Care and the shadow of the fourth age: how does home care get caught up in it and how does it stay away from it?

Abstract

This article examines how care encounters at the elders’ homes are forged, and how the way these encounters are forged avoids or evokes the social imaginary of the fourth age. Data were gathered in Portugal from elders receiving home care (16 cases), their care workers (eight cases) and family carers (six cases), through participant observation and informal conversations (conducted at the elders’ homes), as well as focus groups. The collected data were analysed according to the procedures of Framework Analysis. This study found five forms of care encounters – marked by conflict, infantilisation, burden, harmony and indifference – the harmony form being the only one found to maintain the fourth age at a distance. It concludes that home care has a Janus-like nature in relation to the fourth age, and that the way home care encounters are forged depends on the conditions of the care settings and the actions of all participants in care encounters. It also concludes that it is difficult to maintain the social imaginary of the fourth age at a distance when the elders exhibit high levels of infirmity. Finally, it concludes that family carers play a crucial role in the way care encounters unfold. Implications for practice and policy include vocational training regarding the relational component of care, and information and educational programmes for family carers.

An exploration of the experiences of informal carers supporting a relative living with dementia during and after the move to technology-enriched supported accommodation

“…This care provider role was dynamically evolving, through provider and manager, into a single care manager modality, which was considered to continue post-transition. This is aligned to the emerging understanding of the complexity consistent within the caring role (Ryan and McKenna, 2015; São José, 2018). This change in the care-giving role was a natural transition that emerged from the need to support their loved one move into TESA and emerged from the ‘hitting the crisis point’ theme where ICs identified the provision of safety as a key issue.…”

“…Informal care-giving will generally have a relational dimension, and whilst often the spouse is the main carer, other family members often provide a significant contribution (McDonnell and Ryan, 2014). There are many stages to caring and indeed the nature and type of care varies depending on the needs of the person receiving the care (São José, 2018). Many studies have reported the negative impact of care-giving, particularly on those who care for people living with dementia who may experience clinical depression or anxiety or other less-severe psychological impacts (Cross et al, 2018; Ryan et al, 2018; Wang et al, 2018; Watson et al, 2018).…”

“…Other factors affecting care-givers are associated with the type of care provided. Archbold (1983) initially conceptualised care-giving into two types: care providers and care managers, however, this falls short of capturing the complexity of informal care/caring as described by São José (2018) who attempts to critique the empirical literature on this topic specifically for the fourth age (later life with care, associated with loss of agency and decay), highlighting the inherent complexity of caring.…”

Ask us! Adjusting experience‐based codesign to be responsive to people with intellectual disabilities, serious mental illness or older persons receiving support with independent living

“…EBCD often focuses on specific aspects or moments in service delivery that impact the experiences of service users. However, in long‐term care, the care relationship is central to the quality of care 7–10 . The focus of EBCD in these settings should thus be on the care relationship.…”

“…However, in long‐term care, the care relationship is central to the quality of care. 7 , 8 , 9 , 10 The focus of EBCD in these settings should thus be on the care relationship. This care relationship is complex as it is often laden with value tensions.…”