This chapter considers the negotiations with change which occur within many people’s lives in relation to both health and social care; for instance, through acquiring impairments, becoming a carer or encountering substance misuse issues, individuals and their families are forced to respond to roles which have often been imposed upon them. It becomes necessary, therefore, for people in such circumstances to reassess their position, renegotiate their identity and contest the way(s) they may be perceived. The stigma, stereotypes and challenges which individuals encounter as a result of enforced change can be a huge shock and an additional imposition on the person and their significant others, yet often only by constructing or reconstructing their sense of self can people effectively position themselves within the new role. In this chapter the theoretical aspects considered are applied throughout to four examples based upon individuals’ personal experiences. The roles of ‘service user’, ‘patient’ and ‘carer’ are ones which most of us incorporate into our lives at some point, but are rarely the only determining factors by which a person may wish to be identified. As a result, the implications of such roles being integrated into a family setting, and how these are perceived by the wider society, have considerable significance. As part of this discussion, it is acknowledged that many people no longer live within what may be viewed as a traditional family unit (Bengtson, 2001). A ‘family’, then, can constitute a much broader range of individuals than biological parents and children, but may well include friends, neighbours and many others with whom they have enduring and affectionate relationships.
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