From the "rising tide" to solidarity: disrupting dominant crisis discourses in dementia social policy in neoliberal times




MacLeod, Suzanne

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As a social worker practising in long-term residential care for people living with dementia, I am alarmed by discourses in the media and health policy that construct persons living with dementia and their health care needs as a threatening “rising tide” or crisis. I am particularly concerned about the material effects such dominant discourses, and the values they uphold, might have on the collective provision of care and support for our elderly citizens in the present neoliberal economic and political context of health care. To better understand how dominant discourses about dementia work at this time when Canada’s population is aging and the number of persons living with dementia is anticipated to increase, I have rooted my thesis in poststructural methodology. My research method is a discourse analysis, which draws on Foucault’s archaeological and genealogical concepts, to examine two contemporary health policy documents related to dementia care – one national and one provincial. I also incorporate some poetic representation – or found poetry – to write up my findings. While deconstructing and disrupting taken for granted dominant crisis discourses on dementia in health policy, my research also makes space for alternative constructions to support discursive and health policy possibilities in solidarity with persons living with dementia so that they may thrive.



social determinants of health, social exclusion, crisis discourse, Alzheimer's, Alzheimer Society of Canada, Suzanne MacLeod, Susan Strega, Donna Jeffery, poststructural, poststructuralism, admission to long-term care, funding for long-term care, Improving BC's care for persons with dementia in emergency departments and acute care hospitals Findings and Recommendations, acute care, aging demographic, BC Psychogeriatric Association, biomedical, British Columbia, Canada Health Act, collective social responsibility, competition, corporate profit, corporatization, deresponsibilization, elder friendly, elderly citizens, family caregivers, Foucault, found poetry, genealogy of power knowledge, incompetent, Ministry of Health, moral economics, pharmaceutical, bed blocker, stigmatized, tsunami, absent-person, action plan, aging population, alternative discourse, apocalyptic demography, appropriate, archaeology, archaeology of knowledge, archaeological, British Columbia, burden, Canada, caregiver, charity, charitable, collective, collective car, community, community care, condition of possibility, conditions of possibility, corporate, counter-discourse, dementia, dementia care, dementia policy, dementia social policy, dependent, depoliticize, discourse, discourse analysis, disruptive discourse, economic burden, economics, economy, elder, emergency, epidemic, exclusion, fear-monger, Foucauldian, found poem, genealogy, genealogical, health authority, health care, health care staff, health care system, health policy document, healthy lifestyle, home and community care, homogenization, homogenize, hospital, imaginaries, imaginary, incapable, individual responsibility, individualism, knowledge, long-term care, material effect, materiality of discourse, media, moral panic, national strategy, neoliberal, neoliberalism, neoliberal rationality, not prepared, object, objectification, other, person-centered, people living with dementia, person living with dementia, persons living with dementia, person with dementia, poem, poetic representation, poetry, policy, policies, political, politics, power, power knowledge, power relations, private, privatize, privatization, productivity of dominant discourse, public health care, residential care, resistance, responsibility, responsibilization, rising tide, Rising Tide The impact of Dementia on Canadian Society, safety net, shift costs to caregivers, responsibility, social policy, social policy imaginary, social well-being, social work, social worker, solidarity, specialized, stakeholder, state, stigma, subject matter expert, taxpayer, threat, unprepared, unproductive, voluntary, volunteer, wait time, wave