Integrating Care for Older People: New Care for Old, a Systems Approach

By Christopher Foote; Christine Stanners | Go to book overview

Chapter 12
Changing Places
The Way Ahead for the Care
of Older People

If an organization is perfectly determined it has no choice but to accept the overriding
institutional norms on the assumption they are immutable: such an organization is
paralysed, has no choice, can make no decisions and the structure, once set, remains in
place
.

Richard Butler, Reader in Organizational
Analysis, University of Bradford

In this chapter we review the concepts of structures and distinguish between their
hard physical and their softer process attributes. The suggestion is that viewing the
systems as processes will free thinking to create innovative ways of doing things. The
chapter looks at hospital-based and community-based processes that relate to health
and social care and suggests some alternative approaches. The ultimate basis for pro-
viding integrated care for older people is the community model, which integrates the
micro-community of the older person, the community of care and community of
practice, all of which lie within the community of living.

Structures and organizations are important to everybody. People think in terms of
structures and organizations. The more mechanistic the thinking, the more likely those structures and organizations are to have a definite, physical form that can be seen and touched. These physical elements (buildings, people, equipment) then assume the role of being the banner for the values and purpose for which they were

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