Choice, risk, and responsibility in Manitoba’s self and family managed home care program
Bibliographic record
Abstract
Enhancing choice in home care has become part of a national discourse that aligns with aging in place strategies. Choice in home care is best realized through the mechanism of direct funding (DF), where the client and/or a family member is given funding to make their own decisions about their care services. Having more choice is generally accepted as automatically beneficial, but choice also involves making decisions and accepting any risks involved in taking on that responsibility. The literature indicates there are several benefits for working-age adults who take responsibility for their own care, but there are a number of gaps in our understanding of the ways older adults and their caregivers experience having more choice over their home care services. The objectives of this dissertation are to identify whether and how having choice in home care may have policy implications, and to explore and describe experiences of choice, risk, and responsibility among clients and families using DF home care. This is a thesis by publication presenting findings from three qualitative studies conducted in the context of Manitoba’s home care system. Each study examines different aspects of choice and risk and each uses different means of collecting and analyzing data. Nevertheless, all three studies are conceptually linked by the overall research objective and are philosophically linked by feminist care ethics following Tronto’s political ethics of care and Mol’s logic of care. Together, the research presented in this dissertation provides new insight into the way clients and families experience the responsibilities and risks of having choice in home care. This dissertation concludes with a set of recommendations to improve home care services in Manitoba.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.025 | 0.008 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.001 | 0.005 |
| Research integrity | 0.001 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".