Some Communicational Aspects of Patient Placement and Careers in Two Nursing Homes

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Doctor of Philosophy (PhD)
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Sigman, Stuart Jay

The dissertation is concerned with selected communicational aspects of nursing home patients' intra-institutional careers (life courses). The specific investigatory focus is "social recruitment," i.e., that system of multichannel interaction by which individuals are moved into filling the statuses or positions which comprise a given social structure. The dissertation proposes that nursing homes, in order to ensure their continuity, must organize to meet the recruitment demands occasioned by residents' deaths, discharges, or transfers to different institutional positions. Two skilled care facilities were selected as sites for this study which employs ethnographic methods. It was hypothesized that the two nursing homes (one church-affiliated, the other non-sectarian) would exhibit different patterned processes for the selection of individuals for entry into each facility, and for the assignment of these residents to existing social positions. It was further hypothesized that different behavioral expectations would be placed on residents with different assignments and in anticipation of or preparation for positional reassignments. Interview and observational data were collected during a nine month period. The comparative data indicate a number of similarities and a number of differences with regard to how each nursing home patterns its particular recruitment processes. At both nursing homes, recruitment was seen to consist of rules for admitting applicants to each facility, procedures for assigning individuals to the available residential positions and training them for "appropriate" behavioral performances, and routines for monitoring all participants and for deciding status continuations, transitions, and expulsions. However, the data also indicate that one nursing home's recruitment system was related to the existence of distinctly defined and evaluated wards, while the second facility avoided most attempts at segregating the various categories of patients. The dissertation relates these differences to the respective ideology and "mission" of each institution.

Birdwhistell, Ray L
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