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Do Assessment Tools Shape Policy Preferences? Analysing Policy Framing Effects on Older Adults’ Conceptualisation of Autonomy

Published online by Cambridge University Press:  25 January 2021

DANIEL DICKSON Open the ORCID record for DANIEL DICKSON [Opens in a new window] ,
PATRIK MARIER Open the ORCID record for PATRIK MARIER [Opens in a new window]  and
ANNE-SOPHIE DUBÉ
DANIEL DICKSON
Affiliation:
Department of Political Science, Concordia University, 1455 Blvd. de Maisonneuve West Montreal, Quebec, CanadaH3G 1M8 email: daniel.dickson@mail.concordia.ca
PATRIK MARIER
Affiliation:
Department of Political Science, Concordia University, 1455 Blvd. de Maisonneuve West Montreal, Quebec, CanadaH3G 1M8 email: daniel.dickson@mail.concordia.ca
ANNE-SOPHIE DUBÉ
Affiliation:
Centre de recherche et d’expertise en gérontologie sociale, 5800 Cavendish Blvd, Côte Saint-Luc, Quebec, CanadaH4W 2T5
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Abstract

The concept of autonomy is essential in the practice and study of gerontology and in long-term care policies. For older adults with expanding care needs, scores from tightly specified assessment instruments, which aim to measure the autonomy of service users, usually determine access to social services. These instruments emphasise functional independence in the performance of activities of daily living. In an effort to broaden the understanding of autonomy into needs assessment practice, the province of Québec (Canada) added social and relational elements into the assessment tool. In the wake of these changes, this article studies the interaction between the use of assessment instruments and the extent to which they alter how older adults define their autonomy as service users. This matters since the conceptualisation of autonomy shapes the formulation of long-term care policy problems, influencing both the demand and supply of services and the types of services that ought to be prioritised by governments. Relying on focus groups, this study shows that the functional autonomy frame dominates problem definitions, while social/relational framings are marginal. This reflects the more authoritative weight of functional autonomy within the assessment tool and contributes to the biomedicalisation of aging.

Keywords

Policy FramingSocial ServicesAging PolicyAutonomyNeeds AssessmentBiomedicalisation of Aging
Type
Article
Information
Journal of Social Policy , Volume 51 , Issue 1 , January 2022 , pp. 114 - 131
Copyright
© The Author(s), 2021. Published by Cambridge University Press

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