their own needs, Hospitals, schools and universities, nursing
homes, churches etc all provide valued roles in society, However these
institutions are used is determined by the values, cultures etc
(institutions) of the society in which they are used.
Shows the
relationship between
the the skills and resources of the community,
and the amount of support that can be provided
within the
community.
(See Community
care Vrs Institutional care)
