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3.10 Working with difference

If ‘racial’ or ethnic differences are produced as part of a process that ‘racialises’ certain groups as ‘other’, how should services respond to the issue of difference? What practical steps can service providers take to ensure all members of the population, whatever their assumed ethnicity, have equal access to services and can participate fully?

Lena Robinson is a psychologist and social work educator who has written extensively on issues of cross-cultural communication for
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Acknowledgements

The content acknowledged below is Proprietary (see terms and conditions) and is used under licence (not subject to Creative Commons licence).

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Illustrations

Figure 1 (top right, middle left and bottom left): www.britainview.com; (top left): John Birdsall Photography; (bottom right): BBC, BBC London Live and BBC London Live Chatroom word marks and logos are trade ma
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Introduction

The unit you are about to study is exciting and stimulating. Working with adults in the community is changing at a pace that can sometimes feel bewildering. Practitioners are being asked to review what they are doing in a critical way and to adopt new approaches. For example, the word ‘community’ is one that we all use quite readily and is at the heart of many social work policies. However, we tend to take it for granted that everyone means the same thing when they talk about a com
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2.2.2 Treatment regimes

As well as asylums which housed people with mental illness and learning difficulties there was a turn towards a style of mass provision generally.

Development of special schools for disabled children began in 1750 when the first private schools for blind and deaf children were opened in Britain. The earliest public institution, run on a charitable basis, the London Asylum for the ‘support and education of the deaf and dumb children of the poor’, was opened in Bermondsey, south Londo
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3: The five giants

At this point let us examine the idea of the ‘five giants’ (Want, Ignorance, Disease, Squalor and Idleness). Beveridge, remember, was not just writing about income protection; he had a vision of social reconstruction and social progress. The five giants represented the key areas of need for all of us – the areas where we should pool resources to tackle our needs collectively (see the box below).

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1.4.13 Defining a ‘good death’

The Good Death?82.8KB PDF document
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1.2.7 Margaret

Margaret was in her thirties when she learnt she had breast cancer. Some three years later, after the removal of the affected breast, she was leading a very busy life working full-time at the Open University, studying part-time for an OU degree and running a family. Fitness activities such as jogging and various sports had become very important in her life. She was also very involved in cancer research fundraising activities. She described the impact of her brush with death in this way:


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Introduction

This unit examines life stories. It looks at the way in which objects, trends, cultures or disabilities may contribute to a person's identity. This unit also considers the contribution that our own life stories make to who we are, and how remembering and revisiting our past may help us to move forward with our lives.

This material is from our archive and is an adapted extract from Understanding Health and Social Care (K100) which is no longer taught by The Open University. If you
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3.1 Doctors: the ‘Great-I-Am’

We pin a lot of hopes on doctors. We expect them to know all that is relevant about the classification and treatment of diseases. We expect them to be able to make us better, and to give us an indication of what will happen to us next. There are strong pressures on doctors to respond to this expectation – to be knowledgeable and confident, to set themselves apart from ordinary mortals. Lesley Mackay is a researcher who, in 1989–90, carried out an extensive study involving over a hundred i
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Acknowledgements

Except for third party materials and otherwise stated (see terms and conditions), this content is made available under a Creative Commons Attribution-NonCommercial-ShareAlike 2.0 Licence

Grateful acknowledgement is made to the following sources for permission to reproduce mater
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1.8.1 The experience of Hillsborough

We have explored the challenges of entering into situations which are ambiguous and open to competing interpretations. But what happens in a situation where nobody knows what is going on, where established meanings have collapsed altogether? Tom Heller gives a graphic account of such a situation in his description of his experience of the Hillsborough football stadium disaster.

Click on 'view document' below to read Tom Heller's account of his experiences at Hillsborough.

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1.5.3 The doctor-nurse relationship

In reality, however, the nurse spends much more time with patients and often knows a lot that the doctor does not. Somehow the nurse needs to be able to communicate essential knowledge to the doctor, in the patient’s presence, without appearing to undermine the doctor’s ‘omniscient’ status. According to Leonard Stein’s research in America, they achieve this through playing ‘the doctor–nurse game’.

T
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1.4.3 Structures that both enable and constrain

Life within a society is made possible by structures. They operate at many levels, from the details of daily life (e.g. the routines of getting up in the morning, or the ritual greetings we use when we meet people) to the broader organisation of society (e.g. the channels through which mass media ‘news’ is generated, or the rules under which benefit payments are made). Even the language through which I am communicating now is a structured system of written symbols. But structures not only
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1 Playing roles together

Care relationships are seldom just a matter of ‘doing what come naturally’. For one thing, you may be caring for, or being cared for, by someone you would not otherwise get on with. A care relationship has to adapt to circumstances: it may be brief, as in an acute hospital ward, or it may be very long lasting; it may be flexible according to need or it may involve a high degree of regularity. It is a distinctive relationship with unique elements. Some of the things you and the other perso
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1.3.6 Relocation: acceptance

Of equal importance in terms of adjustment is an acceptance of the new situation and identification with the new life (Lieberman and Tobin, 1983). Reed and Roskell Payton (1995) have shown how ‘adjusting to life in a care home is a complex process, requiring a range of social skills’. They have observed a range of strategies from those people who ‘"push" themselves on strangers’ to those who ‘construct familiarity’ using what little they know about people and places to find common
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1.3.3 Change on a daily basis: shared care for the elderly

In the case of Mr Bright care is shared between his wife and formal carers and changes in the place of care are primarily to give Mrs Bright a break and Mr Bright a change of scene.

Click below to hear an audio clip describing a day in the life of Mr and Mrs Bright.

1.2.4 Places and spaces as resources

Attachment to places can be a resource within care relationships, especially where people have a shared history of attachment to places. An older couple may have experienced the ups and downs of moving between places together for much of their lives. Or a daughter may be caring for her mother in the home where she was born and brought up. A shared understanding of the home environment and the support which may be available locally can be invaluable in developing a care relationship. Such know
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3.3.1 Care: a cautious definition

For study purposes, we do need a definition of care, just as we needed a definition of informal carer. So we propose that in the context of health and social care we define care as:

something that is needed when people cannot function in daily life without the practical help of others.

But, as I have shown, care is a loaded word. It is both a word used by ordinary people to mean love, tende
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1.5.2 Duration and frequency

We do not know if Katrina's caring responsibilities took up more than 20 hours per week. In a sense, though, whether they did or not is immaterial. What is important is that her schooling was adversely affected. We can speculate that, even if caring accounted for less than 20 hours per week, the emotional impact of being a young carer overflowed into a far larger proportion of her life.


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Introduction

Care is needed at all stages of life. This unit makes care in the family its focus because the overwhelming majority of care, including health care, is supplied in families, much of it in private, much of it unnoticed and unremarked upon. The meaning of the term (informal carer) and the word (care) itself are explored.

This material is from our archive and is an adapted extract from Understanding Health and Social Care (K100) which is no longer taught by The Open University. If y
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