University of Alberta, Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, Alberta, Canada.
J Aging Stud. 2013 Jan;27(1):30-7. doi: 10.1016/j.jaging.2012.10.004. Epub 2012 Nov 15.
This paper examines the issue of what thinking is necessary in order to advance a notion of accommodation in the organization and provision of supportive home care for older people. Accommodation in this context is understood as responsiveness to the singularity of older adults, and we consider how this idea might be used to support opportunities for (independent) living for elders as they age and become frailer. To elaborate the question we draw on examples from our empirical work - ethnographic studies of home care practice undertaken in Canada and Iceland - and consider these examples in light of critical philosophical and social theory, particularly Agamben's (1993) work, The Coming Community. This is a relevant frame through which to consider the potential for the accommodation of the unique needs of older adults in home care because it helps us to problematize the systems through which care is accomplished and the current, dominant terms of relations between individuals and collectives. We argue that giving substance to a notion of accommodation contributes an important dimension to aligned ideas, such as patient-centeredness in care, by working to shift the intentionality of these practices. That is, accommodation, as an orientation to care practices, contests the organizational impulse to carry on in the usual way.
本文探讨了为了在组织和提供老年人支持性家庭护理方面推进适应性概念，需要什么样的思维。在这种情况下，适应性被理解为对老年人独特性的回应，我们考虑如何利用这个概念来支持老年人随着年龄的增长和身体变得更加脆弱而获得（独立）生活的机会。为了详细阐述这个问题，我们借鉴了我们的实证工作的例子——在加拿大和冰岛进行的家庭护理实践的民族志研究——并根据批判性哲学和社会理论，特别是阿甘本（Agamben）的（1993）著作《即将到来的共同体》（The Coming Community）来考虑这些例子。这是一个通过考虑在家庭护理中适应老年人独特需求的潜力的相关框架，因为它帮助我们使通过护理完成的系统和当前个人与集体之间的主导关系复杂化。我们认为，通过努力改变这些实践的意图，赋予适应性概念以实质性内容，为以患者为中心的护理等理念增添了一个重要维度。也就是说，作为护理实践的一种取向，适应性挑战了以通常方式继续下去的组织冲动。
