Bringing together the Listening Guide and Moral Self-Definition for narrative analysis of older people’s understanding of health-related decision-making

Abstract

Identity and decision-making are interrelated concepts, but the relationship between them is complex particularly when an unwell person’s ability to make decisions is compromised. In this article we discuss how moral self-definition (Nelson, 2001;Walker, 1987) can be used within a Listening Guide (LG) analysis to extend analysis of the temporal relationship between identity and decisions. In this project, the LG was used to analyze interviews exploring older people’s understanding of medical decision-making when the unwell person’s capacity is diminished. The second step of the LG drew attention to the participants’ expression of decision-making voices and health-related identities, but the iterative and temporal relationship between identity and decisions was less well illuminated. Therefore, we applied the theoretical framework of moral self-definition within the third listening. The focus of this article is on how moral self-definition can be integrated as a theoretical framework within the contrapuntal listening to extend the LG analysis.