Context and contextual factors

When discussing the health and experiences of older people and the issues of equity that arise from complex and dynamic social positions, it is important to recognize the context of the care environment. Where people are located has significant implications for how people interact, what their roles are, what they think they can do and what they think they can’t do. Not only is context important in larger sociocultural ways that shape views about social groups, it is also important in the physical places that people interact, such as hospitals or homes. [add a bit of theory? Book chapter, liaschenko, freier]

Older people are diverse and have unique histories, possibilities and constraints in their lives. Recognizing the role of context becomes crucial to responding to the needs of individuals. Traditional approaches to addressing the health and functional changes that come with aging often view individuals as independent from their social and relational surroundings and are problematic in supporting effective, empowering care strategies.  However, older people’s context represents the interconnected elements that define a person’s circumstances. For example, traditional approaches to addressing health changes would be to follow the doctors’ orders regardless of your preferences… (expand) [examples?]

Context is the environment and conditions that shape individual experiences and perspectives.

It can be further defined as “the physical, organisational, institutional, and legislative structures that enable and constrain, and resource and realize, people and procedures.” (May et al., 2007)

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Context includes the care context where older people interact with health care providers and others whose job it is to enable the working of the hospital. Context acts as a lens through which individuals perceive and engage with their surroundings, shaping their understanding of aging and influencing their aspirations, expectations, and behaviors. This understanding allows us to move beyond outdated narratives of aging as decline and withdrawal, toward an emancipatory approach that values the agency and uniqueness of older adults.

In this module we explore the hospital setting as an example of the how context shapes the experiences of older people. This material is meant to support learners to question their roles and the expectations for different people in the hospital setting so that they see other possibilities and ways to support change. It is situated in the literature on context, structural competency and place. While individuals are shaped by their context, they also possess the capacity to challenge and transform these dispositions through acts of reflexivity and resistance (Bourdieu, 1977).  [add parts about structural competency here?] Hulko, view a person holistically.