Policy discourses on homecare services for rural older people in Ireland: Spatial and age-based drivers of narratives and absences
本文批判性审视爱尔兰政策如何构建农村老年人居家护理，发现碎片化和缺失是主要话语主题，并揭示农村政策忽视老年人、老年政策忽视农村的双重问题，对政策改革有启示。
Research highlights significant inequalities in the provision of homecare in rural communities. However, less is known about how these inequalities are rooted within existing policies and policy discourse, and to what degree values and assumptions related to spatial constructions or age-related constructions are driving these inequalities. This article presents a critical review of how homecare for rural dwelling older people is framed in policy and policy-related materials to assess the underpinning values in relation to related representations and discourses. Using Ireland as an illustrative case, a critical discourse analysis approach was employed that was informed by spatial justice and ageism as conceptual perspectives. Analysis focused on 53 documents that captured official policy, policy-related material and the broader narrative context of Ireland's policy landscape. A discourse of fragmentation and absence emerged as the overarching discursive theme regarding home care for rural older people in Ireland. However, this narrative was interwoven with and reinforced by a complex array of discourse framings that are layered across rural, ageing and care polices, including: a rural de-prioritization of ageing and older adults; a care and ageing subordination of rural contexts; economic-oriented development; and all-age-inclusion. Findings are discussed with respect to a rural spatial ageism, and the future of homecare reform in Ireland. • Fragmentation and absence emerged as the overarching discursive theme related to homecare for rural older people in Ireland. • Fragmentation and absence defined both the description of service provision, and the formal discursive neglect of this topic. • A parallel disregard of older people in rural policy, and of rural contexts in ageing-related and care policy was evident. • A rural spatial ageism lens may foster equitable procedural inclusion and equitable distribution in future homecare reform.