Reflections on Power

When you get up in the morning, generally, you exercise control over what time that is. Obviously there are factors that influence that decision, the time you start work, the time you need to get the kids up and ready for school or perhaps you might find yourself changing your routine for a special event. Whatever the constraints you still make the decision because you know how much time you need in the morning to get ready etc. Some people like plenty of time, others seem to be able to get up and get out within minutes.

Think about your lunch today, again there are probably constraints on time depending on your personal schedule but the choice of what to if, if anything, is yours.

Now fast forward to this evening and what you will be eating, you may have already planned your evening meal, perhaps you will make up your mind at the last minute or perhaps you will abandon your plans to have that takeaway you’ve really developed a craving for. The power to choose is yours, as is the power to make the decision about what time you go to bed.

What would it feel like to have that power removed?

Most of us can probably recall times in our youth when we rebelled, to a greater or lesser degree, against the constraints put upon us by our parents about what time we had to come home or go to bed but imagine having the power to make decisions about your own life be taken away from you as you age, imagine the frustration you would feel.

Yet this is the situation we put many elderly people in as their own personal circumstances dictate the need for social care services. The personal power that we all take for granted is swept away and taken up by the bureaucratic process that then takes over the life of the individual.

Whether we like it or not we take away personal power the moment someone enters the care system.

Even where we use the terms empowerment and co-production the reality is personal power has been taken away.

To empower someone simply means to allow them a certain degree of power, in order to empower someone you must hold power over them in the first place in order to release that power to them, and, ultimately you still hold that power and have the power to withdraw that empowerment at any time.

Similarly, co-production, by its very name, indicates that we are allowing someone to share power about their daily lives, as with empowerment the real power lies with those who allow co-production and who, if they wish, also have the power to withdraw that sharing.

Naturally things are not quite so black and white in the real world, exercising personal power may well be dependent on personal capacity and other factors but the bottom line is personal power is removed and only partially given back within the framework of the local authority or care provider. The time many get up or go to bed is dependent on the availability of staff to assist them, what many eat is not dictated by the own personal choice but only a choice of limited availability.

We often take our own personal power for granted, for example when you do your weekly shopping you are able to make spur of the moment choices depending on your own whims, imagine the limitations on your personal power when others have to shop for you or your meals are dictated by the care home you are in.

Power in our lives is important and we need to remember how the loss of power feels to those who are vulnerable and remember that the loss of power may impact on an individual’s mental well-being and general health. Those who need social care services should be empowering us to assist them in their lives rather than social care professionals dictating lives and the amount of power a person can retain.

It is a complex area but it is important that we reflect on individual power to ensure we can, at the very least, assist people in retaining their own power rather than creating a situation where we patronisingly hand a limited amount of power back to them.

Social Identity and Social Care

Do you prefer to shop in Asda, Morrisons, Sainburys, or Tesco (or any other supermarket). Chances are that you prefer one over the rest even if shop around. It is all to do with social identity and supermarkets often market their image to appeal to a particular social identity. The same is true of newspapers, cars and even political parties.

The issue of our identity becomes more complicated because we combine these various elements to form our identity and differences with others. Two people could both be Guardian reading, Asda shoppers and would have that in common but equally one may be a Labour supporter and one may be a LibDem, so both would consider themselves to be different to the other.

There is a link between social identity and self-esteem, if we can find ‘our place’ in the world we can be considerably more content in our overall well-being.  There are of course, extremes as can be seen in the crowd mentality of football team supporters but social identity seems to be an integral part of being human.

We are all different, we define ourselves as much by who we are not as by who we are and often our social identity defines the choices we make about our lives. Because of that the ‘market’ panders to our wishes in terms of supplying goods and services that we can identify with.

With a serious exception – Social Care

The provision of social care is a market economy nowadays with around 80% of all care provision being supplied by private organisations (Companies & Charities). Now this change has been relatively rapid and the ‘market’ may not have fully established itself but there does need to be a consideration of this if we are to provide services that truly support individuals.

This has to be a key element to the personalisation agenda.

Let’s be brutally honest – you will have chosen to avoid certain people and certain places and you will have made choices that you feel are ‘more’ you.

Are the same sorts of choices available in social care provision? And to what extant do assessments of those who may need social care services look beyond the physical needs of the individual to the needs of sustaining their social identity.

Helping to maintain a person’s social identity is important for mental well-being. Imagine if you were left with no choice in any service you needed, how frustrating it would be to be placed in the company of others that you had little in common with or your day was dictated by what others considered good.

In our everyday lives we choose who we wish to spend time with and generally we choose people who share the same ideas, enthusiasms and outlook on life. Obviously there are times when we have to ‘put up’ with people at work etc. but we will always chose to spend our more intimate moments with friends. So what does it feel like to a person who has to have personal intimate care from somebody they have had no choice in selecting?

Our social identity is the core of who we are and it seems wrong that just because age means we may need support and care from others that this social identity is taken away by lack of choice in social care services.