Power, empowerment, and person-centred care: using ethnography to examine the everyday practice of unregistered dementia care staff.
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Abstract |
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The social positioning and treatment of persons with dementia reflects dominant biomedical discourses of progressive and inevitable loss of insight, capacity, and personality. Proponents of person-centred care, by contrast, suggest that such loss can be mitigated within environments that preserve rather than undermine personhood. In formal organisational settings, person-centred approaches place particular responsibility on 'empowered' direct-care staff to translate these principles into practice. These staff provide the majority of hands-on care, but with limited training, recognition, or remuneration. Working within a Foucauldian understanding of power, this paper examines the complex ways that dementia care staff engage with their own 'dis/empowerment' in everyday practice. The findings, which are drawn from ethnographic studies of three National Health Service (NHS) wards and one private care home in England, are presented as a narrative exploration of carers' general experience of powerlessness, their inversion of this marginalised subject positioning, and the related possibilities for action. The paper concludes with a discussion of how Foucault's understanding of power may help define and enhance efforts to empower direct-care staff to provide person-centred care in formal dementia care settings. |
Year of Publication |
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2017
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Journal |
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Sociology of health & illness
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Volume |
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39
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Issue |
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2
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Number of Pages |
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227-243
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ISSN Number |
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0141-9889
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URL |
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https://doi.org/10.1111/1467-9566.12524
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DOI |
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10.1111/1467-9566.12524
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Short Title |
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Sociol Health Illn
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