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Power, empowerment, and person-centred care: using ethnography to examine the everyday practice of unregistered dementia care staff

Scales, Kezia, Bailey, Simon, Middleton, Joanne, Schneider, Justine (2017) Power, empowerment, and person-centred care: using ethnography to examine the everyday practice of unregistered dementia care staff. Sociology of Health & Illness, 39 (2). pp. 227-243. ISSN 0141-9889. E-ISSN 1467-9566. (doi:10.1111/1467-9566.12524) (KAR id:75379)

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https://dx.doi.org/10.1111/1467-9566.12524

Abstract

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.

Item Type: Article
DOI/Identification number: 10.1111/1467-9566.12524
Uncontrolled keywords: dementia, person-centred care, Foucault, power, ethnography
Subjects: H Social Sciences
Divisions: Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Centre for Health Services Studies
Depositing User: Meg Dampier
Date Deposited: 16 Jul 2019 14:14 UTC
Last Modified: 21 Mar 2020 04:11 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/75379 (The current URI for this page, for reference purposes)
Bailey, Simon: https://orcid.org/0000-0001-9142-2791
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