The broker: bridging the gap between the bureaucratic and the locl in supporting older rural people
Orpin, P and Walker, J, The broker: bridging the gap between the bureaucratic and the locl in supporting older rural people, National Rural Health Alliance, 13-16 March 2011, Perth, pp. 1-20. ISBN 978-1-921219-20-7 (2011) [Conference Edited]
older rural people
Australia has developed a sophisticated system of centrally organised, bureaucratic, formalised services and supports for its older citizens. However, this system would not function without substantial supplementation from informal, flexible and personalised supports at the community level. There are, however, inherent tensions at the interface of these two different forms of support flowing from fundamental differences in their very nature. These tensions are particularly evident in rural communities where there are fewer locally based formal services and less familiarity and comfort with bureaucracy. The paper draws on two studies of older rural people, to suggest that one crucial element in dealing successfully with these tensions is the unofficial ‘broker’ who is able to operate within, and between, the two worlds, providing translation and a buffer in both directions.
Study 1 was designed to explore the relationship between formal and informal services in rural dementia and involved in-depth interviews with 18 rural carers of people with dementia. Study 2 was focussed on the maintenance of social engagement among rural older people. It involved interviews with 69 rural dwelling people aged 65+ years and 32 on-the-ground rural service providers. Interviews were transcribed and thematically analysed in NVivo.
Carers in Study 1 identified the confusion of multiple providers, rather than the lack of services, as a major concern. In order to manage, most settled on a single individual who, regardless of their official role, became their trusted guide, informant and translator and first point of reference on any issue or concern. In study 2 it was evident that service access was less of an issue for rural older participants than a general wariness of the system and reluctant help seeking. Local service providers recognised the need to take the time to build trust and adopt a flexible individualised approach based an intimate understanding of the individual and the local context. This often required innovative exploration of the creative possibilities within the system.
Discussion and Relevance
These studies reveal the importance of those individuals who can operate, and translate, across the bureaucratic and community interface. Such brokerage roles are frequently unrelated to official roles and statuses but gain their power from familiarity, flexibility and personal relationships of trust. We need to identify and support such people in this work and be aware that services providers who are not locally immersed, no matter how well intentioned, will struggle to fill these roles.