Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-27T21:41:35.890Z Has data issue: false hasContentIssue false
  • English
  • Français

The emotional labour of health-care assistants in inpatient dementia care

Published online by Cambridge University Press:  21 August 2013

SIMON BAILEY ,
KEZIA SCALES ,
JOANNE LLOYD ,
JUSTINE SCHNEIDER  and
ROB JONES
SIMON BAILEY*
Affiliation:
Manchester Business School, University of Manchester, UK.
KEZIA SCALES
Affiliation:
School of Sociology & Social Policy, University of Nottingham, UK.
JOANNE LLOYD
Affiliation:
South West Yorkshire Partnership NHS Foundation Trust, Wakefield, UK.
JUSTINE SCHNEIDER
Affiliation:
School of Sociology & Social Policy, University of Nottingham, UK.
ROB JONES
Affiliation:
School of Sociology & Social Policy, University of Nottingham, UK.
*
Address for correspondence: Simon Bailey, Manchester Business School, Booth Street East, Manchester M15 6PB, UK E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Although there is much written on the emotional labour of nursing, there is little research grounded in the experience of so-called ‘unqualified’ care assistants. This paper is drawn from an ethnographic study conducted with care assistants on three dementia care wards in one mental health trust within the United Kingdom National Health Service (NHS). We describe the emotional labour carried out by care assistants in their attempts to provide personalised care for people whose cognitive degeneration renders conventional relationship-building very difficult, produces unpredictable ‘challenging behaviour’ and calls into question the notion of ‘feeling rules’. This context requires the ability to strike a balance between emotional engagement and detachment, and it is the complexities of this relationship that are the focus of this paper, arguing that a degree of detachment is a prerequisite to engagement in this context. In conclusion, we argue that the contribution of care assistants in this context needs to be better acknowledged, supported and remunerated.

Keywords

emotional labourethnographydementiacare-giverscare-givingengagementdetachment
Type
Articles
Information
Ageing & Society , Volume 35 , Issue 2 , February 2015 , pp. 246 - 269
Copyright
Copyright © Cambridge University Press 2013 

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

Abraham, A. 2011. Care and Compassion? Report of the Health Service Ombudsman on Ten Investigations into NHS Care of Older People. Parliamentary and Health Service Ombudsman, London. Available online at http://www.ombudsman.org.uk/__data/assets/pdf_file/0016/7216/Care-and-Compassion-PHSO-0114web.pdf [Accessed 21 March 2011].Google Scholar
Ahmed, L. and Kitson, A. 1993. The Role of the Health Care Assistant Within a Professional Nursing Culture. National Institute for Nursing, Oxford.Google Scholar
All-Party Parliamentary Group on Dementia 2009. Prepared to Care: Challenging the Dementia Skills Gap. Alzheimer's Society, London.Google Scholar
Argyris, C. 1986. Reinforcing organizational defensive routines: an unintended human resources activity. Human Resource Management, 25, 4, 541–55.Google Scholar
Astrom, S., Nilsson, M., Norberg, A. and Winblad, B. 1990. Empathy, experience of burnout and attitudes towards demented patients among nursing staff in geriatric care. Journal of Advanced Nursing, 15, 11, 1236–44.Google Scholar
Bate, P. and Robert, G. 2002. Knowledge management and communities of practice in the private sector: lessons for modernizing the National Health Service in England and Wales. Public Administration, 80, 4, 643–63.Google Scholar
Bolton, S. 2000. Who cares? Offering emotion work as a ‘gift’ in the nursing labour process. Journal of Advanced Nursing, 32, 3, 580–6.CrossRefGoogle ScholarPubMed
Bolton, S. 2001. Changing faces: nurses as emotional jugglers. Sociology of Health & Illness, 23, 1, 85–100.CrossRefGoogle Scholar
Bray, J. 1999. An ethnographic study of psychiatric nursing. Journal of Psychiatric and Mental Health Nursing, 6, 4, 297–305.Google Scholar
Brooker, D. 2007. Person-centred Dementia Care: Making Services Better. Jessica Kingsley, London.Google Scholar
Carmack, B. 1997. Balancing engagement and detachment in caregiving. Journal of Nursing Scholarship, 29, 2, 139–43.Google Scholar
Department of Health 2009. Living Well with Dementia: A National Dementia Strategy. Department of Health, London.Google Scholar
Department of Health 2012. Prime Minister's Challenge on Dementia. Department of Health, London.Google Scholar
Douglas, M. 1966. Purity and Danger: An Analysis of the Concepts of Pollution & Taboo. Routledge, New York.Google Scholar
Foucault, M. 1973. The Birth of the Clinic: An Archaeology of Medical Perception. Tavistock Publications, London.Google Scholar
Foucault, M. 1977. Discipline and Punish: The Birth of the Prison. Translator Sheridan, A., Penguin, Harmondsworth, UK.Google Scholar
Foucault, M. 1982. The subject and power. In Dreyfus, H. and Rabinow, P. (eds), Michel Foucault: Beyond Structuralism and Hermeneutics. Harvester Press, Brighton, UK, 208–26.Google Scholar
Goffman, E. 1990. The Presentation of Self in Everyday Life. Penguin Books, London.Google Scholar
Henderson, A. 2001. Emotional labor and nursing: an under-appreciated aspect of caring work. Nursing Inquiry, 8, 2, 130–8.Google Scholar
Hochschild, A. 1983. The Managed Heart: Commercialization of Human Feeling. University of California Press, Berkeley, California.Google Scholar
Holmes, M. 2004. Feeling beyond rules: politicizing the sociology of emotion and anger in feminist politics. European Journal of Social Theory, 7, 2, 209–27.Google Scholar
Holstein, J. and Gubrium, J. 1995. The Active Interview. Sage, London.Google Scholar
Hughes, E. C. 1962. Good people and dirty work. Social Problems, 10, 1, 3–11.CrossRefGoogle Scholar
Huynh, T., Alderson, M. and Thompson, M. 2008. Emotional labour underlying caring: an evolutionary concept analysis. Journal of Advanced Nursing, 64, 2, 195–208.Google Scholar
Kahn, W. 1990. Psychological conditions of personal engagement and disengagement at work. Academy of Management Journal, 33, 4, 692–724.Google Scholar
Kahn, W. 1992. To be fully there: psychological presence at work. Human Relations, 45, 4, 321–49.Google Scholar
Kahn, W. 1993. Caring for the caregivers: patterns of organizational caregiving. Administrative Science Quarterly, 38, 4, 539–63.CrossRefGoogle Scholar
Kitwood, T. 1997. Dementia Reconsidered: The Person Comes First. Open University Press, Buckingham, UK.Google Scholar
Kralik, D., Koch, T. and Wotton, K. 1997. Engagement and detachment: understanding patients' experiences with nursing. Journal of Advanced Nursing, 26, 2, 399–407.Google Scholar
Lloyd, J., Schneider, J., Scales, K., Bailey, S. and Jones, R. 2011. In-group identity as an obstacle to effective multidisciplinary teamworking: findings from an ethnographic study of healthcare assistants in dementia care. Journal of Interprofessional Care, 25, 5, 345–51.Google Scholar
Maslach, C. and Leiter, M. 1997. The Truth about Burnout. Jossey-Bass, San Francisco.Google Scholar
Morse, J. M. 1991. Negotiating commitment and involvement in the nurse–patient relationship. Journal of Advanced Nursing, 16, 4, 455–68.Google Scholar
Noelker, L. and Ejaz, F. 2005. Training direct care workers for person centred care. Public Policy and Aging Report, 15, 4, 1–19.Google Scholar
Omdahl, B. L. and O'Donnell, C. 1999. Emotional contagion, empathic concern and communicative responsiveness as variables affecting nurses’ stress and occupational commitment. Journal of Advanced Nursing, 29, 6, 1351–9.Google Scholar
Quinn, M. and Tomita, S. 1997. Elder Abuse and Neglect: Causes, Diagnosis, and Intervention Strategies. Springer, New York.Google Scholar
Roberts, I. 1994. The health care assistant: professional supporter or budget necessity? International Journal of Health Care Quality Assurance, 7, 6, 20–5.Google Scholar
Scales, K., Bailey, S. and Lloyd, J. 2011. Separately and together: reflections on conducting a collaborative team ethnography in dementia care. Enquire, 6, 24–49.Google Scholar
Schaufeli, W. and Bakker, A. 2004. Job demands, job resources, and their relationship with burnout and engagement: a multi-sample study. Journal of Organizational Behavior, 25, 3, 293–315.CrossRefGoogle Scholar
Simpson, M. 2009. Engagement at work: a review of the litererature. International Journal of Nursing Studies, 46, 7, 1012–24.Google Scholar
Smith, P. 1992. The Emotional Labour of Nursing. Macmillan, London.CrossRefGoogle Scholar
Smith, P. and Lorentzon, M. 2005. Is emotional labour ethical? Nursing Ethics, 12, 6, 638–42.Google Scholar
Staden, H. 1998. Alertness to the needs of others: a study of the emotional labour of caring. Journal of Advanced Nursing, 27, 1, 147–56.CrossRefGoogle Scholar
Theodosius, C. 2008. Emotional Labour in Health Care: The Unmanaged Heart of Nursing. Routledge, Abingdon, UK.Google Scholar
Twigg, J. 2000. Carework as a form of bodywork. Ageing & Society, 20, 4, 389–411.Google Scholar