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

hard to come by, because quite frankly who wants a constant reminder of the ailments
and loss of autonomy that colour so much of the ageing process? Hence, most of the
sustained and meaningful interactions that arise, aside from family member visits, come
about from the relationship between a caregiver and a resident. The act of caregiving
itself is not just simple ‘bed and body work’ nor therapeutic companionship (although
this does occur), but rather ritual practice. There are boundaries to be erected and
upheld, and this happens as a function of what I will explain later on as ceremonial
discretion.
The Caregiving Dilemma
Before I turn to some ethnographic examples, a few comments regarding caregiving are
in order. Caregiving is becoming more prevalent as a form of service and wage labour in
places like the United Kingdom and the United States. As societies grapple with the
changing demographics of ageing and longevity, concerns regarding care for the elderly
are being pushed to the forefront of public debate. Yet despite the economics of it all, and
the concerns regarding how people can meet the rising costs of healthcare in late life,
caregiving as a job and social function remains undervalued. Moreover, whether in
hospitals or assisted living facilities, elders are frequently dehydrated and neglected.
Controversies and mishaps are commonplace, and while we recognize that the lack of
basic care is an affront to human compassion, the system continues.
Caregiving takes many shapes and forms. To begin with, informal caregivers consist of
family members and/or friends. Unlike their formal counterparts, they are typically not
trained, nor are they regulated or held accountable to institutional standards and codes
of conduct for the most part. 25 Formal caregivers on the other hand, are certified,
trained and work for organizations like a long-term care facility. They provide respite
and relieve informal caregivers of their duties for a few hours each day. Even part-time
hospice-workers who make house calls are regulated, trained, and can sometimes even
form labour unions. In either case, caregiving still conjures up a gendering of roles and is
25 The division between formal and informal caregiving as work is less straightforward.
Many formal caregivers started off first as informal caregivers. Additionally, informal
caregiving is becoming more visible (in the political economy) now that is has a
professional equivalent.
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