Philip Y. Kao PhD thesis - Research@StAndrews:FullText

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ACRONYMS Activities of Daily Living (ADLs) Bowel Movement (BM) Centre for Health and Rehabilitation (CHR). Certified Nursing Assistant (CNA) Certified Therapeutic Recreation Specialist (CTRS) Civil Rights of Institutionalized Persons Act (CRIPA) Clostridium Difficile (C.Diff) Continuing Care Retirement Community (CCRC) General Practitioner (GP) Health Insurance Portability and Accountability Act (HIPPA) Mini-Mental State Examination (MMSE) LPN (licensed practical nurse) Long-term Care Facilities (LTCs) Medical Technician (med tech) National Public Radio (NPR) Nursing Home Reform Act (NHRA) Obsessive-Compulsive Disorder (OCD) Position Description (PD) Skilled Nursing Facility (SNF) United States of America (US) US Department of Housing and Urban Development (HUD)
TABLE OF CONTENTS Introduction .................................................................................................................................... 13 i) Ageing and an Anthropology of What ..................................................................................... 13 ii) What is a Continuing Care Retirement Community (CCRC)? .......................................... 19 iii) Methodology .................................................................................................................................... 25 Part 1 ................................................................................................................................................. 34 Chapter 1: Tacoma Pastures: The Past and Present of a CCRC ................................................ 34 Chapter 2: The Accidental Caregiver ................................................................................................ 47 Ryan .......................................................................................................................................................................... 60 Chapter 3: Memory Care: Tales from the 3 rd floor ....................................................................... 68 The 3 rd Floor Layout ........................................................................................................................................... 73 Susan ........................................................................................................................................................................ 78 Anita ......................................................................................................................................................................... 80 Eve and Kent ......................................................................................................................................................... 82 Adorna and Brad ................................................................................................................................................. 86 Chapter 4: Independent Plus: Care on the 4 th Floor .................................................................... 91 The 4 th Floor Layout ........................................................................................................................................... 94 Heather .................................................................................................................................................................. 104 Teri .......................................................................................................................................................................... 107 Lana ........................................................................................................................................................................ 109 Part 2 .............................................................................................................................................. 113 Chapter 5: A Long Way From My Infant Needs: Performances for the Self in Acts of Formal Caregiving ................................................................................................................................ 113 The Caregiving Dilemma ................................................................................................................................ 114 Melanie .................................................................................................................................................................. 118 Gina ......................................................................................................................................................................... 121 Betsy ....................................................................................................................................................................... 124 Conclusion ............................................................................................................................................................ 128 Chapter 6: The Exigency of Care: Caught up in the Transitions of a CCRC ........................ 129 Betty ....................................................................................................................................................................... 131 Mary ........................................................................................................................................................................ 134 Conclusion ............................................................................................................................................................ 140 Chapter 7: When Frost Happens in the Garden: Person-Centred Care and the Eden Alternative............................................................................................................................................... 142 Fred: The Care Receiver ................................................................................................................................. 152 Conclusion ............................................................................................................................................................ 154 Chapter 8: A Home Away From Home: The Antinomies of Caregiving and Kinship ..... 158 A Tale of Two Long-term Care Facilities ................................................................................................. 161 Grandma’s Place ................................................................................................................................................ 162
Page 1 and 2: THE VICTIMS OF A SORTED LIFE : AGEI
Page 4 and 5: THE VICTIMS OF A SORTED LIFE: CAREG
Page 6 and 7: “In the animal kingdom, the rule
Page 8 and 9: ACKNOWLEDGEMENTS Many people have e
Page 12 and 13: The Tacoma Pastures Family ........
Page 14 and 15: Introduction i) Ageing and an Anthr
Page 16 and 17: the one hand we have the shifting p
Page 18 and 19: social relations among residents, s
Page 20 and 21: abyss that caregivers are confronte
Page 22 and 23: ased; other sponsors such as univer
Page 24 and 25: especially in light of the period
Page 26 and 27: a frozen liminality, “a sphere of
Page 28 and 29: nature of social relations. I was c
Page 30 and 31: esidents, and to abide by the gover
Page 32 and 33: order and tension that obtains betw
Page 34 and 35: offer palliation and there is a gen
Page 36 and 37: esidents for one-day plane trips to
Page 38 and 39: seriously think about.” 11 Early
Page 40 and 41: their desire to effect a plan under
Page 42 and 43: floors 1, 2, 4, and 5; 2) Personal
Page 44 and 45: chaotic back then.” I was told to
Page 46 and 47: the third floor is electronically l
Page 48 and 49: Chapter 2: The Accidental Caregiver
Page 50 and 51: transfer residents out of beds and
Page 52 and 53: on the third floor in Memory Care,
Page 54 and 55: On the second day, Nathan took me a
Page 56 and 57: Jennifer was doing so-so. He said,
Page 58 and 59: was from, even though I had just an
Page 60 and 61:
affect; the balloon could be launch
Page 62 and 63:
eminded me of a 1960s hospital room
Page 64 and 65:
Ryan began complaining more about h
Page 66 and 67:
know if you are working for someone
Page 68 and 69:
in old age, especially when they al
Page 70 and 71:
translation. 19 What follows is an
Page 72 and 73:
class by telling us that dementia i
Page 74 and 75:
The 3 rd Floor Layout Many CCRCs, i
Page 76 and 77:
ested in between their tasks at thi
Page 78 and 79:
sofa, others will simply give her a
Page 80 and 81:
morning, the med tech and the careg
Page 82 and 83:
caregivers to try their best to go
Page 84 and 85:
could still communicate with me in
Page 86 and 87:
In the two weeks that followed, Ken
Page 88 and 89:
the trips that she remembered fondl
Page 90 and 91:
Pastures received this. For now, it
Page 92 and 93:
Chapter 4: Independent Plus: Care o
Page 94 and 95:
Although the fifth floor is an “i
Page 96 and 97:
the fourth floor did not need much
Page 98 and 99:
main floor next to the spacious for
Page 100 and 101:
grapple with mechanical E-Z stands
Page 102 and 103:
Grant was not the only person who c
Page 104 and 105:
The situation involving these three
Page 106 and 107:
Brendan escorted me into Heather’
Page 108 and 109:
Teri Teri was a resident in the sam
Page 110 and 111:
Lana Lana lived next door to Teri a
Page 112 and 113:
on other residents, but for some re
Page 114 and 115:
Part 2 Chapter 5: A Long Way From M
Page 116 and 117:
largely associated with the domain
Page 118 and 119:
into Žižek’s ticklish borders b
Page 120 and 121:
“Thanks.” I go into the back of
Page 122 and 123:
insurmountable abyss. The silence w
Page 124 and 125:
had to bring the wheelchair over, c
Page 126 and 127:
drawn out process involving a mixtu
Page 128 and 129:
* * * Betsy and I were subject to T
Page 130 and 131:
Chapter 6: The Exigency of Care: Ca
Page 132 and 133:
Betty When I first met Betty, she w
Page 134 and 135:
Sometimes the caregivers were succe
Page 136 and 137:
company. The CHR is licensed differ
Page 138 and 139:
said, slightly solemnly: “Hi.”
Page 140 and 141:
Tacoma Pastures and into hospice. F
Page 142 and 143:
Looking out into the setting sun fr
Page 144 and 145:
control, over the bodies and action
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Figure 12 An Eden plaque At Tacoma
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way to community. The main dining r
Page 150 and 151:
They cannot just be a passive board
Page 152 and 153:
hearing the director go on about cr
Page 154 and 155:
golf flat-cap, and behind his squar
Page 156 and 157:
This chapter has been motivated by
Page 158 and 159:
complex and generative space openin
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family represents where one comes f
Page 162 and 163:
just down the road from Tacoma Past
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link fence of post-industrial subur
Page 166 and 167:
The young woman came back after adm
Page 168 and 169:
as she made the rounds on the third
Page 170 and 171:
I decided to confront Sylvia about
Page 172 and 173:
* * * Mistakes were made in the fie
Page 174 and 175:
work. If care is inevitably and hum
Page 176 and 177:
was being uttered in their negative
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an X-ray, and that we could issue a
Page 180 and 181:
parental responsibilities and care
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caregivers and care recipients? Doe
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was not a structure or discourse th
Page 186 and 187:
and McKechnie 1999, 1). Furthermore
Page 188 and 189:
extending the period of training fo
Page 190 and 191:
It will be useful now to venture in
Page 192 and 193:
y taking up oneself in real duratio
Page 194 and 195:
organisation of a CCRC for example,
Page 196 and 197:
Furthermore, the post-Cartesian min
Page 198 and 199:
Pastures when it is institutionalis
Page 200 and 201:
Appendix Ethics Form 199
Page 202 and 203:
A Room with No View In the corner r
Page 204 and 205:
A Blue-Gray Raga Some places the sm
Page 206 and 207:
Diamond, T. Making Grey Gold: Narra
Page 208 and 209:
Hummert, Mary Lee Nussbaum Jon F. "
Page 210 and 211:
Nouwen, H. and Gaffney, W. Aging: T
Page 212:
Williams, Allison. "Therapeutic Lan
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