Find two journal articles that cover the topic of advocacy in health and social care. Use these articles in conjunction with the module materials to discuss how advocacy can increase the power of service users when engaging with health and social care services.
At some point in people’s lives, they will find themselves in a situation where they may need to participate in decision-making about their care and this essay looks at how advocacy can increase the power of service users when engaging in health and social care services. It will look at Arnstein’s ladder of participation, outline the process and aim of advocacy and its different forms, and have a brief look at power. It will consider Henderson and Pochin’s idea of advocacy and Wong’s framework of power, before considering the story of Ellinor, a woman expecting her first baby. Finally, it will look at two articles which look at advocacy and children’s rights and advocacy and social work support for older people moving to a care home.
There is a great emphasis on service user involvement as a means of levelling out the power imbalances within health and social care, and studies have shown that people who are involved in decisions about their care, experience better health. Active participation goes back to the 1990s when the Community Care Act 1990 transferred greater responsibility to individuals and communities to care for people who would previously be cared for by institutions, (MacKian, 2010, p.5). One popular model of participation is that of Sherry Arnstein cited in Turner, 2010, who created a ladder as a means of understanding the different levels which people might be able to participate in decision making. At the bottom of the ladder is the lower level of involvement being relatively powerless and the top where a substantial involvement results in being relatively powerful, (Turner, 2010, p.26). Within the health and social care system, some service care users are able to play an active part in making decisions that affect their own lives, however, some individuals are marginalised or vulnerable and this is where advocacy can come in to play.
Some Individuals can find it hard to speak up and voice their wishes or they may not be aware of the choices that are available to them. Furthermore, individuals who are normally quite confident can suddenly feel powerless when they find themselves in a new set of circumstances, and the role of advocacy is to support people like this to ‘have a voice’, either by supporting them in speaking for themselves or to speak up on their behalf.
The process of advocacy is to identify a person’s wishes and needs, and representing there views and concerns. It is also concerned with challenging power, particularly power within the health and social care system, (Tilley, 2010, p.47). Advocacy can take different forms, depending on the circumstances. Informal advocacy might be undertaken by friends, family members, campaigning groups and some health and social care practitioners, and formal advocacy which is undertaken by organisations. As suggested by Henderson and Pochin (2001) cited in Tilley, 2010, at the core of advocacy is the quest for justice, they argue that the aim of advocacy is to help people achieve three things, choice, access and justice. In addition, the fact that the aim of advocacies is bound up with these three key things, illustrates advocacy as a process that pushes for change. Furthermore, advocacy is also about relationships, and relationships are linked to negotiations of power. Kwok-Fu Wong’s (2003) cited in Tilley, 2010, framework of power, is useful in understanding the role of advocacy in health and social care. Wong identifies four types of power, power-from-within, power-to, power-with and power-over, which helps to understand what might be happening in advocacy-related situations. Power-from-within develops personal power which comes from self-esteem,...
References: Dr J. Boylan, J. Dalrymple. (2011) ‘Advocacy, Social Justice and Children’s Rights’, in Practice: Social Work in Action, 23:1, 19-30, DOI:10.1080/09503153.2010.536212 (Accessed on 3 January 2014)
J.Manthorpe, S. Martineau. (2010) ‘Deciding to Move to a Care Home: The Shared Territory of Advocacy and Social Work Support’ in Practice: Social Work in Action, 22:4, 217-231, DOL: 10.1080/09503153.2010.494236 (Accessed on 3 February 2014)
MacKian, S. (2010) ‘Understanding power and participation for people who use services’, in, The Open University (2010) ‘Exploring power and participation’, Milton Keynes, The Open University.
Tilley, L. Walmsley, J. Bornat, J. Goodley, D, (2010) ‘Understanding advocacy – justice, choice and access’, in, The Open University (2010) ‘Exploring power and participation’, Milton Keynes, The Open University.
The Open University (2013) ‘Activity 9.6: Elinor’s story’, K217 Learning Guide 9: Power and Participation for people who use services [online]. Available at https://learn2.open.ac.uk/mod/oucontent/view.php?id=349915§ion=2.6 (Accessed 3 February 2014)
Turner, A. MacKian, S. Woodthorpe, K. (2010) ‘Understanding participation, empowerment and citizenship in health and social care’, in, The Open University (2010) ‘Exploring power and participation’, Milton Keynes, The Open University.
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