Choices for people with an intellectual impairment: official discourse and everyday practice

Official policy talk of "choice" for people with intellectual impairments tends towards fundamental life-choices (e.g. who to marry, what job to work at) at the expense of the minor but more frequent concerns of daily living (when to wash, what to eat, where to go in the evening). Statutes and Mission Statements are unspecific about how any such choices, big or small, are, or should be, offered. It is also silent on the relation of choices to institutional imperatives. To redress the balance, we report on five everyday varieties of choices in a (British) residential home. The data come from an ethnographic study of residential services for people with intellectual impairment, located within a National Health Service Trust in the South of England. Over the course of nine months, a researcher (one of the authors, C.W.) engaged with residents and staff in two residences in the geographical boundaries of this Trust. He took ethnographic field notes of everyday interactions, and made video and audio recordings. Conversation Analysis was used to explicate the interactions. It showed how staff, although undoubtedly well-meaning, can use the discourse of choice to promote institutional managerial objectives, and we discuss the gap between such practice and overarching policy theory and recommendation.