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The impact of the life course in health and social care

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Drawing on the concepts you have studied in Block1, critically reflect on the ways in which your own life course has affected how you work in, or use, health and social care.

In this essay I will look at the life course perspective, and how it has provided me with an essential tool to offer a more personalised service. I will describe how my own life course and ‘Biographical Disruption (Bury 1982) has changed the person I am beyond the expectations I had of my presumed journey, and how it has impacted on my practice. Where it has proved to be a strength or a weakness, and how it has made me more sensitive to people’s needs and behaviour. I will look at how my personal values have been shaped and influenced by my life course, and discuss possible ethical conflicts. I will start off explaining the concept of life course using the five principles discussed by Bengtson et al. (2005).

Recognising the course that people’s lives take is relatively new to study and research. Until relatively recently the understanding of human development was based on the life cycle approach, one of the oldest accounts of how life’s and families are organised over time (Bengtson, et al 2005, p.9). The approach is based on the idea that people’s lives go through a series of relatively predictable and chronological stages and transitions from birth to death, providing insight in peoples changing roles and identities in relation to landmark occasions such as coming of age, marriage, childbirth and old age. From the 1960’s onwards the life cycle approach began to incorporate psychological elements, which considered the relationship between an individual’s inner world, and the social context in which they live. This idea of considering the whole of a person’s life as offering opportunities for development and change (Crawford and Walker p.2) is referred to in literature as life –span development (Sugarman, L. 1986, p.3) or the life-span perspective (Baltes, P. 1987, p.3).

At the same time these approaches began to merge with the idea that age and ageing is not only related to a chronological stage in human development, but also to subjective experiences between the individuals own construction of their life course, and social constructions such as schools, labour markets and normative pathways. Ageing is a lifelong process, in general common to all of us, but throughout our journey from birth to death, events can be imposed upon us from which we may have to make decisions and choices that change the path of our life course. Timing is often unexpected and change may not happen at a time we would have chosen it to; this not only impacts upon our own life and future but on those we are linked with. understanding my own life course also supports me professionally working in social care, Crawford and Walker (2003, p.2) point out that social work practice involves interactions between people, which are influenced by each person’s life course, their experiences and perceptions about their own life, emphasising the quality of these personal relationships between service users, their families, carers and professionals. In order to understand the impact human development and life events have on individuals I need to have a critical, reflective understanding of how my own life course has shaped me, my behaviour and influenced my beliefs and values. This will enable me to engage with people better, respond more sensitively to people’s experiences and needs and explain why people don’t always act in ways that appear to be in their best interests (K319, Learning Guide 3, 2013). My self-perception and my values and beliefs are very much shaped by my own life courses’ significant events, experiences and transitions, such as growing up in a very large family in the seventies, being a divorced woman with young children and being a main carer for my terminally ill mum.

Bengtson et al (2005) identifies five principles that are essential to the life course perspective.

First there is the principle of linked lives, which emphasizes on the fact that people’s life courses are interdependent with others, especially relevant in the context of families. Having grown up in a very large family my life has been linked to my siblings and parents, so when my dad fell seriously ill, and never recovered enough to ever return to work, and he needed almost constant supervision and support. The impact on all the family was life changing, my siblings that still lived at home had to find jobs to help the household finances, and they all feel this event ended their childhood. I was 10 years old I was taken to live with my eldest brother and his family. This felt very strange and I remember feeling afraid I would not see my parents again. It was thought that I was too young to understand what was happening so I was never told how ill my dad was, I was never allowed to visit him in hospital, and he was there for a full year. I was just told to be good and not make a fuss. I then stayed for short periods of time with my grown up siblings and extended family, this went on for many months , living a very transient existents and not staying in one place long enough to develop friendships with children my own age. Looking back from my adult self, I can now relate to my difficulties in developing long term relationships and poor self-esteem. On the positive side I was able to develop a lifelong close relationship with a maiden aunt which looking back I don’t feel would have happened if I had stayed in the family home over that period.

Secondly there is the principle of historical time and place, “emphasising the importance of social and historical context in shaping individual lives” (Bengston et al, 2005 p11). This is discussed as how events such as wars, trauma, depression or a period of prosperity affects our lives, Impacting on the life courses of all generations living in that particular time and place. My dad’s illness in the seventies meant he could no longer work and provide for his family, so from being a provider he became cared for, which changed the whole dynamic of the family structure. He also had to rely on sickness benefit, which in the seventies welfare system was very difficult to get and the financial support was very low. This impacted on all the family. We were poor prior to his illness but this plunged us further into poverty. This had a negative effect on us all, but for me at a time when I was just about to start secondary school I felt the stigma of being subjectively poor. I spent many difficult days in school feeling marginalised and bullied by my peers, because I didn’t have nice clothes and had to have free school dinners, at that time children on free dinners had to queue in different lines, this compounded the feelings of inferiority. My mum did her best, and managed to get some part time work alongside her being the main carer for dad, and mother to her children. Looking back, I realise my mum must have been a very strong person to cope with the situation she found herself in, she instilled a strong work ethic into her children, believing hard work would bring rewards. She influenced me with her single minded determination, like Enid with her mother (k319, Learning Guide 3 Audio 3.1). With hindsight this period of my life forced me to become more independent as I had to fend for myself a lot, it also provide me with a valuable lesson in managing on very little money. This benefitted me when I was a single parent following a divorce I was able to budget with a small income.

The next principle considers “the timing of significant life transitions and whether they fit well with cultural expectations of when things should happen” (K319, Learning Guide 3, Activity 3.1). I came into my career as a result of two biographical disruptions in my life. First I was divorced in my mid-twenties and needed to get work to support my children. Then my mum was diagnosed with terminal cancer and I became her carer. I was able to get part time paid work as a home care assistant through social care, I found I could transfer the skills I had used as a carer and the training I received helped me to support my mum better. I discovered I had very good people skills and enjoyed supporting older people to stay independent. Even later in my life I commenced my social work degree studies in contradiction to society’s view of what is ‘normal’. As with Mike, the case study in Learning Guide 3, Activity 3.5, I had concerns that studying as a mature student would lead to ‘sub-normative’ feelings of being different but on reflection my life skills and experiences have enriched my learning experience.

The fourth principle considers the control most people have over their own lives and “they make choice about what to do and have plans for the future” (K319, Learning Guide 3, Activity 3.1). Although I did not have any influence on my upbringing and not a large amount over my divorce. My experiences have provided me with the power and choice over my future which included a career in social care. I feel my life experience has made me aware of understanding everyone has past life events that impact on their current life. So when I am working with service users and planning for social work interventions, having an understanding of the potential of disruptions such as illness, and other life changes can be major turning point in their lives, and can help people see how they can become an opportunity for them to make changes (agency) in their lives. As in the story of Doireann and Iskender (K319 Learning Guide 3, Audio 3.7), where Iskender’s heart attack became a turning point in both his and Doireann’s life.

Finally the fifth principle that affirms that ageing is relevant to both the young and old, and development is not exclusive to younger people and children. Our lives are fluid as we travel our life course and we continue to change and develop whatever age we are. My life is still developing and changing as I age, in the sense that I am developing my academic skills, and my experience of caring for my mum throughout her terminal illness and the impact this had on my life.

The life cycle assumed that people would have a ‘normative life course’ (K319 Learning guide 3, Activity 3.5).That is to say people will have a life that is expected to be desirable and virtuous by society that is free from problems. Whereas a person with a “non-normative life course” is often considered to be judged and having to justify and explain their lifestyle. As a divorced woman in my mid-twenties, with two young children, which was not the normal status in the social groups I mixed in, this resulted in me feeling ‘different’ and stigmatised. I felt I had to explain my single status and felt I was seen as a threat to my married friends. I felt I had failed both myself and my children and was worried my children would feel as I did as a child, being bullied for not having a normal childhood. These feelings gave me insight into the lives of others with ‘non-normative’ life courses, whether due to their sexuality or life style choices.it has also made me question as a social care provider, does that service user feel as I did, and feel I am judging them therefore they have to explain themselves?. My own experiences of feeling ‘different’ has made me sensitive to the feelings and needs of those who society judges as non-normative, in comparison to people who follow the expected ‘norms’ and pathways we are expected to take.

My own life course was in my early childhood a non- normative course, due to the biographical disruption of my dad falling ill and resulted in me having an unconventional childhood. As I grew into adulthood my life course was comparable to the life cycle in that it had proceeded in a socially accepted pattern within a presumed time span which Giele and Elder (1998) described as “a sequence of socially defined events and roles that the individual enacts over time.” My early adult life followed a life that was considered ‘normative’, I was following the cycle of “completing formal education, working, forming relationships, marrying and having children…”(K319 Learning Guide 3, Activity 3.3).I did not predict that in my mid-twenties my life would suffer more biographical disruption that would have a huge impact on me, my family and lead into a future I would not have predicted.

Bury (2012) describes biographical disruption to be a negative experience but I would disagree with that in relation to my own experience so far as a career in social care is concerned. If I had stayed married and my mum had not got ill, I am sure I would not have followed this path and likely I would have had a very different life now.

However I had not consciously thought about entering into the social work profession, I presumed my entry into social care was the result of events that has steered me in the direction of this profession and opportunities that have presented themselves to me i.e. I was in the right place at the right time. Having read ‘Life experience: A neglected form of knowledge in social work education and practice, by Christie et al 1998,I am inclined to agree that my career choice has not been a coincidence but a choice I have made based on the knowledge I have acquired as a result of my life experiences. I am able to draw on my experiences as a knowledge base for my practice alongside the ever developing knowledge I am gaining from my studies. However, I do not “persist in viewing social work as the profession effective in bringing about social change” (Christie et al 1998). I feel my role is to support others in bringing about their own change, as I have been able to do. However I am mindful that the experiences I draw on in my practice are my personal experiences and are owned by me, and others experiences are exclusive to them. I am aware that my knowledge within in my work is limited to my own personal experiences and my personal feelings could influence my approach to service users and the decisions I make in my assessments of them.

In conclusion the article from Christie and Weeks has in fact made me question my theory that I did not choose social work as a profession purposefully; perhaps my life experiences have directed rather than influenced my choice to be a social worker, ”my own working class background, marriage difficulties, poverty, powerlessness, has influenced me strongly” (Christie el at 1998).This assignment has shown that our life course is an unpredictable path that we follow; it is constantly being reshaped from what we have imagined our life path to follow, by the events that take place around us. But although it presents us with many situations that are out of our control that impact upon us. The understanding of our life course gives us the strength to move forward in our lives, it also presents us with choice and power and positivity to look forward to the future. And as Winston Churchill says “the farther backwards you can look, the farther forward you are likely to see” (Churchill circa 1941)

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References

Baltes, P. (1987) in Crawford, K. and Walker, J. (2003) Social Work and Human Development, Exeter, Learning Matters Ltd.

Bengtson, V. L., et al. (2005) ‘The lifecourse perspective on ageing: linked lives, timing and history’ in Katz, J., Peace, S. and Spurr, S. (ed) Adult Lives; A life course perspective, Bristol, Policy press/Milton Keynes, The Open University.

Bury, M. (1982) ‘Chronic illness as biographical disruption’ in Katz, J. Peace, S. and Spurr’ S(eds)Adult Lives: A life course perspective, Bristol, Policy press/Milton Keynes, The Open University.

Christie, A &Weeks J (1998): Life experience: A neglected form of knowledge in social work education and practice: Social work in Action. http://dx.doi.org/10.1080/09503159808411477 (accessed 25 November 2013)

Crawford, K. and Walker, J. (2003) Social Work and Human Development, Exeter, Learning Matters Ltd.

Hareven, T. K. (1982) in Hutchinson, E. (2011) Dimensions of Human Behaviour ; The Changing Life Course, London, Sage Publications.

Hutchinson, E. (2011) Dimensions of Human Behaviour; The Changing Life Course, London, Sage Publications.

National Churchill Museum: Miscellaneous Wit and Wisdom

http://www.nationalchurchillmuseum.org/wit-wisdom-quotes.html (assessed 25 November 2013)

Phillips, D. (2006) ‘Quality of Life’ in in Katz, J., Peace, S. and Spurr, S. (ed) Adult Lives; A life course perspective, Bristol Policy press/Milton Keynes, The Open University.

Sugarman, L. (1986) in Crawford, K. and Walker, J. (2003) Social Work and Human Development, Exeter, Learning Matters Ltd.

The Open University, (2013), ‘Learning Guide 3.1 The life course perspective’, K319 Block 1 Approaches to adulthood and ageing, [online] available at http://www.learn2.open.ac.uk/mod/oucontent/view.php?id=255389 (Accessed 23 November 2013)

The Open University, (2013), ‘Learning Guide 3.5 ‘unusual life course’, K319 Block 1 Approaches to adulthood and ageing, [online] available at

https://learn2.open.ac.uk/mod/oucontent/view.php?id=255389 (Accessed 23 November 2013)

The Open University (2013) ‘Learning Guide 3: Introduction’, K319 Block 1 [Online]. Available at https://learn2.open.ac.uk/mod/oucontent/view.php?id=255389 (accessed 23 November 2013).

The Open University (2013) ‘I Think I’m still working through it’ [Audio], ‘Learning Guide 3.3: Biographical Disruption’, K319 Block1 [Online]. Available at https://learn2.open.ac.uk/mod/oucontent/view.php?id=255389&section=3 (accessed 26 November 2013).

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