Constructing citizens: a matter of labeling, imaging and underlying rationales in the case of people with dementia

Abstract

A highly significant element in politics and policies is the process of constructing, categorizing and imagingsuch as categorizing citizens as target groups. In governing documents, distinctions are drawn to distinguish deserving and undeserving categories of citizens. This paper explores the construction of citizenship for people with dementia and the connection to underlying categories of rationales, by analyzing how this group has been categorized and imaged in policy documents. The study is based on a qualitative textual analysis of national policy documents in Sweden, covering nearly 40 years. It shows that the way people with dementia have been imaged has differed over time, where people living with dementia have been situated in various target groups and discourses. However, to a large extent, the underlying understanding has nevertheless remained persistent where the position of people with dementia has remained weak. It offers a taxonomy of categories of rationales and shows the interplay of rationales and target groups for certain social constructions. The study offers insights into the policy process related to policy change, and on citizenship as something transformative and interrelated that risks upholding democratic values that delimit disempowered groups, in this case people with dementia, to influence their citizenship.

Qualitative, Quantitative, or Mixed Methods? A Systematic Scoping Review on Methodological Applications in Ageing and Dementia Studies

“…Equally, striking in this review was that a good number of studies depended on relatively small sample size [49][50][51][52][53][54]. Some of them described sample estimation procedure very loosely where the determination of data saturation (e.g.…”

“…Some of them described sample estimation procedure very loosely where the determination of data saturation (e.g. time and reason for ceasing data collection) was unclear [53,54]. In addition, the lack of re exivity, dubious data interpretation, and incomplete transparency of analytic processes made some of the studies di cult to draw a precise conclusion.…”

The patient as a policy problem: Ambiguous perceptions of a critical interface in healthcare

“…A policy problem is not just “there”; it does not follow pure rationality, and it is often constructed before the goals are formulated, by the goals or after a solution has been identified. Both the means and the goals are subject to discussion, where people with social roles—and not abstractions of actors—interact and negotiate ideas and values (Nedlund and Nordh, 2018; Schneider and Ingram, 1997; Stone, 2002) in an attempt to come to shared understandings about how to handle collective concerns appropriately (Colebatch, 2006; Nedlund, 2012).…”

“…Still, the making of policy, as directed toward large groups, is by necessity the simplification of problem-solving. The process for constructing policy problems and categorizing groups of citizens is a prominent element in the political and the policy process (Nedlund and Nordh, 2018; Schneider and Ingram, 2005). In terms of health policy-making, patients—particularly in universal systems, although this is a highly heterogeneous group—must largely be treated as a fairly homogeneous mass with regard to entitlement and services.…”

Reclaiming constructivism: towards an interpretive reading of the ‘Social Construction Framework’

“…Moreover, it should be noted that Schneider and Ingram did not explicitly claim that the SCF is the only way of doing constructivist research, and there certainly is research which refers to their ideas without adhering to a positivist logic of inquiry (cf. Sidney 2001Sidney , 2005Østergaard Møller and Sommer Harrits 2013;Nedlund and Nordh 2018). However, it has also to be beard in mind that categorising is a performative act.…”