Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-24T01:48:27.408Z Has data issue: false hasContentIssue false

Care and the shadow of the fourth age: how does home care get caught up in it and how does it stay away from it?

Published online by Cambridge University Press:  24 September 2018

José Manuel Sousa de São José*
Affiliation:
Interdisciplinary Centre of Social Sciences (CICS.NOVA), Faculty of Economics, University of Algarve, Faro, Portugal

Abstract

This article examines how care encounters at the elders’ homes are forged, and how the way these encounters are forged avoids or evokes the social imaginary of the fourth age. Data were gathered in Portugal from elders receiving home care (16 cases), their care workers (eight cases) and family carers (six cases), through participant observation and informal conversations (conducted at the elders’ homes), as well as focus groups. The collected data were analysed according to the procedures of Framework Analysis. This study found five forms of care encounters – marked by conflict, infantilisation, burden, harmony and indifference – the harmony form being the only one found to maintain the fourth age at a distance. It concludes that home care has a Janus-like nature in relation to the fourth age, and that the way home care encounters are forged depends on the conditions of the care settings and the actions of all participants in care encounters. It also concludes that it is difficult to maintain the social imaginary of the fourth age at a distance when the elders exhibit high levels of infirmity. Finally, it concludes that family carers play a crucial role in the way care encounters unfold. Implications for practice and policy include vocational training regarding the relational component of care, and information and educational programmes for family carers.

Type
Article
Copyright
Copyright © Cambridge University Press 2018

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Allan, KD (2009) Explorations in Classical Sociological Theory: Seeing the Social World. Los Angeles, CA: Pine Forge Press.Google Scholar
Ayalon, L and Roziner, I (2016) Satisfaction with the relationship from the perspectives of family caregivers, older adults and their home care workers. Aging & Mental Health 20, 5664.CrossRefGoogle ScholarPubMed
Bettio, F and Verashchagina, A (2010) Long-term Care for the Elderly. Provisions and Providers in 33 European Countries. Rome: EU Expert Group on Gender and Employment, Fondazione G. Brodolini.Google Scholar
Bloor, M, Frankland, J, Thomas, M and Stewart, K (2000) Focus Groups in Social Research. Los Angeles, CA: Sage.Google Scholar
Breitholtz, A, Snellman, I and Fagerberg, I (2012) Older people's dependence on caregivers’ help in their own homes and their lived experiences of their opportunity to make independent decisions. International Journal of Older People Nursing 8, 139148.CrossRefGoogle ScholarPubMed
Chon, Y (2015) An exploratory qualitative study on relationships between older people and home care workers in South Korea: the view from family carers and service providers. Ageing & Society 35, 629652.CrossRefGoogle Scholar
Denzin, N and Lincoln, Y (eds) (1994) Handbook of Qualitative Research. Thousand Oaks, CA: Sage.Google Scholar
England, K and Dyck, I (2011) Managing the body work of home care. Sociology of Health and Illness 33, 206219.CrossRefGoogle Scholar
Eustis, N and Fischer, L (1991) Relationships between homecare clients and their workers: implications for quality of care. The Gerontologist 31, 447456.CrossRefGoogle Scholar
Fujisawa, R and Colombo, F (2009) The long-term care workforce: overview and strategies to adapt supply to a growing demand. Organisation for Economic Co-operation and Development, OECD Health Working Paper 44. Available at http://dx.doi.org/10.1787/225350638472.CrossRefGoogle Scholar
Fujiwara, K, Tsukishima, E, Tsutsumi, A, Kawakami, N and Kishi, R (2003) Interpersonal conflict, social support, and burnout among home care workers in Japan. Journal of Occupational Health 45, 313320.CrossRefGoogle Scholar
Glaser, B (1998) Doing Grounded Theory: Issues and Discussions. Mill Valley, CA: Sociology Press.Google Scholar
Goffman, E (1961) Asylums. Garden City, NY: Doubleday, Anchor Books.Google Scholar
Goffman, E (1971) Relation in Public: Microstudies of the Public Order. New York, NY: Basic Books.Google Scholar
Graham, JE and Bassett, R (2006) Reciprocal relations: the recognition and co-construction of caring with Alzheimer's disease. Journal of Ageing Studies 20, 335349.CrossRefGoogle Scholar
Heijst, vH (2011) Professional Loving Care. An Ethical View of the Healthcare Sector. Herent, Belgium: Peeters.Google Scholar
Higgs, P and Gilleard, C (2015 a) Rethinking Old Age. Theorising the Fourth Age. London: Palgrave.CrossRefGoogle Scholar
Higgs, P and Gilleard, C (2015 b) Interrogating personhood and dementia. Aging & Mental Health 20, 773780.CrossRefGoogle ScholarPubMed
Higgs, P and Gilleard, C (2016) Personhood, Identity and Care in Advanced Old Age. Bristol, UK: Policy Press.Google Scholar
Isaksen, LW (2002) Toward a sociology of (gendered) disgust images of bodily decay and the social organization of care work. Journal of Family Issues 23, 791811.CrossRefGoogle Scholar
Karner, T (1998) Professional caring: homecare workers as fictive kin. Journal of Aging Studies 12, 6982.CrossRefGoogle Scholar
Kitwood, TM (1997) Dementia reconsidered. The person comes first, Buckingham: Open University Press.Google Scholar
Lloyd, L, Calnan, M, Cameron, A, Seymor, J and Smith, R (2014) Identity in the fourth age: perseverance, adaptation and maintaining dignity. Ageing & Society 34, 119.CrossRefGoogle Scholar
Moe, A, Hellzen, O and Enmarker, I (2013) The meaning of receiving help from home nursing care. Nursing Ethics 20, 737747.CrossRefGoogle ScholarPubMed
Ritchie, J, Lewis, J, Nicholls, CM and Ormston, R (2014) Qualitative Research Practice. A Guide for Social Science Students & Researchers, 2nd Edn. Los Angeles, CA: Sage.Google Scholar
Rummery, K and Fine, M (2012) Care: a critical review of theory, policy and practice. Social Policy and Administration 46, 321343.CrossRefGoogle Scholar
Saraceno, C and Keck, W (2010) Can we identify intergenerational policy regimes in Europe? European Societies 12, 675696.CrossRefGoogle Scholar
Spiers, JA (2002) The interpersonal contexts of negotiating care in home care nurse–patient interactions. Qualitative Health Research 12, 10331057.CrossRefGoogle ScholarPubMed
Stewart, J and McVittie, C (2011) Living with falls: housebound older people's experiences of health and community care. European Journal of Ageing 8, 271279.CrossRefGoogle ScholarPubMed
Sundler, AJ, Eide, H, van Dulmen, S and Holmström, IK (2016) Communicative challenges in the home care of older persons – a qualitative exploration. Journal of Advancing Nursing 72, 24352444.CrossRefGoogle Scholar
Tadd, W and Calnan, M (2009) Caring for older people: why dignity matters – the European experience. In Nordenfelt, L (ed.), Dignity in Care for Older People. Oxford: Wiley-Blackwell, pp. 119145.CrossRefGoogle Scholar
Trojan, L and Yonge, O (1993) Developing trusting, caring relationships: home care nurses and elderly clients. Journal of Advanced Nursing 18, 19031910.CrossRefGoogle ScholarPubMed
Tronto, J (1993) Moral Boundaries. A Political Argument for an Ethic of Care. London: Routledge.Google Scholar
Tronto, J (2013) Caring Democracy. Markets, Equality, and Justice. New York, NY: New York University Press.Google Scholar
Twigg, J (2000) Bathing. The Body and Community Care. London: Routledge.Google Scholar
Twigg, J, Wolkowitz, C, Cohen, RL and Nettleton, S (2011) Conceptualising body work in health and social care. In Twigg, J, Wolkowitz, C, Cohen, RL and Nettleton, S (eds), Body Work in Health and Social Care. Critical Themes, New Agendas. Malden, MA: Blackwell Publishing, pp. 118.CrossRefGoogle Scholar
Valokivi, H (2005) Participation and citizenship of elderly persons. Social Work in Health Care 39, 181207.CrossRefGoogle Scholar
Vivian, BG and Wilcox, JR (2000) Compliance communication in home health care: a mutually reciprocal process. Qualitative Health Research 10, 103116.CrossRefGoogle ScholarPubMed
Walsh, K and Shutes, I (2013) Care relationships, quality of care and migrant workers caring for older people. Ageing & Society 33, 393420.CrossRefGoogle Scholar
Wibberley, G (2013) The problems of a ‘dirty workplace’ in domiciliary care. Health & Place 21, 156162.CrossRefGoogle ScholarPubMed