Dispensing care?: The dosette box and the status of low‐fi technologies within older people’s end‐of‐life caregiving practices

Abstract

Technology has been lauded as a solution to range of challenges presented by ageing population internationally. While the lion‐share of scholarship has focussed on high‐fi, digital technologies, there has been a recent shift to exploring the contributions mundane, low‐fi technologies make to older people's daily lives and our understandings of health, illness and care more broadly. Drawing from serial narrative interview data collected with 19 married couples aged 70 and over living in the U.K., this article explores the way one medical technology—the dosette box—was taken‐up and deployed in their end‐of‐life caring process. Informed by actor–network theory and critical feminist scholarship, this article considers how the dosette box played an active role in structuring relationships, scheduling daily care activities and enforcing medical compliance. In doing so, we suggest that the dosette box provided an unexpected companion and ‘weapon of the weak’ for older partner's attempting to assert their expertise and power while caring. We also explore how the dosette box demanded an even higher level of regular, vital care from older partner's once introduced into the home, thus entrenching the physical and emotional demands of dispensing care.

Dosing practices made mundane: Enacting HIV pre‐exposure prophylaxis adherence in domestic routines

“…Evolving and variable situations demanded not only routine and planning but also experimentation, with dosing emerging as a practice of coordination in which things come together to capacitate PrEP to work (or not work so well). Many of the aspects of medication use, we analysed are mundane and less attended to in medical discourse (Buse et al., 2018; Michael, 2003; Morgan et al., 2022). However, it is the quotidian aspects of these socially, materially and temporally mediated practices that provides insight into how interventions are made to work in practice, sometimes in unexpected ways (Rhodes & Lancaster, 2019).…”

“…As they point out, there is a danger in habits becoming too ‘automatic’ and ‘unmemorable’ because their absence may be unnoticed. The maintenance of a range of objects and routines therefore must be continuously negotiated in subtle and largely domestic and mundane ways (Buse et al., 2018; Morgan et al., 2022; Rosenfeld & Weinberg, 2012).…”

“…Fieldnotes informed regular team meetings and guided the direction of subsequent interviews and the conceptualisation of data. For example, the richness of participants’ accounts of different pill taking practices and routines led the team to explore these practices further in subsequent interviews and to review theoretical thinking on mundane objects (Buse et al., 2018; Michael, 2003; Morgan et al., 2022) and the materiality of pharmaceuticals in the home (Dew et al., 2014; Rosenfeld & Weinberg, 2012). As data generation finished, A.S. (re)listened to interviews and read the transcripts multiple times, with the aim of identifying extracts related to routines, planning and the materiality and embodiment of PrEP.…”

“…Dosing involves ongoing and processual adaptations to the variabilities of everyday life, including building and sustaining practices and managing disruptions to routines and space (McCoy, 2009; Race & Wakeford, 2000). Mundane household objects also serve to coordinate dosing—for example, the dosette (pill) box is a central mundane object in the coordination of end‐of‐life care (Morgan et al., 2022). Upon first use, medications themselves can be exotic but often recede into the background of everyday life (Race & Wakeford, 2000).…”

Yonder: Drunkorexia, dosette boxes, doctor shopping, and slums

“…Amidst this focus on digital interventions, there has been a parallel interest in exploring the contributions of more mundane technologies that can nonetheless make important differences to their daily lives. 2 Drawing on serial narrative interview data collected with married couples aged 70 and over living in the UK, a recent article explored the way one medical technology -the dosette box -was taken up and deployed in their end-of-life caring process. 2 The authors suggest that the dosette box can provide an unexpected companion and 'weapon of the weak' for older partners attempting to assert their expertise and power while caring.…”