Can a service philosophy be identified in aging and disability resource centers? A study of institutional logics as applied to the creation of new hybrid organizations
Keefe, Bronwyn Rebekah
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The aging of our society is well known, with policy makers and analysts forecasting enormous increases in people living with chronic illness and disabilities (AoA, 2009). Less well known is that services for older adults and younger people with disabilities - historically separated by different funding streams, service systems, and workforces - have increasingly merged (Putnam, 2007). The movement to combine services for older adults and younger persons with disabilities is reflected in the creation of a hybrid organization - Aging and Disability Resource Centers (ADRCs) - designed to combine services for both populations (O'Shaughnessy, 2011; Putnam, 2011). Using ADRCs as the principal organizational strategy to combine aging and disability services has been challenging, primarily because these organizations have different histories and service philosophies (Kane, 2007; Putnam & Stoever, 2007; DeJong, 1979). Independent living centers, who serve people of all ages with disabilities, have a service philosophy that emphasizes `consumer direction', characterized by consumer control, advocacy, and peer models. While the aging service delivery philosophy is based in a medical model of care where care plans are developed by medical providers and services are provided by professionals in order to protect the well-being of older adults (DeJong, 1986; Simon-Rusinowitz & Hofland, 1993). The purpose of this dissertation is to examine the experiences of ADRCs to combine aging and disability services. The study employs institutional logics theory and a mixed-methods design to assess whether a unified organizational philosophy for these services can be identified. In this dissertation, I found that there were competing logics between directors located at aging organizations when compared to directors at Independent Living Centers. These competing logics were also present among their staff in these organizations. As a mechanism to manage the co-existing logics, I found that the joint activity of collaborating in creating a training program to describe overarching service philosophies helped to unify the two organizations. Additionally, I found that the workers located at aging organizations who took the training had increases in their understanding of the professional logic of consumer control, which is dominant in the disability organizations; therefore, this training helped in managing the co-existence of logics.