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12-06-2017 | Empirical Study/Analysis

Help-Search Practices in Rehabilitation Team Meetings: A Sacksian Analysis

Author: Hiroaki Izumi

Published in: Human Studies | Issue 3/2017

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Abstract

Using Harvey Sacks’s concept of membership categorization devices (MCDs), this article examines the help-search sequences in which Japanese rehabilitation team members use a set of categories to locate the availability of stroke family caregivers. Specifically, based on an analysis of audiovisual data from rehabilitation team conferences in Japan, the article illustrates the ways in which participants at the meetings: (1) evaluate the expectable behaviors of various category incumbents; (2) classify which category of person is proper to turn to for help; and (3) arrive at the conclusion that no one is available, and so the patient must be institutionalized. Analysis shows that participants routinely choose co-resident family members to fulfill the caregiver position. However, the position is not guaranteed unless the selected incumbent can satisfy additional criteria, especially physical strength and time availability. By exploring the ways in which participants use categories to negotiate discharge destinations, the article adds to Sacks’s analysis by illustrating methodical activities for deciding whether someone is unavailable to help. Moreover, it considers the applicability of Sacks’s notion of MCDs to Japanese data.

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Activities of daily living refer to self-care tasks, such as eating, toileting, and dressing, which people routinely perform in their daily life.

Persons aged 40–64 years old may also qualify for LTCI if they are diagnosed as having one of 16 specific diseases (e.g., cerebrovascular disease) as defined by the MHLW.

Patients with mimamori (‘supervision’) require a caregiver to watch while they are performing activities of daily living because there might be some risks involved with their behavior. However, a caregiver does not need to use his or her hands to physically assist them. Instead, s/he can utilize verbal and gestural cues to instruct them.

The excerpt does not explain why the participants do not consider the patient’s mother to be a helper, but the patient’s mother is 90 years old and probably lacks the strength to help with transfers. Such background knowledge might be shared by the participants.

It should not be assumed that non-family members are always treated as improper. In the following excerpt, participants can and do choose a patient’s neighbors as the potential helper. However, the kinds of help offered by the neighbors seem to be limited, such as giving a ride (see lines 10–12).

Excerpt 5 .

Here, Sacks’s (1974) “consistency rule” could be extended. That is, when the speaker lists three candidate incumbents A, B, and C, and if A is treated as improper, this applies to B and C even though their capacities are not explicitly talked about.

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Title: Help-Search Practices in Rehabilitation Team Meetings: A Sacksian Analysis
Author: Hiroaki Izumi
Publication date: 12-06-2017
Publisher: Springer Netherlands
Published in: Human Studies / Issue 3/2017
Print ISSN: 0163-8548
Electronic ISSN: 1572-851X
DOI: https://doi.org/10.1007/s10746-017-9430-z

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