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DSpace at Massey University author Neville, Stephen John 2007-05-23T01:30:08Z2007-11-25T23:13:43Z 2007-01-162007-05-23T01:30:08Z2007-11-25T23:13:43Z 2005 http://hdl.handle.net/10179/265 Q112158898 https://www.wikidata.org/wiki/Q112158898 The purpose of this thesis has been to explore the discursive production of delirium in people over the age of 65 years. The philosophical approaches underpinning the study were derived from the field of critical gerontology, postmodernism and the utilisation of a Foucauldian understanding of discourse and power/knowledge. Data sources included published documents on delirium, interviews with people over the age of 65 years who had been delirious (as well as their clinical notes), family members, registered nurses and a doctor.Textual analysis revealed the presence of two contesting and contradictory discourses that impacted on being an older person who had delirium. These were identified as the discourse of delirium as a syndrome and a personal discourse of delirium. The discourse of delirium as a syndrome is underpinned by the biomedicalisation of the ageing process. This process utilises scientific methods as the foundation from which to understand, research and provide a health service to older people with delirium. Any personal perspectives on delirium are rendered unimportant and relegated to marginalised positions. Nursing through its vicarious relationship to medicine is interpellated into deploying the discourse of delirium as a syndrome and has largely ignored the personal dimensions associated with this phenomenon. Consequently, the older delirious 'body' is known and inscribed as unruly, problematic, physically unwell, cognitively impaired and at risk.Conversely, a personal discourse of delirium privileges the individual narratives of people who have been delirious and provides a different perspective of delirium. The deployment of a personal discourse of delirium offers another position that views this group of older people as bringing to the health care setting a rich tapestry of life experiences that are more than a cluster of signs and symptoms. It is these varied life experiences that need to be included as a legitimate source of knowledge about delirium. This thesis demonstrates how nursing needs to espouse a critical gerontological position when working with older people who have delirium. Critical gerontology provides nurses with the theoretical tools to challenge the status quo and uncover the multiple, varied, contradictory and complex representations of delirium in older people. The Author Delirium Gerontological nursing Social gerontology Confusion Critical gerontology Older people Delirium in the older adult : a critical gerontological approach : a thesis presented in fulfilment of requirements for the degree of Doctor of Philosophy in Nursing at Massey University, Palmerston North, New Zealand Thesis URL https://mro.massey.ac.nz/bitstreams/f11e5ba4-ed44-47f4-9ae5-5c834cbac3a0/download File MD5 ef8fa30c8bdf47cbe83caab2a15b28b4 1720854 application/pdf 02whole.pdf URL https://mro.massey.ac.nz/bitstreams/e29ad9ef-3217-41cb-b752-22b184d560da/download File MD5 48b2c2eb2491d961f2bc864cc272bfa5 93124 application/pdf 01front.pdf URL https://mro.massey.ac.nz/bitstreams/00fd3033-b2e6-4a13-b096-585b8ed6f107/download File MD5 75b242dd613bdcd88f7c46c2b05fae98 515250 text/plain 02whole.pdf.txt URL https://mro.massey.ac.nz/bitstreams/f3b2bc47-f641-4c92-86c4-53fc6b970b20/download File MD5 6271e05c581229584ac3ad295f0195fc 11832 text/plain 01front.pdf.txt