Practising Participation at the Street Level: Hospital Discharge Care Planning With Older Adults and Their Family Members

ABSTRACT Drawing on Brodkin's ‘structuring voice’ framework, this article explores how health and social care professionals understand and operationalise the ambiguous policy objective of client and family member participation in relation to the conditions structuring the hospital discharge process for older adults. Using vignettes, 17 qualitative group and individual interviews were conducted with health and social care professionals responsible for hospital discharge care planning. The findings revealed that the work with participation was affected by structural, organisational, and individual‐level conditions. In light of these, participation was structured in various ways: by obtaining consent and presenting options; persuading and compromising; creating opportunities for expressing opinions and sharing information; shifting responsibility to clients and family members; structuring choice; and opening and closing the door to family member participation. In conclusion, this study highlights the need to acknowledge the multifaceted conditions of hospital discharge care planning, requiring a more flexible approach to client and family member participation.