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Saying no to the staff: an analysis of refusals in a care home for people with severe communication difficulties.

By W. M. L. Finlay, Charles Antaki and Chris Walton


People with severe communication difficulties may attempt to exercise control over their lives by verbally or non-verbally refusing an activity proposed by supporters. We detail examples in which such refusals are treated by care home staff as a temporary reluctance, warranting further attempts to persuade the individual to co-operate. We identify the following conversational (and bodily) practices by which staff achieve their institutional ends: appreciating a resident's behaviour as something other than refusal; formulating the invitation again in a no-blame format; minimising the task required; escalating the invitation to a request and an order; moving the person bodily; and positively glossing the proceedings. Dealing with refusals illustrates the dilemma faced by institutional personnel in health and care settings in accepting choices which might disrupt the efficient management of the service

Year: 2008
OAI identifier:
Provided by: Lancaster E-Prints

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  11. (1997). Longitudinal study of deinstitutionalization and the exercise of choice. Mental Retardation, 35, 159-169 Saying no to staff…. 25 doi
  12. (1994). NB authors' references are not included in this submission
  13. (1987). Opportunities to express preferences and make choices among students with severe disabilities in classroom settings.
  14. (1988). Preliminary notes on a possible metric which provides for a 'standard maximum' silence of approximately one second in conversation. In
  15. (1992). Repair after next turn: the last structurally provided defense of intersubjectivity in conversation. doi
  16. (1989). Speech to and from a severely retarded young Down's syndrome child. In
  17. (1967). Studies in Ethnomethodology. Englewood Cliffs, doi
  18. (2004). The Resident Choice Scale: a measure to assess opportunities for self-determination in residential settings. doi
  19. (2004). The social construction of Intellectual disability. doi
  20. (2005). Valuing People: making things better (The Government’s annual report on Learning Disability,
  21. (2001). Who’s in control?: decision-making by people with learning difficulties who have high support needs. London: Values Into Action.
  22. (1997). Whose text? Whose context?", doi

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