Challenging the Rhetorical Conception of Health Literacy: Aging, Interdependence, and Networked Caregiving

Abstract: Caregiving is a critical and yet understudied area related to aging, health, and wellness. Despite the importance of caregiving in the lives of older adults, assumptions about aging “actively” or “successfully” suggest that aging is independent, not interdependent. The healthcare industry reiterates these gerontological assumptions about aging when invoking notions of skills-based health literacy. This essay is an analysis of and response to the rhetorics of literacy as used in health care. Using John Duffy’s theoretical framework for literacy development as well as scholarship in age studies and community-literacy studies, I argue that literacy has become a rhetorical construct that promotes a view of older adults as particularly draining on the healthcare system. A more productive approach would be to frame the collaborative, distributed, and mediated work of giving and receiving care in the context of Paul Prior’s concept of literate activity. Finally, with a community-literacy approach that incorporates engagement and dialogue rather than individualistic skill development, I respond to this rhetorical construct of health literacy by considering how aging, interdependence, and networked caregiving expand the notion of what contributes to healthy living and well-being as we age. Using examples from a community care coordination project, this essay shows how compositionists might work together with patients, caregivers, and professionals to reframe health literacy rhetorics and act for change.