Strategies for Independence : Individual, Society and Welfare among Seniors Living Alone and Home-care Services in Finland

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  • 自立のストラテジー : フィンランドの独居高齢者と在宅介護システムにみる個人・社会・福祉
  • ジリツ ノ ストラテジー フィンランド ノ ドッキョ コウレイシャ ト ザイタク カイゴ システム ニ ミル コジン シャカイ フクシ

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Abstract

<p>The dichotomy between the Western and the non-Western has been a basic presupposition for anthropological discussions of the idea of "personhood." Anthropologists tend to find another kind of personhood within so-called "savage" societies. Those kinds of personhood have been grasped as relativizing and criticizing the modern Western notion of personhood, "the modern individual." However, the concept of "the modern individual" itself has been accepted rather uncritically. Anthropological works, especially those in the fields of the anthropology of welfare or the medical anthropology, have shared that vision. They try to criticize "the modern individual" in two ways. The first looks for a social or relational personhood instead of the modern one, while the second pursues a more universal and "unsocial" self. However, those ways of criticizing are not successful at all, because the dichotomy between the Western and the non-Western is only strengthened by that logic. The cause of that failure derives from confusion about the idea of independence. Independence, which is the background idea to the "modern individual," has drastically changed throughout Western history in accordance with the contrary concept, dependence. Nowadays, it contains the physical, economic, and self-determining kinds of independence, which are interwoven with each other. Therefore, it is meaningful to show how different kinds of independence shape the total personhood. In this paper, I discuss the independence of elderly people in Finland who live alone and are supported by home help services. The data shown in this paper were obtained from fieldwork I did in a small municipality called "Archipelago Town." In the Nordic welfare states, de-institutionalization has been the mainstream policy since the 1980s. Elderly and handicapped people are to get assistance at home, and that assistance is to be provided by local authorities. In that way, municipalities have become obliged to provide welfare services. Nowadays, they have established local welfare systems with a central focus on the services to assist elderly people living alone at home, especially the home help services. In Archipelago Town, the lives of elderly people living alone are supported by a broad range of services extended by the home helpers. Not only do home helpers carry out domestic work and primary care, but also try to entertain and communicate with the elderly people. However, they do not interfere in some of the choices made by the elderly people. For example, some of the elderly can leave their rooms in a dirty condition. But too much drinking or smoking must be controlled by the home helpers. That choice-intervention in some cases, and non-intervention in others-depends on the dangerousness of the act. The physical risks to the elderly thus legitimize the intervention by home helpers. Those risks are noticed by the home helpers in the course of their daily proceedings. Especially, they pay attention to wandering outside and falling. Though those two risks are regarded very serious and are to be carefully avoided, elderly people frequently wander out of their home, and the "Anshin Denwa (hot line)" for use when elderly people fall down is frequently used. Why such risks often end up becoming a reality stems from the logic of self-determination. Until an elderly person reaches the stage where he/she loses his/her judgment and causes injuries to himself/herself, home helpers are not to interfere in his/her self-determination. Such interference sometimes leads to the decision that the elderly person can no longer stay at home alone. After incidents of wandering out or falling, the municipality in charge might decide to move the elderly person in question into an institution such as a nursing home. Therefore, it is possible to regard that such risks</p><p>(View PDF for the rest of the abstract.)</p>

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