Agency and the Limits of Responsibility: Co-Management of Technology-Enabled Care in Supported Housing

Abstract

Since at least 2012, UK housing providers (and policy makers) have introduced policies aimed at developing autonomy and independence among service users, through an agenda sometimes referred to as ‘responsibilisation’. This paper considers the role that technologies play in this agenda, through an analysis of how wellbeing and independence are facilitated amongst older social housing tenants. Based on case studies of four supported housing schemes in England, the research considers the capacity to exercise agency amongst older persons, through their willingness and ability to accept technological interventions, and the role of support networks to facilitate independent living. Using the concept of modalities of agency, the research examines the impact of implementing ‘low-level’ assistive technologies in the home, based on the perspectives of residents and staff. The interventions studied were designed to improve social relationships, promote self-sufficiency and support self-managed care (based on the principle that the most effective projects facilitate individual agency). The research findings identified that residents responded differentially to technology, based on their levels of capability, motivation, reluctance and resistance. Whilst the study demonstrated that small technological innovations could have disproportionately positive impacts in improving wellbeing, the research demonstrates the complex nature of agency and limits of responsibility. The paper argues that responsibilisation is part of a wider neoliberal project, where choice and agency are manufactured to create an idealised notion of the autonomous actor (in this case through technology-enabled care). The article argues that a collaborative approach to service provision in which responsibility is shared, via co-managed care, is a more effective means of enhancing agency, than one which advocates a withdrawal of support (in the guise of autonomy).

Keywords

• technology-enabled care
• co-management
• ageing
• supported housing
• responsibilisation