The utility of positioning theory to the study of ageing: Examples from research with childless older people

Growing older is hard to make sense of. Opposing perspectives are presented on everything from individual to population ageing, and there is widespread ambivalence towards many aspects of ageing. Positioning theory is a research approach that can tolerate such ambiguity and provides a clear, useful framework to make sense of research data, while doing justice to its complexity. It is starting to be used in gerontology; the aim of this paper is to give gerontologists the tools and impetus to use it more. The positioning triad is outlined, comprising positions (how we position ourselves and others within a single conversation or across a lifetime), storylines (the individual and social narratives which furnish those positions), and the speech acts (and acts of research) through which storylines and positions are enacted. In addition, considering the rights and duties associated with different positions and storylines can usefully illuminate some of the tensions around competing positions on ageing. Worked examples from a qualitative study on childless older people (38 participants aged 63 to 93) in terms of their positioning of childlessness, views on residential care, and positioning of emotional support show how the complexity of such diverse topics can be usefully studied using a positioning theory framework.     

Equal or individual treatment: contesting storylines in needs assessment conversations within Swedish eldercare

This article examines the role of care managers and their work in putting policy into practice in micro-interactions with older people in Swedish eldercare. The care managers assess the individual needs of older people, and decide what type of social care and services will be given. Dilemmas in care management are often related to the gap between needs and resources. The aim was to study the positioning of care managers within different storylines advanced in needs assessment conversations. Positioning theory was applied to study discursive practices and discursive strategies within Swedish eldercare. Audio-recorded needs assessment conversations among care managers, older people and their relatives at care planning meetings in connection with hospital discharge were analyzed. Two overall positions were identified for care managers—as ‘professional experts’ and as ‘organizational representatives’—allowing the care managers to maneuver within two contesting storylines: ‘distribution of scarce eldercare resources based on the principles of eligibility and equal treatment’ and ‘older people entitled to eldercare according to their own perceived individual needs’. For social work, the results showed the importance of discussing how care managers might move towards exercising greater professional autonomy, becoming less dependent on their position in the organization.     

Dementia,disability rights and disablism: understanding the social position of people living with dementia

This article considers the recent history and consequences of positioning people living with dementia in the realms of disability, disablism and disability rights. The geo-political focus is the United Kingdom and neighbouring resource-rich nations in the Global North. The first section examines the growing trend of identifying ‘dementia’ with ‘disability’, a trend fuelled by the expansion of dementia-related activism and research. The second section focuses on how researchers who have published in Disability & Society and other journals have applied the social model of disability to individuals living with dementia. The third section discusses three conceptual challenges that lie ahead for those who choose to research and theorise the dementia/disability connection. These challenges concern: theorising dementia as disability; understanding intersectionality in dementia contexts; and understanding ‘abuse’ in dementia contexts.     

Positioning,participation, and possibility: using post-structural concepts for social change in Asia-Pacific youth HIV prevention

This article addresses one of the areas of global concern for Southern youth: HIV rates amongst young people from key communities. In the Asia-Pacific region 95% of all new infections occur amongst those under 25. Furthermore, in this region the nature of the epidemic is concentrated, chiefly affecting people from certain sub-groups such as those who inject drugs, sell sex, participate in male-to-male sex and people who are transgender. In this article we discuss an innovative peer-led leadership and advocacy program for youth which uses post-structural theoretical frames and concepts in an effort to steer against the dominant medicalised and individualising storylines which tend to inform approaches to HIV prevention. We draw on examples and data collected from the NewGen Asia Leadership training program to illustrate the ways post-structural concepts can be used to inform program design as well as analysis and critique of the impact of change efforts. Rather than the traditional focus on transmission of knowledge, skills, and attitudes in prevention efforts, we aim to show how the concepts of positioning, platform, and possibility may be mobilised in strategies used to address the challenge of HIV prevention amongst key youth populations.     

Constructions of ‘vulnerability’ in comparative perspective: Scottish protection policies and the trouble with ‘adults at risk’

This paper places Scottish adult support and protection (ASP) policy in the context of debates about the nature of ‘vulnerability’ and its usefulness as a defining concept in law and social policy. It examines the construction of ‘adults at risk’ in ASP policy, using a comparison with the construction of children in Scottish child protection policy, on the one hand, and women in Scottish domestic abuse policy, on the other, to illuminate the nature of the vulnerability that ASP considers itself to be addressing. It then problematises this construction, drawing both on the social model of disability and on an ethic of care. It concludes that current ASP policy remains underpinned by unhelpful assumptions about disabled people, older people and people with mental or physical health problems. A more inclusive understanding of vulnerability would be more empowering to these people and others, in policies concerned with mistreatment and abuse.     

Gendered Policies and Practices that Increase Older Men's Risk of Elder Mistreatment

SUMMARY

We aim to detail some of the ways that social policy and gendered practices put older men at risk of elder mistreatment. Research on the abuse and neglect that older adults experience has often focused on the characteristics of the victims and the dynamics within families, emphasizing factors such as the likelihood of an intergenerational cycle of violence, substance abuse and dependency, and older men's financial status as key risks in elder abuse. The effect on men from this type of analysis is that elder mistreatment remains an individual or family problem rather than being viewed as a larger societal concern. This article challenges the individualistic focus by outlining the importance of societal forces affecting older men's risk of mistreatment.     

Gendered policies and practices that increase older men's risk of elder mistreatment

We aim to detail some of the ways that social policy and gendered practices put older men at risk of elder mistreatment. Research on the abuse and neglect that older adults experience has often focused on the characteristics of the victims and the dynamics within families, emphasizing factors such as the likelihood of an intergenerational cycle of violence, substance abuse and dependency, and older men's financial status as key risks in elder abuse. The effect on men from this type of analysis is that elder mistreatment remains an individual or family problem rather than being viewed as a larger societal concern. This article challenges the individualistic focus by outlining the importance of societal forces affecting older men's risk of mistreatment.     

Gendered Rationality? A Genealogical Exploration of the Philosophical and Sociological Conceptions of Rationality,Masculinity and Organization

Although feminist organizational theory frequently refers to the association between rationality and masculinity, this association tends to be stated rather than argued for. This article examines, from a philosophical and sociological perspective, how these two concepts have become genealogically so closely and inseparably intertwined. It proposes that it is the early philosophical and sociological interpretations of reason and rationality that linked masculinity and rationality. To explore the connection between rationality and masculinity that is so fundamental to management and, more broadly, organizational discourse, is the purpose of this article. Commencing with a brief overview of pre‐Cartesian concepts of rationality, the main focus of the article is on modern conceptions of rationality, starting with the philosophy of Descartes. It examines the influence of the ideas of Francis Bacon, Enlightenment interpretations of rationality and the influence of Weberian rationality and subsequent interpretations of this concept of rationality by early organizational theorists. Finally, it demonstrates, via a case study of strategic management, how contemporary organizational discourse continues to reflect many of the assumptions about masculinity and rationality that are deeply embedded in more traditional organizational discourse. The article concludes with a number of suggestions for a way forward for critical gender studies that moves beyond the standard feminist critique of organizational discourse and practice.     

Mistreatment of Older People in the United Kingdom: Findings from the First National Prevalence Study

There have been few national studies of the prevalence of elder mistreatment (abuse and neglect) in private households. This article provides an overview of the UK National Prevalence Study of Elder Mistreatment that took place in 2006. It addressed 2,111 respondents in four countries who answered a face-to-face survey questionnaire. The achieved sample was weighted to be representative of the UK older population. Of respondents, 2.6% reported mistreatment by family members, close friends, or care workers. The predominant type of reported mistreatment was neglect (1.1%) followed by financial abuse (0.6%), with 0.4% of respondents reporting psychological abuse, 0.4% physical abuse, and 0.2% sexual abuse. Women were significantly more likely to have experienced mistreatment than men, but there were gender differences according to type of abuse and perpetrator characteristics. Divergent patterns were found for neglect, financial, and interpersonal abuse. Further analysis of the data indicated that the likelihood of mistreatment varied with socioeconomic position and health status.     

Exploring the Gaps between Meanings and Practices of Gender Equity in a Sport Organization

This article analyses the explanations organizational members used to make sense of the meanings and practices of gender equity. Studying gender equity as an organizational value provided a way of understanding how gender inequity is perpetuated and embedded in the culture of an organization. This study was informed by post‐structuralist feminist theory as it provided a lens for understanding and critiquing the local meanings and production of gendered knowledge, and encouraged discussion of transforming meanings and practices. This study was situated in a Canadian university athletic department in which gender equity was an espoused organizational value, but gender inequities were evident. Data were collected from in‐depth interviews with administrators, coaches and athletes, observations of practices and competitions, and the analysis of relevant documents. These data were coded and categorized using Atlas.ti. Respondents' explanations for the gap between what was espoused and what was enacted centred on two dominant, but contradictory, themes: a denial of gender inequities and a rationalization of gender inequities. These themes suggested respondents often understood inequities as expected, natural, or normal.     

Reframing the whistleblower in research: Truth‐tellers as whistleblowers in changing cultural contexts

Whistleblowing is fraught with conceptual dilemmas, including those who may be considered whistleblowers and fundamental concepts associated with the term. Whistleblowing is a dynamic concept, set within and deeply related to culture, yet scholarship has focused primarily on whistleblowing and its ramifications within management and organizational settings, as opposed to engaging with the wrong‐doing disclosed and conceptualizing how we assign meaning to whistleblowers/ing in changing landscapes of societal values and cultural institutions. To grasp the cultural sociological understanding of what constitutes whistleblowing, these themes and how they are shaped need to be drawn out in scholarship. Thus, the purpose of this review is to determine through which disciplines, lenses and discourse whistleblowing has been developed in academia and to identify gaps in disciplines and methods, highlighting how these affect our broader understanding of whistleblowing. This review article offers preliminary insight into how people engage in meaning‐making connected with terms such as whistleblowing, abuse and corruption through the lens of the #MeToo movement. The article encourages further research in disciplines such as sociology, political theory, human rights, socio‐legal studies and particularly, within cultural sociology.     

Beyond words: Older people with dementia using and interpreting nonverbal behaviour

This article addresses a gap in research on nonverbal communication and dementia. It presents findings from a study that explored ways in which older people with dementia used and interpreted nonverbal behaviour within the context of social interactions. Two researchers, using an ethnographic approach, jointly observed nonverbal communicative behaviours occurring in a day-care centre. The findings show that older people with dementia used nonverbal behaviour in meaningful ways for others to interpret, and as a way of self-communication; and that they actively interpreted others' nonverbal behaviour. In specific situations, these people acted in the context of shared meanings, possessed a ‘self’, and took on the ‘role’ of others. This approach has implications for understanding the social experience of dementia and for the ways that care is organised. The role of nonverbal behaviour offers potential for carers to preserve older people's self-identity and improve their quality of life and care.     

The Case of Mitchell's Cube: Interactive and Reflexive Positioning During Collaborative Learning in Mathematics

Using positioning theory as a guiding framework, this qualitative research examined the experiences of students who appeared to be marginalized from collaborative learning in mathematics in a middle school setting. Positioning theory describes the discursive process whereby people are located in conversations as observably and subjectively coherent participants in jointly produced story lines. Interactive positioning describes when one or more persons position another individual. Reflexive positioning describes the positioning of oneself. In this research, I examined instances of (mis)alignment between interactive and reflexive positioning during collaborative learning. Factors potentially contributing to (mis)alignment are considered as well as implications for students, learning, and instruction.     

Elder mistreatment in underserved populations: Opportunities and challenges to developing a contemporary program of research

ABSTRACT

This article provides an overview of the status of research on elder mistreatment among underserved populations in the United States, including gaps in our current knowledge base and scientific and structural barriers to growing research on the exploitation, neglect, and abuse of older people from diverse and disadvantaged ethnic/racial, geographic, sexual identity, and socioeconomic groups. High-priority areas in need of new elder mistreatment research with underserved populations are identified, and suggestions are given for how this research can be facilitated by researchers, university institutional review boards, and funding agencies.     

A critical perspective on organizational values

This article looks critically at the results of one nonprofit volunteer center in its identification of organizational values and associated workplace behaviors. Using Martin's cultural framework (2002) inclusive of integration, differentiation, and fragmentation perspectives revealed a richer understanding of how staff, board members, and in‐service service volunteers variously interpret the meanings of workplace values. In particular, views that might otherwise have been ignored or remained silent were more clearly understood.     

Prevention of Elder Mistreatment in Nursing Homes: Competencies for Direct-Care Staff

Existing training on elder mistreatment in nursing homes focuses on detection and reporting of abuse, with little training specifically targeted toward prevention of mistreatment before it occurs. We used qualitative interviews with nursing home staff, policy makers, and related professionals to identify training needs. Based on participant accounts, we drafted a number of competencies essential for caregiver training to prevent mistreatment in nursing homes. Competencies include those dealing with definitions and policies, risks for mistreatment, communication and respect in relationships with residents, and development of a cooperative work environment. Competencies are discussed along with illustrative examples, and implications for practice and policy are addressed.     

Pathologizing behavior: Meanings of behaviors in dementia care

Deficit and problem-based approaches to behavior stigmatize persons with dementia and cause great unnecessary suffering. In order to reduce the harm caused to persons misunderstood, it is important to understand the process by which staff attach meaning to behaviors and how those meanings ultimately influence how staff respond to behaviors. To this end, this research sought to examine the perceptions and meanings that staff attach to behaviors, how staff experience these behaviors, and the role that meanings and experiences have in staff actions and responses to specific behaviors. This paper focuses on one sensitizing concept that emerged from our study — pathologizing behavior — that reflects how behaviors become pathologized and problematized in the long-term care context. Conducted as part of a larger interpretive grounded theory study, active interviews were conducted with 48 staff members working in a range of positions in long-term care homes in Ontario, Canada. All staff interpreted and placed residents' behaviors in context through a complex process that started with the process of filtering behavior through the lens of pathology, and guided how staff then assigned meaning to the behaviors, how they characterized behaviors as “challenging”, and ultimately reacted through crisis management. The findings demonstrate the impact biomedical discourses have on meanings attached to behaviors and responses to behaviors and point to the need for alternative discourses that emphasize understanding meanings of actions using multidimensional lenses.     

Elder Abuse and Neglect—“Old Phenomenon”: New Directions for Research,Legislation, and Service Developments

This article poses the question: Is elder abuse and neglect a social problem, showing that it is. Elder abuse, though, is still the most hidden form of mistreatment and a key to governmental responses to an ageing population. It is an important facet as a family violence problem, an intergenerational concern, as well as a health, justice and human rights issue. Because the phenomenon of elder abuse and neglect is so complex and multi-dimensional, it has to be addressed by multi-professional and inter-disciplinary approaches. Raising awareness is a fundamental prevention strategy and an important step in causing changes in attitudes and behaviors. This has been accomplished by INPEA and the article was developed from the lecture given by the author on receiving the International Rosalie Wolf Award from INPEA. The discussion focuses on elder abuse as a product of global ageing, stemming from population ageing, which is consistent with an increased prevalence of abuse of all vulnerable groups, older people among them. It is pointed out that baseline and trend data on the nature and prevalence of senior abuse are crucial to policy responses and the development of appropriate programs and services. Difficulties in assessing the scope of the phenomenon, though, are due to: problems in definitions and methodology, which create difficulties in comparing data from various countries; lack of social and familial awareness; isolation of some elders, especially migrants; elder abuse as a ‘hidden issue’ that usually occurs in the privacy of the home and is viewed as a family affair; limited access to institutional settings. Difficulties also exist in constructing a unifying research framework in order to study the phenomenon due to a lack of comparison groups, a lack of representative national surveys and difficulties in measurement. There is currently, however, an increase in prevalence and incidence studies from both sides of the Atlantic and especially from Europe. But while prevalence studies provide base-data on numbers, little is known about key conceptual issues for policy, practice and the understanding of different forms of abuse and neglect. Theoretical under-development hampers the collection of systematic cumulative knowledge which is based on universally agreed upon and standardized tools, and reduces the ability to discover unifying themes and their relationship to local idiosyncrasies existing in the field. Additionally, there has been no attempt to develop theoretical knowledge grounded in data from the study of elder abuse itself. The following vehicles for action are, thus, suggested: Developing international, national and regional research agendas and data bases; developing policy and legislation; developing services and interventions and developing educational programs.     

“The troublesome other and I”: Parallel stories of separated parents in prolonged conflicts

This qualitative study aims to explore how noncohabiting parenting couples in prolonged conflict construct the other parent and themselves. Ten parents from five parent couples were interviewed. A dyadic analytical design was used, where parent's stories of conflict were analyzed in parallel with their co‐parent. Drawing on positioning theory, self‐identity as parents emerged as implicit counter positions in storylines, which construct the co‐parent as “the troublesome other.” Two typologies of conflicted storylines were prominent in the findings: storylines of violations of trust, positioning the co‐parents in relation to traumatic events in the past and, storylines of who is bad, positioning the co‐parent as either a disloyal co‐parent or a dysfunctional parent. The findings indicate that prolonged conflicts made it impossible to find available positions for cooperation. We argue that family therapists should aid each household toward promoting child and family resilience rather than continued efforts to solve chronic conflicts.     

Conflict and Aggression as Stressors in the Work Environment of Nursing Assistants:

Elder abuse and mistreatment occuring in institutional settings is a phenomenon that is as yet poorly understood. In considering the context in which elder abuse and mistreatment may arise, understanding the caregivers' work environment is an important variable. As front line staff, nursing assistants are subject to multiple stressors that underscore the highly interpersonal nature of caregiving. This paper describes the results of a Canadian study that examined conflict, aggression, and burn-out in one group of nursing assistants. Nursing assistant burn-out scores were similar to scores reported for other health-care workers. Subjects reported that conflict with residents most commonly related to the resident wanting to go outside the facility or personal hygiene. An analysis of incident reports indicated that less than 0.3% of the physical and verbal aggression nursing assistants endure from residents is formally acknowledged. On average, a nursing assistant in this health care facility may expect to be physically assaulted by residents 9.3 times per month and verbally assaulted 11.3 times per month. Findings indicate a slight correlation between burn-out and conflict and also between burn-out and reported aggression from residents. A statistically significant relationship was noted between conflicts with residents and resident aggression from residents.