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Images of the protected in nursing home regulation.

Kerrison, Susan Helen (2007) Images of the protected in nursing home regulation. PhD thesis, London School of Economics and Political Science.

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Abstract

In a simple model of regulation, three different types of actor, "the regulator", "the regulated" and "the protected" are positioned in relationship to each other by a legal framework. Academic scholarship has mainly focused on the first two types of actor, with little attention paid to "the protected". Yet "the protected" are the raison d'etre of nursing home regulation and "the resident" is at the centre of many key rules. Without an image of "the resident", such rules are without meaning. The central question for this thesis, then, is how are nursing home residents represented in the regulatory system which aims to protect them. Within this regulatory regime a number of social networks in which the category of "the resident" has meaning were identified. These included elements of the system that are key to the interpretation of regulatory rules - specifically, the practices of nursing home inspectors and the appeal system for nursing home owners - as well as the discourses of nursing and health policy. The practices of nursing home inspectors were observed, the decisions of the Registered Homes Tribunal analysed, and the construction of "the resident" in the discourses of nursing and health policy was explored. Taken together, these methods provided a broad multiperspectival understanding of influences and constraints on the construction of the term "resident". As a group, the residents of nursing homes are elderly people in poor health and at the end of their lives. This thesis concludes that there are great difficulties in understanding extreme old age either as a lived experience or a sociological construct. In nursing home regulation, these difficulties are compounded by a framework of normative and fiscal policies where the state ensures that the term "resident" remains unstable or ill-defined. Against this background, the articulation of any clear moral purpose for nursing home regulation becomes extremely vexed.

Item Type: Thesis (PhD)
Uncontrolled Keywords: Sociology, Public and Social Welfare, Health Sciences, Health Care Management
Sets: Collections > ProQuest Etheses
URI: http://etheses.lse.ac.uk/id/eprint/2037

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