“Church Is Important to Our Clients”: Autonomy, Community, and Religious Expression within a Long-term Care Organization

Abstract

Autonomy and selfhood are primary concerns for scholars of long-term care. Previous work has shown how organizational routines threaten client autonomy and disrupt access to the material and symbolic resources that ground the biography of the self. In this article, I examine how a group of African-American older adults within an adult day service center ameliorated these threats through religious expression. In most health care settings, religion is delivered as an individual, clinical resource. At this site, religion and recreation became intertwined such that religion became a participatory resource that affirmed client membership to a community beyond the walls of the organization. However, as an institutionally provided resource, religion was delivered through work routines that constrained which versions of community to which clients could belong. I conclude by considering the implications for the expanding universe of long-term care organizations tasked with the maintenance of the body as well as the continuity of the self.