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

More documents

Recommendations

Info

social relations among residents, staff, and their families, I will be addressing salient aspects of American culture, and how persons in American society understand relationships and themselves. These negotiations between understandings and instantiations of autonomy, independence and dependence constitute human development regardless of age or life stage. Toren's phenomenological approach to the “mind as a function of the whole person constituted over time in intersubjective relations with other in the environing world” is a good way to understand how people construe themselves as socially meaningful persons in relation to one another (Toren 2002, 193). I take the American idiomatic expressions and tensions surrounding independence and dependence as a dialectic in this intersubjective approach to personhood and sociality. Myerhoff and Simic state that ageing is work; in fact a life's career (Myerhoff and Simic 1978). Self-care is part of it, but also what occurs is the way we engage ourselves in relations based on our perceptions of independence and dependence. If the way we engage others is part of our own becoming, then issues of independence and dependence, as culturally inflected, play a role in structuring who we are (becoming). Ultimately the concern here is with persons and relations in and through time, and how issues of independence and dependence play out and influence the nature of social relations and the experience of life and ageing. What is also interesting is a consideration of the caregiving relationship between particular people, and the relationship as a structural feature developing out of a wider social, economic, and historical context. My interest in ageing has to do partly with the industry and practice of caregiving and what this says about our social and emotional linkages to one another. This is not to say that I am interested in how people are (or are not) culturally obligated to take care of the sick or elderly. Rather, it is the intimate and corporeal relationship that unfolds between a caregiver and a care-receiver that illuminates what it means to be independent/dependent, whole/broken, and social in specific contexts. Caregiving then is never neutral; i.e. it can sometimes stand in as a metaphor for an assertion of (bio)power. I once heard a female caregiver in a nursing home confront a nurse about a particular resident. The certified nursing assistant (CNA) was trying to convince the nurse that ‘her’ resident was acting up and needed some medical attention. After the nurse neglected to pursue any follow up, the CNA walked away noting sarcastically, “Well what do I know? After all I am just the caregiver! I am 17
with her Monday through Friday” In other contexts, caregiving can be operationalized to assert a type of labour identification and experience. Caregivers often say to themselves that, “Not everyone can be a caregiver. It takes passion; you have to like taking care of people. Not everyone is cut out that way.” In that same conversation, another caregiver said, “It is an impossible job. Doing everything is still not enough!” In caregiving, the emotional dimension is far more complex than the sheer physical task of transferring someone out of bed, brushing their teeth, and getting them to various appointments while making sure that they are ‘toileted’ every two hours. In fact, caregivers themselves have developed a form of dependency as well. I overheard several times that, “If it wasn’t for my residents, I would have quit a long time ago.” There is a creeping suspicion (on my part) that caregivers need their residents just as much as the residents need them. The caregiving industry can be analysed as a set of structural relationships, developing out of a wider social, economic, and historical context. Traditional nursing homes are being replaced by the sprawl of assisted living communities, Continuing Care Retirement Communities and other long-term care facilities. Carder and McLean have turned their attention to new spaces such as the world of assisted living facilities and the Green House Project—which is a spatial concept spawned from the Eden Alternative for designing more personal and homier nursing homes (Carder 2003, McLean 2006). For one thing, Continuing Care Retirement Communities incorporate many services and long-term care facilities and services in one location. The resident who transitions from an independent condominium to a unit which has more surveillance and nursing staff provides an interesting segue to explore how spatial organizations reinforce and reproduce practices, perceptions and relations of independence and dependence. The sterile nursing homes of the past will have nothing to do with the changing attitudes of the baby-boomers. They have witnessed the institutionalisation of their parents, and they will no doubt advocate for spaces of dignified living, new criteria for care, and new incarnations of home and kinship. For the formal caregivers, who comprise of a diverse work force, including pre-med and nursing students, and recent immigrants, the burdens on and expectations of them are immense. One of the underlying challenges remains: how much can we know about ageing, dementia and impairment if we do not actually experience these life transformations ourselves? It is this epistemological 18
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 10 and 11: ACRONYMS Activities of Daily Living
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 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
Page 146 and 147:
Figure 12 An Eden plaque At Tacoma
Page 148 and 149:
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
Page 160 and 161:
family represents where one comes f
Page 162 and 163:
just down the road from Tacoma Past
Page 164 and 165:
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
Page 178 and 179:
an X-ray, and that we could issue a
Page 180 and 181:
parental responsibilities and care
Page 182 and 183:
caregivers and care recipients? Doe
Page 184 and 185:
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
show all

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

Create successful ePaper yourself

Delete template?

Save as template?