Manufacturing social exclusion in the home care market

This paper examines how the health care perspective which dominates home ca re obscures the broader processes of social exclusion that play out in this arena of public policy. A study of elderly women and women with disabiliti es receiving home care in Ontario reveals how managed community care genera tes and reinforces service users' social isolation and their spatial, insti tutional, and political exclusion. Analysis of study participants' experien ces points to the challenges of moving away from a market discourse and a h ealth framework to develop home care policy which achieves the inclusion an d participation of elderly citizens and citizens with disabilities in need of assistance at home.