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Help-Search Practices in Rehabilitation Team Meetings: A Sacksian Analysis

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Abstract

Using Harvey Sacks’s concept of membership categorization devices (MCDs), this article examines the help-search sequences in which Japanese rehabilitation team members use a set of categories to locate the availability of stroke family caregivers. Specifically, based on an analysis of audiovisual data from rehabilitation team conferences in Japan, the article illustrates the ways in which participants at the meetings: (1) evaluate the expectable behaviors of various category incumbents; (2) classify which category of person is proper to turn to for help; and (3) arrive at the conclusion that no one is available, and so the patient must be institutionalized. Analysis shows that participants routinely choose co-resident family members to fulfill the caregiver position. However, the position is not guaranteed unless the selected incumbent can satisfy additional criteria, especially physical strength and time availability. By exploring the ways in which participants use categories to negotiate discharge destinations, the article adds to Sacks’s analysis by illustrating methodical activities for deciding whether someone is unavailable to help. Moreover, it considers the applicability of Sacks’s notion of MCDs to Japanese data.

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Notes

  1. Activities of daily living refer to self-care tasks, such as eating, toileting, and dressing, which people routinely perform in their daily life.

  2. Persons aged 40–64 years old may also qualify for LTCI if they are diagnosed as having one of 16 specific diseases (e.g., cerebrovascular disease) as defined by the MHLW.

  3. Patients with mimamori (‘supervision’) require a caregiver to watch while they are performing activities of daily living because there might be some risks involved with their behavior. However, a caregiver does not need to use his or her hands to physically assist them. Instead, s/he can utilize verbal and gestural cues to instruct them.

  4. The excerpt does not explain why the participants do not consider the patient’s mother to be a helper, but the patient’s mother is 90 years old and probably lacks the strength to help with transfers. Such background knowledge might be shared by the participants.

  5. It should not be assumed that non-family members are always treated as improper. In the following excerpt, participants can and do choose a patient’s neighbors as the potential helper. However, the kinds of help offered by the neighbors seem to be limited, such as giving a ride (see lines 10–12).

    Excerpt 5

    figure g

    .

  6. Here, Sacks’s (1974) “consistency rule” could be extended. That is, when the speaker lists three candidate incumbents A, B, and C, and if A is treated as improper, this applies to B and C even though their capacities are not explicitly talked about.

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Acknowledgements

I am deeply indebted to Jack Bilmes for his excellent advice and useful comments on earlier manuscripts. My thanks also go to the two anonymous reviewers for their helpful comments and suggestions. Albert Britt Robillard generously shared his social network with me, helping me connect to a Japanese rehabilitation hospital for conducting my fieldwork and data collection. Jack Bilmes and Pamela Runestad provided valuable editing assistance. An earlier version of this article was presented at the International Institute for Ethnomethodology and Conversation Analysis Conference held at the University of Southern Denmark (4–7 August, 2015). I am thankful to the participants for their useful feedback. All errors are my own responsibility.

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  1. Department of Anthropology, University of Hawai‘i at Mānoa, 2424 Maile Way, Saunders Hall, Honolulu, HI, 96822, USA

    Hiroaki Izumi

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Appendix: List of Abbreviations Used in the Interlinear Gloss

Appendix: List of Abbreviations Used in the Interlinear Gloss

Adopted from Iwasaki (2013) and Hayashi (2010).

ACC

Accusative

NML

Nominalizer

ASP

Aspect

NOM

Nominative

AUX

Auxiliary

PAST

Past

CAU

Causative suffix

PFX

Prefix

CLS

Classifier

POL

Polite suffix

COM

Comitative

POT

Potential suffix

COND

Conditional form

PP

Pragmatic particle

COP

Copula

PSS

Passive suffix

DAT

Dative

PURP

Purposive

EMPH

Emphasis marker

Q

Question marker

FL

Filler

QT

Quotative particle

GEN

Genitive

REP

Representative

HON

Honorific

RP

Retrospective particle

IMP

Imperative form

SE

Sentence extender

INJ

Interjection

SOF

Softener

INS

Instrumental

TE

TE form

LOC

Locative

TL

Title

NEG

Negative

TOP

Topic marking particle

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Izumi, H. Help-Search Practices in Rehabilitation Team Meetings: A Sacksian Analysis. Hum Stud 40, 439–468 (2017). https://doi.org/10.1007/s10746-017-9430-z

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