Deborah O'Connor

Professor

Relevant Degree Programs

 

Graduate Student Supervision

Doctoral Student Supervision (Jan 2008 - May 2019)
Settling in or just settling? Exploring older adults' narratives of relocation to assisted living (2018)

Since 2001, British Columbia has seen an expansion in the assisted living (AL) segment of supportive housing for older adults. Values associated with AL typically include independence, choice, self-direction, and autonomy, which position it as an attractive alternative to traditional residential care models or ‘nursing homes.’ Yet, there have been few studies that critically examine AL in the Canadian context. Such investigations are important because of the variation in AL facilities internationally. Also, there is lack of research generally on the significance of the transition to AL for older adults or what their experiences are once they have arrived. The purpose of this study was therefore to explore older adults’ narratives of moving to AL, in order to learn about their relocation experiences and how they fit with the overarching goals and values of AL. To do this, the study employed thematic content analysis of 18 provincially-focused, publicly available documents about AL. Collectively, the documents addressed both service users and providers and spoke to expectations and regulations for service delivery. The study also employed multi-level narrative analysis of four older adults' relocation stories, gathered over the period of a year. Findings from the study indicate that there are tensions between the foundational values and purposes of AL, how these are operationalized at the facility level, and how they are experienced by those moving in. While participants were generally pleased with the supportive and health care services they accessed by relocating, their accounts also highlighted a lack of social connection within AL and restrictions to choice in a variety of areas including dining and recreational pursuits. However, the findings also illuminate positive and innovative practices that can ease the transition to AL. Recommendations include: 1) finding avenues for residents to express their choices in meaningful ways, such as increasing resident input at an organizational level and expanding the type of activities offered; and 2) offering more deliberate facilitation of social and place connections in AL through an increased role for social workers in AL, peer support programs, and stronger community ties.

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Challenges of person-centred dementia care : a critical ethnography of culture change in long-term care (2013)

To address shortcomings in traditional long-term residential care (LTRC), facilities are increasingly adopting person-centred care (PCC) approaches. Despite the proliferation of PCC models and discourses, there is limited understanding in gerontology of how such approaches are experienced on the ground. This dissertation addresses this gap through an ethnographic study of Cedar Grove, a large facility located in an urban centre in Western Canada that is undergoing culture change. During 12 months of fieldwork, I explored the range of issues this organization encountered as it endeavours to maintain the “person” at the centre of care. The purpose of this study is to contribute empirical data on how this orientation shapes daily life for residents, families, staff and administrators.This study is informed by the literatures of PCC and personhood theory, and it draws on a conceptual framework integrating critical, feminist and Foucauldian gerontology. It analyzes care across personal, interpersonal, and organizational levels, and considers the broader social-political-economic context of LTRC. Data generation employs multiple methods: participant observation, Dementia Care Mapping (DCM), group meetings, individual interviews, researcher-produced photographs, and a review of relevant organizational and policy documents. Findings reveal organizational tensions between ideals of safety and PCC, multifaceted challenges to relational care, and the importance of everyday activity toward social inclusion. Data suggest five key implications: 1) Intersectionality highlights residents’ disparate access to social inclusion and ways to support more heterogeneous populations, 2) Increased access to unstructured, everyday activity might address boredom and foster meaning in residents’ lives, 3) Job descriptions might better prioritize social care and flexibility in work roles to better address issues of time constraints, workload, and resident acuity, all of which challenge PCC, 4) Organizational support for narrative-based biography is vital to overcoming systemic barriers to its use in practice. Finally, 5) A methodological implication of this study relates to how DCM facilitated insight into residents’ non-verbal expressions of personhood and bodily, affective communications. The mobilization of this research to practice during fieldwork highlights DCM’s ability to convey positive practice skills in a way that supports uptake, positively impacting residents’ quality of life.

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Exploring dementia care in Chinese immigrant families in Greater Vancouver, British Columbia, Canada (2012)

Three aspects of dementia caring in the everyday life of Chinese immigrant families are not well understood: First, the notion of Chinese family or filial norm, in particular the key component of love and affection largely missing from the literature; second, the pathways between cultural beliefs and the actual caring practices of partners in care; and third, the Chinese person with dementia and the relationship with her or his carer, and their relationship within larger care contexts and structures. Borrowing notions from Buber, Bourdieu and Liang, the purpose of the study was to explore these gaps and uncover the connections between culture, emotions, and practice in Chinese families. Using the case study method and guided by principles of hermeneutical interpretation, four families comprising two or more family members and/or a service provider participated in in-depth interviews and observation sessions. Data were analyzed using ATLAS.ti to develop a holistic picture of each case situated in the particular and complex person-circumstance-time contexts of each family. Whereas the ‘story’ of each case, in its rich in-depth and contextualized details, was different and unique, cross-case analysis showed several themes that cut across all cases. First, routine caring practices are a culturally adaptive device as the routine practices embody the history, preferences and emotional investment of individuals. Second, the families draw on the cultural value of a Chinese relational self as reference for understanding family or filial obligation. Within the obligation are two aspects of responsibility and affection that co-exist and co-constitute each other. Third, in practice, participants draw on different cultures from their family, social, religious, and other life experiences in fluid and non-thinking ways that often introduce contradictions and tension between their thoughts and their actions. These non-thinking ways in between cultural spaces and dualities suggest alternative ways of knowing and being, such as emotional rationality or intelligence. Study findings on dementia care practices of Chinese immigrant families have important research and practice implications.

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The cultural whisper in our ear : intercultural dementia care in a Jewish long-term care facility (2012)

Long-term care facilities are becoming more representative of the diverse ethno-cultural demographics of Canadian society in the make-up of residents, family and staff that live and work there. Therefore, it is entirely likely that care given and received in these facilities will be intercultural in nature. That is, the people caring for them may be from different ethno-cultural, racial and religious backgrounds than the people they are caring for. The impacts of this phenomenon on care provision within elder care settings, such as long-term care have not been adequately explored in the research literature, especially in a Canadian context. The purpose of this qualitative, ethnographic research study was to explore the impact of these intercultural dynamics on care for people with advanced dementia. This study took place over 9 months on a care unit based in a Jewish long-term care facility. The choice of an ethno-culturally specific facility allowed for an exploration of the culture concept in a setting in which culture and cultural identity are deeply embedded within daily life. Field work included approximately 210 hours of participant observation, 21 interviews with a diverse mix of staff and family members, 20 Dementia Care Mapping sessions with residents, and document analysis including resident care charts, and facility-based and systemic policies and procedures. The findings from this study illustrate the ways in which individuals and groups utilize the culture concept in a myriad of strategic and resourceful ways. They include: helping to secure scarce resources; to make sense of the differences that exist within the health care interactions and dementia care; to help position and locate oneself within the context of an overtly ethno-cultural and medical setting; and to challenge more dominant Western, medical paradigms about dementia, personhood and care that are specific to the end of the dementia process. Dementia care acted as a discursive space through which intercultural dynamics and negotiations were played out that represent and reflect the world outside of the facility. While this study was specific to a Jewish facility, the intercultural dynamic is applicable to a myriad of elder care settings which have different cultural configurations, inferring that the findings could be of benefit to recognizing and further exploring this topic.

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(Re)visioning whole-person are: an interpretation of the health care experiences of culturally diverse personis living with a life-limiting ilness (2011)

No abstract available.

Master's Student Supervision (2010 - 2018)
"Normal or...?" narratives of youth seeking online support (2017)

As technology continues to advance, there has been an increase in youth using online forums to seek help and access emotional, relational, and mental health support; yet, very little is known about how youth are using these forums and what online intervention tools have to offer youth. Therefore, the purpose of my research is to explore what online narratives (disclosures and responses posted on support site blogs) have to teach social workers and others about the lived experiences of youth accessing online supports, including their online interactions with peers and professionals. To meet this purpose I applied a narrative ethnographic methodological approach analyzing 18 peer-to-peer disclosures and responses and 14 youth disclosures with professional responses from two online support sites: Teenline Online (teenlineonline.org) and Kids Help Phone (kidshelpphone.ca). Three primary themes were revealed. The first two themes 'Identity Formation' and 'Access to Power and Autonomy' underscores the ways in which youth used these forums to narrate their unique stories. The third theme, 'Unique Contributions of Online Support' illustrates that while there were similarities in which support was offered between the two sites, there were also some notable differences in how peers offered support compared to professionals. These findings have important implications for social workers as it demonstrates the possible motivations behind youth seeking online support, the experiences of youth using online supports and what these forums may offer youth seeking relational and/or mental health support. Further, findings have important implications for the development of online interventions, including the urgent need for professional development and training in this area.

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Forging new alliances : exploring the social work – police constable partnership within the Abuse Against Older Adults unit (2011)

Elder abuse interventions need a multidisciplinary approach to address the complex dynamics of the abusive situation. The introduction of the Abuse Against Older Adults (AAOA) unit provides a unique opportunity to address the psychosocial, criminal and legal dimensions related to elder abuse. This thesis focuses on the evaluation of the AAOA unit in its first year of operation in Vancouver, B.C. A qualitative research study was conducted, utilizing focus groups to gather data. The findings show that a police-social worker partnership model is critical in meeting service gaps in this area of practice. The data also explored the interaction between the AAOA unit and the external health care agencies that refer cases to this team. The results encourage future research to continue studying collaboration across multidisciplinary service providers, and further study on the social work role in law enforcement culture.

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Narrative case study : unheard life story of a senior gay Korean man (2011)

Research exploring the experiences of senior gay Asian men who grew up in Asian culture has not been conducted yet even though they are supposed to have unique needs and challenges different from those in Western culture. The present study examines how one older gay Korean man constructed his life through Korea’s historical events and rapid social and cultural changes. In order to understand the unheard life story, in-depth interviews with one senior gay Korean man living in Seoul, South Korea were conducted and the narrative was interpreted and analyzed by a holistic-content approach. The findings of this study reflect on the man’s unique way, acquired through his life experiences, of balancing a homosexual life and a heterosexual life, especially between his personal desire and family responsibility. In the two disparate worlds, the gentleman pursued true love and adapted himself to changing of patriarchal values as well as aging instead of insisting on the time-honoured cultural heritage. The senior man faced challenges and changes in his later life with a positive attitude and wisdom he acquired through experiences in his early life. The findings derived from this study reinforce the social constructionist perspective that sexual identity is fluid, and prove that the notion of binary opposition from the white model is not well applicable to the notion of fluidity of sexuality in Asian culture. The understanding from this study suggests developing online services guaranteeing confidentiality for senior gay Korean men and approaching the minority group’s challenges on family level rather than individual level. These suggestions can be applied to senior gay men who grew up under Confucianism and patriarchism.

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