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Papers by Maggie FitzGerald
Policy Press eBooks, Jul 21, 2022
Policy Press eBooks, Jul 21, 2022
Policy Press eBooks, Jul 21, 2022
Policy Press eBooks, Jul 21, 2022
Policy Press eBooks, Jul 21, 2022
Policy Press eBooks, Jul 21, 2022
Policy Press eBooks, Jul 21, 2022
Policy Press eBooks, Jul 21, 2022
BMC Health Services Research, Jan 18, 2023
Background Directly-funded home care (DF) provides government funds to people who need assistance... more Background Directly-funded home care (DF) provides government funds to people who need assistance with the activities of daily living, allowing them to arrange their own services. As programs expand globally, many allow DF clients to hire home care agencies to organize their services rather than finding their own workers. In Canada, half of the DF home care programs allow users to purchase agency services. The goal of this research is to describe the role of agency providers in DF home care in Canada and consider potential equity implications for service access from the perspectives of clients and families. Methods Framed with intersectionality, the study included online focus groups with families and clients (n = 56) in the two Canadian provinces of Alberta and Manitoba between June 2021-April 2022. All transcripts underwent qualitative thematic analysis using open and axial coding techniques. Each transcript was analyzed by two of three possible independent coders using Dedoose qualitative analysis software. Results The article presents five thematic findings. First, the focus groups document high rates of satisfaction with the care regardless of whether the client uses agency providers. Second, agency providers mediate some of the administrative barriers and emotional strain of using DF home care, and this is especially important for family caregivers who are working or have additional care responsibilities. Third, there are out-of-pocket expenses reported by most participants, with agency clients describing administrative fees despite lower pay for the frontline care workers. Fourth, agencies are not generally effective for linguistic and/or cultural matching between workers and families. Finally, we find that DF care programs cannot compensate for a limited informal support network. Conclusions Clients and families often intentionally choose DF home care after negative experiences with other public service options, yet the results suggest that in some Canadian contexts, DF home care is a privilege only afforded to some. Given the growing inequalities that exist in Canadian society, all public home care options must be open to all who need it, irrespective of ability to pay, degree of social support, or competence in the English language.
International Journal for Equity in Health
Many countries adopted comprehensive national initiatives to promote equity in higher education w... more Many countries adopted comprehensive national initiatives to promote equity in higher education with the goal of transforming the culture of research. Major health research funders are supporting this work through calls for projects that focus on equity, resulting in a proliferation of theoretical frameworks including “intersectionality,” “health equity,” and variations of equity, diversity and inclusion, or EDI. This commentary is geared at individual principal investigators and health research teams who are developing research proposals and want to consider equity issues in their research, perhaps for the first time. We present histories and definitions of three commonly used frameworks: intersectionality, health equity, and EDI. In the context of health research, intersectionality is a methodology (a combination of epistemology and techniques) that can identify the relationships among individual identities and systems of oppression; however, it should also be used internally by r...
Philosophies
The central role of care in human history is beyond questioning [...]
Philosophies
According to Frantz Fanon, the psychological and social-political are deeply intertwined in the c... more According to Frantz Fanon, the psychological and social-political are deeply intertwined in the colonial context. Psychologically, the colonizers perceive the colonized as inferior and the colonized internalize this in an inferiority complex. This psychological reality is co-constitutive of and by material relations of power—the imaginary of inferiority both creates and is created by colonial relations of power. It is also in this context that violence takes on significant political import: violence deployed by the colonized to rebel against these colonial relations and enact a different world will also be violent in its fundamental disruption of this imaginary. The ethics of care, on the other hand, does not seem to sit well with violence, and thus Fanon’s political theory more generally. Care ethics is concerned with everything we do to maintain and repair our worlds as well as reasonably possible. Violence, which ruptures our psycho-affective, material, and social-political reali...
Care Ethics in the Age of Precarity, 2021
International Journal of Care and Caring, 2021
Politics in the neoliberal/modern/Western world is structured based upon the assumption that poli... more Politics in the neoliberal/modern/Western world is structured based upon the assumption that political subjects are atomistic and self-sufficient; these assumptions suppress and deny (inter) dependency, relationality and vulnerability. Yet, the rapid spread of COVID-19 has devastated many communities, drastically changed political and social life, and foregrounded the ways in which vulnerability is an inescapable fact of our existence. Drawing upon Žižek’s reading of Lacan’s notion of the ‘real’ and the ethics of care, we analyse the COVID-19 pandemic so as to argue that vulnerability must be understood as a fundamental political concept that merits ongoing attention in our political systems.
International Journal of Care and Caring, 2020
Ethics and Social Welfare, 2020
Atlantis: Critical Studies in Gender, Culture & Social Justice, 2018
We provide an autoethnography of gendered encounters in a graduate seminar. We use an affective l... more We provide an autoethnography of gendered encounters in a graduate seminar. We use an affective lens to argue that these encounters stem from "more than" just individual sexism. We also use affect to identify how these encounters related to both exits from and openings for knowledge production in the classroom.
International Journal of Care and Caring, 2019
Health & social care in the community, Jan 9, 2018
In many developed contexts, home-care services have been overhauled with the intent of increasing... more In many developed contexts, home-care services have been overhauled with the intent of increasing control and flexibility for those using social and health services. This change is associated with providing funds directly to individuals, and sometimes their families and supports, to arrange at home-care assistance with the activities of daily living. Directly funded home-care programs, or "direct funding" (DF), are not value-neutral policy interventions, but complex and politicised tools for the enactment of care in contemporary times. In this qualitative metasynthesis, we consider 47 research articles published between 2009 and 2017 that explore various DF programs for older persons in the United Kingdom, Australia, and the United States to identify core concepts in the literature. We find that choice emerges as a central concern. We then assess the literature to explore the questions: How does the existing literature conceptualise choice, and the mechanisms through which...
Policy Press eBooks, Jul 21, 2022
Policy Press eBooks, Jul 21, 2022
Policy Press eBooks, Jul 21, 2022
Policy Press eBooks, Jul 21, 2022
Policy Press eBooks, Jul 21, 2022
Policy Press eBooks, Jul 21, 2022
Policy Press eBooks, Jul 21, 2022
Policy Press eBooks, Jul 21, 2022
BMC Health Services Research, Jan 18, 2023
Background Directly-funded home care (DF) provides government funds to people who need assistance... more Background Directly-funded home care (DF) provides government funds to people who need assistance with the activities of daily living, allowing them to arrange their own services. As programs expand globally, many allow DF clients to hire home care agencies to organize their services rather than finding their own workers. In Canada, half of the DF home care programs allow users to purchase agency services. The goal of this research is to describe the role of agency providers in DF home care in Canada and consider potential equity implications for service access from the perspectives of clients and families. Methods Framed with intersectionality, the study included online focus groups with families and clients (n = 56) in the two Canadian provinces of Alberta and Manitoba between June 2021-April 2022. All transcripts underwent qualitative thematic analysis using open and axial coding techniques. Each transcript was analyzed by two of three possible independent coders using Dedoose qualitative analysis software. Results The article presents five thematic findings. First, the focus groups document high rates of satisfaction with the care regardless of whether the client uses agency providers. Second, agency providers mediate some of the administrative barriers and emotional strain of using DF home care, and this is especially important for family caregivers who are working or have additional care responsibilities. Third, there are out-of-pocket expenses reported by most participants, with agency clients describing administrative fees despite lower pay for the frontline care workers. Fourth, agencies are not generally effective for linguistic and/or cultural matching between workers and families. Finally, we find that DF care programs cannot compensate for a limited informal support network. Conclusions Clients and families often intentionally choose DF home care after negative experiences with other public service options, yet the results suggest that in some Canadian contexts, DF home care is a privilege only afforded to some. Given the growing inequalities that exist in Canadian society, all public home care options must be open to all who need it, irrespective of ability to pay, degree of social support, or competence in the English language.
International Journal for Equity in Health
Many countries adopted comprehensive national initiatives to promote equity in higher education w... more Many countries adopted comprehensive national initiatives to promote equity in higher education with the goal of transforming the culture of research. Major health research funders are supporting this work through calls for projects that focus on equity, resulting in a proliferation of theoretical frameworks including “intersectionality,” “health equity,” and variations of equity, diversity and inclusion, or EDI. This commentary is geared at individual principal investigators and health research teams who are developing research proposals and want to consider equity issues in their research, perhaps for the first time. We present histories and definitions of three commonly used frameworks: intersectionality, health equity, and EDI. In the context of health research, intersectionality is a methodology (a combination of epistemology and techniques) that can identify the relationships among individual identities and systems of oppression; however, it should also be used internally by r...
Philosophies
The central role of care in human history is beyond questioning [...]
Philosophies
According to Frantz Fanon, the psychological and social-political are deeply intertwined in the c... more According to Frantz Fanon, the psychological and social-political are deeply intertwined in the colonial context. Psychologically, the colonizers perceive the colonized as inferior and the colonized internalize this in an inferiority complex. This psychological reality is co-constitutive of and by material relations of power—the imaginary of inferiority both creates and is created by colonial relations of power. It is also in this context that violence takes on significant political import: violence deployed by the colonized to rebel against these colonial relations and enact a different world will also be violent in its fundamental disruption of this imaginary. The ethics of care, on the other hand, does not seem to sit well with violence, and thus Fanon’s political theory more generally. Care ethics is concerned with everything we do to maintain and repair our worlds as well as reasonably possible. Violence, which ruptures our psycho-affective, material, and social-political reali...
Care Ethics in the Age of Precarity, 2021
International Journal of Care and Caring, 2021
Politics in the neoliberal/modern/Western world is structured based upon the assumption that poli... more Politics in the neoliberal/modern/Western world is structured based upon the assumption that political subjects are atomistic and self-sufficient; these assumptions suppress and deny (inter) dependency, relationality and vulnerability. Yet, the rapid spread of COVID-19 has devastated many communities, drastically changed political and social life, and foregrounded the ways in which vulnerability is an inescapable fact of our existence. Drawing upon Žižek’s reading of Lacan’s notion of the ‘real’ and the ethics of care, we analyse the COVID-19 pandemic so as to argue that vulnerability must be understood as a fundamental political concept that merits ongoing attention in our political systems.
International Journal of Care and Caring, 2020
Ethics and Social Welfare, 2020
Atlantis: Critical Studies in Gender, Culture & Social Justice, 2018
We provide an autoethnography of gendered encounters in a graduate seminar. We use an affective l... more We provide an autoethnography of gendered encounters in a graduate seminar. We use an affective lens to argue that these encounters stem from "more than" just individual sexism. We also use affect to identify how these encounters related to both exits from and openings for knowledge production in the classroom.
International Journal of Care and Caring, 2019
Health & social care in the community, Jan 9, 2018
In many developed contexts, home-care services have been overhauled with the intent of increasing... more In many developed contexts, home-care services have been overhauled with the intent of increasing control and flexibility for those using social and health services. This change is associated with providing funds directly to individuals, and sometimes their families and supports, to arrange at home-care assistance with the activities of daily living. Directly funded home-care programs, or "direct funding" (DF), are not value-neutral policy interventions, but complex and politicised tools for the enactment of care in contemporary times. In this qualitative metasynthesis, we consider 47 research articles published between 2009 and 2017 that explore various DF programs for older persons in the United Kingdom, Australia, and the United States to identify core concepts in the literature. We find that choice emerges as a central concern. We then assess the literature to explore the questions: How does the existing literature conceptualise choice, and the mechanisms through which...