The effect of carers’ healthcare practices on the categorization of elderly patients as vulnerable

Abstract

Purpose The purpose of this paper is to show that the categorization of elderly patients as vulnerable is affected by health-care service interactions with caregivers, which may increase, reduce or even negate entirely elderly patients’ vulnerable status. Design/methodology/approach The paper reports the results of a qualitative study based on in-depth interviews conducted with a large and varied sample of health-care personnel in charge of elderly patients in two hospital geriatric departments in France. Findings Findings show that the limits of the service-dominant logic approach when the service (care) relationship concerns vulnerable individuals who are, completely or partially, unable to take part in the co-creation of the service and the roles played by caregivers as resource integrators (intermediaries, facilitatorapomediaries and transformativeapomediaries) and that this affects the categorization of elderly patients as vulnerable. Research limitations/implications The results enrich knowledge about the service relationship with vulnerable people by showing that the categorization of elderly patients as vulnerable is not immutable but stems from the dynamics among actors that may variously “reify it” (contribute to its internalization), “reduce it” (enable access to aspects of normal life), or “neutralize it” (help free this cohort from their categorization as vulnerable). Practical implications The findings provide insights for care providers by stressing the need to raise awareness among hospital staff regarding their active role in affecting the categorization of elderly patients as vulnerable through their care practices. In the context of public health policies, the findings show that the regulatory injunction to empower patients to preserve their well-being tends to produce the opposite effect on the frailest patients, who are unable to participate in their care pathway. Originality/value The research shows that categorization as vulnerable, in the health-care services context, is affected by the care interactions between caregivers and elderly patients. The support provided to hospital staff in this context helps to maintain patients’ well-being and dignity.

Well-being co-creation in service ecosystems: a systematic literature review

“…At the meso level, we differentiate between organizational actors (Patrício et al , 2018b) (e.g. the focal service organization, other service organizations nongovernmental agencies and other stakeholders) and social actors, such as social and online communities (Amine et al , 2021; McColl-Kennedy et al , 2017; Parkinson et al , 2017), as well as transformative service mediators (Johns and Davey, 2019). Studies offering evidence on the importance of social actors for well-being co-creation include Taiminen et al (2020), who demonstrate the influence of social support on customers’ well-being outcomes and transformative value potential.…”

Editorial: Stop saying “vulnerable consumers/customers”!

“…Depending on the context, such situations may lead to various types of harm, including psychological, social, emotional, physical, economic and/or material harm. Stagnates the problem: assumes the person’s situation will not change, which implies that the person is constantly vulnerable, at all times, to all things. Classifying and treating customers as “vulnerable” reinforces a deficit bias that changes how the organisation interacts with the individual, potentially resulting in misinterpretation of needs and wants and ineffective solutions (Amine et al , 2021; Snipstad, 2022). Hence, labelling the individual as “vulnerable” may retain the status quo biases of organisations, stagnating problems and reinforcing negative self-perceptions and disempowerment (Baddeley, 2015), potentially causing social, emotional, economic, physical, financial or material harm. Assigns misdirected “blame”: this assumes that the situation people find themselves in is deliberate, or by their planned design, whereas for many, the circumstances they are in are not of their own making, or not solely of their own making.…”

“…Stagnates the problem: assumes the person’s situation will not change, which implies that the person is constantly vulnerable, at all times, to all things. Classifying and treating customers as “vulnerable” reinforces a deficit bias that changes how the organisation interacts with the individual, potentially resulting in misinterpretation of needs and wants and ineffective solutions (Amine et al , 2021; Snipstad, 2022). Hence, labelling the individual as “vulnerable” may retain the status quo biases of organisations, stagnating problems and reinforcing negative self-perceptions and disempowerment (Baddeley, 2015), potentially causing social, emotional, economic, physical, financial or material harm.…”

Stepping up, stepping out: the elderly customer long-term health-care experience

“…When older people reach a point in their lives at which they have limited ability to care for themselves and/or maintain quality of life through economic transactions (Hill and Sharma, 2020; Ho and Shirahada, 2020; Kang and Ridgway, 1996), they become underprivileged in the service ecosystem (Smith and Cooper-Martin, 1997). Not all elderly people are vulnerable; they become categorized as vulnerable only when they suffer a decline in their functional and social ability (Amine et al , 2021; Hill and Sharma, 2020; Ho and Shirahada, 2020; Kang and Ridgway, 1996). For the sake of reducing perceived vulnerability, those vulnerable elderly are likely to receive long-term care services (Lehnert et al , 2019).…”