Ways of Home Making in Care for Later Life

Bernike Pasveer, Oddgeir Synnes, Ingunn Moser, Bernike Pasveer, Oddgeir Synnes, Ingunn Moser

• Publisher: Palgrave Macmillan
• Year: 2020
• Print ISBN:
  9789811504051
• eBook ISBN:
  9789811504068
• Topic: Social Sciences
• Subtopic: Anthropology
• Index: Social Sciences

This is a book on how home is made when care enters the lives of people as they grow old at home or in 'homely' institutions. Throughout the book, contributors show how home is a verb: it is something people do. Home is thus always in the making, temporal, contested, and open to negotiation and experimentation. By bringing together approaches from STS, anthropology, health humanities and health care studies, the book points to the importance of people's tinkerings and experiments with making home, as it is here that home is being made and unmade.

© The Author(s) 2020

B. Pasveer et al. (eds.)Ways of Home Making in Care for Later LifeHealth, Technology and Societyhttps://doi.org/10.1007/978-981-15-0406-8_1

Begin Abstract

1. Doing Home with Care in Ageing Societies

Bernike Pasveer¹ , Oddgeir Synnes² and Ingunn Moser³

(1)

Department of Society Studies, Maastricht University, Maastricht, The Netherlands

(2)

Centre of Diaconia and Professional Practice, VID Specialized University, Oslo, Norway

(3)

Faculty of Health Studies, VID Specialized University, Oslo, Norway

Bernike Pasveer (Corresponding author)

Email: [email protected]

Oddgeir Synnes

Email: [email protected]

Ingunn Moser

Email: [email protected]

End Abstract

Home as a Noun

‘Old age has its infirmities’, or so the saying goes. This is a book about what happens to ‘home’ when its defaults—its unquestioned, standard settings—are being disrupted by infirmities: ageing, frailty, dementia and dying. Of course, whether and how ageing disrupts default ways of living is not a universal given. This book takes issue with Western policies and desires in light of what is cast as the ‘problem’ of ageing societies, here defined as a twofold crisis: of a rapidly ageing population and of a resulting care deficit, both quantitative and qualitative. Ageing thus seems to disrupt home as it exceeds its ‘normal’ capacities for caring, and it disrupts care as it exceeds available care provisions. We do not think of homes as places without care until ill health enters. Rather, when we see care as the work of ‘holding together that which does not necessarily hold together’ (Law 2010: 69), home and care are always and already intrinsically intertwined (Barnes et al. 2015; Tronto 2013). But, when understood as the more or less skilled work necessitated by (ill) health, health care has only quite recently become a publicly acknowledged responsibility of welfare societies, and a multitude of care institutions have been erected over the past sixty years or so, thus concentrating care away from home and from connotations with home. Much more recent is a shift back to home, family and community: we are to age in place (see Callahan 2018; Duyvendak 2011; Jacobsen, Chap. 5, this volume).

As part of this latter shift, but also as a relief and a solution to the alleged crisis of ageing, ‘home’ is now increasingly being forwarded in policies, public discourse, academia and in the expressions of ageing people themselves as the place to grow old in and die. Home as a place of care connotates cost-effectiveness, the informalization of care and a plethora of normative ideals about ageing well, despite and with its frailties: independence and autonomy, control, productivity, proximity and familiarity.

Yet low cost often comes at a high price: it is largely women and (illegal) migrants who do most of the informal care work at home (see Bettio et al. 2006; Dalmer 2019; Lutz 2008). Policies aimed at making formal care work cost-effective and operating along market logic, tend to imply charged and burdened care, despite the good intentions of care providers. At the same time, the struggle to maximally informalize care work still comes with state interventions behind people’s front doors (Duyvendak 2011). Nevertheless, home is promoted as the preferred place to be when growing old and frail, living with dementia and dying. Only when home cannot provide any longer do care institutions come into view. However, these too must now aspire to be ‘homely’ and provide home with care to their residents.

It is relevant to note that the apparent coalition of formal policies and people’s desire for ageing-in-place¹ scenarios do not come from a complete like-mindedness between them. Quite likely, policies express compromises between concerns about costs and governmentability, care needs and critiques of health-care systems, while people may desire home over large, total care institutions governed by bureaucracy and efficiency. It is just as relevant to note that the care landscape is not universally shaped by this crisis, and ageing-in-place is not the singular referent of the stories in this book. The landscape of health-care systems, schemes, solutions and histories in which age is articulated as problematic is still very diverse, and ageing still takes on different forms.

Yet a common and fundamental assumption within the ageing-in-place discourse is that home is always somehow available as a singular, given location that naturally affords the inhabitant to live and age well (i.e. independently, healthily, productively, etc.). Home seems to always be a noun. Of course, this home does not always actually exist. In the contexts of migration and transnational kinning, as well as when home is lost due to dementia, home as a singular place is very literally not available (any more). And home—even if singular and in place—does not in and of itself afford living well and being ‘at home’, as Douglas (1991) has so forcefully shown. ‘Home starts with bringing some space under control’ (289, emphasis ours), she writes, and its orderings may be blissful as well as with ‘laughably complex, tyrannical rules, unpredictably waived and unpredictably honored, and never quite amenable to rational justification’ (298).

This book aspires to unlock home and look at the work it always takes to make home when home intersects with new forms or modes of care because of ageing. We treat what happens to home when care is needed in a double sense: as experienced and done in practice when someone’s age brings about the need for rearrangements involving care (including moving to ‘homely’ care institutions), and as breaching experiments (Garfinkel 1967): as instances and processes in which things considered normal, default, just there, are being foregrounded. This foregrounding helps us understand the fragile nature of the orderings called home. They allow us to unravel the mystery of making home with care for later life.

Home as a Verb

This book argues for the need to understand home and how it intersects with care in later life as a making. We treat the intersections with care as moments or processes that call for articulations of what it takes to do home with care, care with home. We regard home as a verb (Blunt and Dowling 2006; Mallett 2004). Home making always requires relations and arrangements between very different actors: older persons, care workers, family members, stairs, walkers, wheelchairs, spaces, policies and health-care systems. Whether and how home emerges from and in these practices can never be taken for granted. Emphasizing the work that goes into home in care as making allows us to underline any eventual achievement of home with care as temporal, partial and unfinished. We hope to show how such a dynamic understanding of home brings to our attention the precariousness, the tensions and dilemmas and the possible uncanniness of home and home making in later-life care. But by looking at what appears as (im)possible in practice, we also hope to create leeway and alternatives for those involved in the dynamics of making home with care in later life. We think that such an understanding of the intersections of home and care is timely given the desires and policies for ageing-in-place, their problematic fixation on the placeness of home and care, and the often unachievable normativities of ageing. By treating ‘home’ as a verb instead of a noun, as made not given, we open up new understandings of care work and home work as productive, surprising and ways of world making (with a partial reference to Goodman 1978).

Where attempts to look into home making that unpack or unbracket the assumptions that go into its practices are scarce, interdisciplinary approaches are even more so. In addition, much of the work that focuses on home when looking at care tends to take for granted what it is that people desire when they choose to ‘die at home’ or ‘stay at home as long as possible’. Moreover, studies of home with care are scattered over a range of academic fields that do not necessarily intersect. Still, this book is not the first attempt at unravelling the mystery of home as it intersects with care in elderly life, and we aspire to join and constructively add to a growing body of critical ageing studies in gerontology, geography, anthropology, narrative medicine, care research, science and technology studies and other humanities and social science disciplines.

An important strand of research on ageing, home and care focuses on what home comes to mean or represent when it accommodates ageing (and care). For example, Rowles and Chaudhury (2005) examine how home acquires different meanings in different (trans)national contexts and look into the importance of home as a provider of contexts to life ‘experience, recollections, imaginations, and aspirations’ (3) and ‘the meaning of home to elders’ (4). Although undoubtedly an important element of practices of making home in care for elderly life and also figuring in some of the analyses in this book, home itself often appears here still as a referent to other kinds of doing such as identity work and belonging (see also Rowles and Bernard 2013; Anderson et al. 2018). Other work, notably in science and technology studies, anthropology and human geography, focuses on the materialities of doing home in care (Schillmeier and Heinlein 2009; Lopéz 2015), on how proposals and prescriptions of how to do home and/or care are built into the very designs of buildings (Buse et al. 2017) and their interiors (Lovatt 2018) and on the shifting arrangements that emerge when care technologies are brought into the home or are used to provide care from a distance (Pols 2012).

What all these studies have somehow in common, and to which this volume desires to add, comes close to what Mallett (2004)² concluded from her analysis of home as represented in the conceptual and empirical literature, namely that home ‘all depends’ (84), that it is ‘a verb rather than a noun, and not necessarily bounded by a physical location’ (79).

This book moves forward with the idea of verbing home and in focusing on home making in care for later life, we like to forward an understanding of home making as about things not given—as temporal and partial, not lasting and encompassing. As experimental, not fixed, as forever unfinished and thus open to new possibilities of making careful arrangements. With qualities that may, when opened up, bring forth helpful insights and inspirations for all who care.

The thirteen chapters that follow address a range of geo-political contexts, and the authorship covers a multitude of disciplines: science and technology studies, narrative medicine, (medical) anthropology, nursing studies, philosophy, psychology, sociology, and migration studies. And with this multitude comes an array of qualitative methodologies and data elicited and used: from (auto)-ethnographic work to document analysis, and from interviews to poetry and storytelling. Through this, and with use of the book’s specific ordering, we hope to forward an interdisciplinary approach to the study of home in care for later life.

Opening Up the Book

A book that proposes and proceeds to analyse home in care for later life as a verb can be ordered in many ways. The decision to order the contributions according to a logic of moving imaginaries, negotiati...

Table of contents

• Cover
• Front Matter
• 1. Doing Home with Care in Ageing Societies
• Part I. Moving Imaginaries
• Part II. Negotiating Institutions
• Part III. Shifting Arrangements