Integration as 'Boundary Redefinition Process'

Integration is usually viewed as an action aimed at establishing or strengthening connections between entities in order to improve outcomes for people in need of care. In this contribution however, integration is understood as a “boundary redefinition process”. Referring to the boundary approach developed in the social sciences during the past two decades, it suggests that the integration process does not simply alter the ties between entities; it affects the entities themselves, as it contributes to reshaping them.

The analysis uses as its data-base 94 “practice examples” (policies, implemented practices, pilot and on-going projects) aiming at a better integration of long term care (LTC). They have been identified between May 2010 and October 2011 in 13 European countries by the 15 partner organisations of INTERLINKS, a research project funded by the European Commission under the Seventh Framework Programme (Grant agreement no. 223037). The methodological approach is qualitative. The analysis shows that the boundary redefinition process at work in the examples examined does reshape key constitutive elements of the LTC system such as the older person in need of care, the informal carer, the care provider organisation and the care delivered at home. Each of these entities acquires new content and thus takes on a new meaning as care integration progresses.

Résumé : Pierre Gobet