Older Adults' Risk Practices From Hospital to Home: A Discourse Analysis.

Abstract

To understand risk-related practices of older adults returning home posthospitalization. Qualitative methods informed by critical discourse theory, designed to uncover linkages between broader social practices and peoples' talk and stories, were used. Eight older adults, screened as high-risk from an inpatient cardiology unit, and six partners were interviewed face-to-face within three weeks of discharge. A discourse analysis of participants' accounts of risk was conducted: the cultural and social understandings or conceptual frameworks used to understand risk were identified. Ableism, a discourse in our society that privileges abledness, was found to permeate the data. Participants underscored that being abled was normal and being disabled was abnormal. Ableism, as a discourse or conceptual framework, compelled participants to appear and act abled, or to perform "compulsory abledness." That, in turn, produced their responses to risk: a pressure to preserve ableist identities created internal and external tensions related to objects and situations of risk and forced participants to use strategies to diminish and minimize risk. Participants created a new response-a position of "liminality" or in-between-where their accounts portrayed them as neither abled nor disabled. This discourse of liminality allowed them to reconcile tensions associated with risk. Critical discourse analysis sheds new light on older adults' risk practices. This approach challenges accepted ways of acting and thinking about what constitutes risk and produces possibilities for alternate ways of representing the same reality.