From Carers to Trainers: Professional Identity and Body Work in Rehabilitative Eldercare

Abstract

This article explores how a nationwide reform initiative, calling for a rehabilitative, activating and 'training' approach to elderly people in Danish homecare services, may transform gendered and embodied conceptions of 'the professional care worker'. Care work for the elderly is a low-paid and low-status occupation, affected by the stigma connected with elderly bodies. Drawing on an ethnographic case study of a homecare unit, this article shows how the adoption of a new distanced, goal-oriented approach to elderly bodies attempts to transform professional identities, and how care work is constructed as reflexive and change oriented, in contrast to emotional and relational approaches. This transformation potentially leads to a more advantageous position for care workers in gendered professional hierarchies. Simultaneously this process seems to render care workers' own bodies more visible, problematizing what are perceived as uncontrolled and unhealthy care worker bodies. The article thus argues that rehabilitative eldercare leads to an intertwining of two forms of bodywork, where work on the care worker's own body and the elderly body mutually constitute each other in a novel body-body articulation.

What constitutes ‘good care’ and ‘good carers’? The normative implications of introducing reablement in Danish home care

“…In this way, reablement is constructed as a dismissal of the previous ‘harmful’ care practices. This is consistent with previous studies demonstrating how reablement entails a devaluation of compensatory care as being a form of ‘mothering’ (Meldgaard Hansen & Kamp, ), only valid as a fall‐back option when reablement is not possible (Dahl, Eskelinen, & Hansen, ). This demonstrates how the normativity pertaining to reablement does not only designate certain care practices as ‘good’, but does so by simultaneously designating other forms of care as ‘bad’.…”

“…As populations worldwide are ageing, Western welfare states are currently implementing welfare reforms aimed at curbing the rising need for social and healthcare services for the ageing population. A central element in home‐care reforms in several welfare countries, including England (Wilde & Glendinning, ), Sweden (Randström, Wengler, Asplund, & Svedlund, ), Norway (Birkeland, Tuntland, Førland, Jakobsen, & Langeland, ) and Denmark (Meldgaard Hansen & Kamp, ), is reablement (also known by other terms including restorative care, enabling care, everyday rehabilitation and home rehabilitation). Reablement refers to short‐term home‐based training programmes aimed at re‐enabling older people to live in their own homes independently of care for as long as possible (Aspinal, Glasby, Rostgaard, Tuntland, & Westendorp, ).…”

“…These studies generally find that professionals appreciate the focus on older people's goals and resources as well as the interdisciplinary collaboration (Birkeland et al, ; Hjelle, Skutle, Førland, & Alvsvåg, ; Randström et al, ). Other studies, however, have shown that home helpers find it difficult to adapt to working as ‘trainers’ or ‘coaches’ (Jensen & Muhr, ; Meldgaard Hansen & Kamp, ; Rabiee & Glendinning, ). These challenges, however, are generally seen to be solvable through organisational adaptions, such as professional training or improved recording systems (Rabiee & Glendinning, ), or by providing interdisciplinary reablement teams with common meeting times and places (Hjelle et al, ).…”

Brugerinddragelse – ny professionalisme ognye omsorgsrum?

“…Relationelle, emotionelle og sundhedspaedagogiske vidensformer indgår som nye elementer i fagligheden og kommer til at spille en stor rolle i den professionalisme, der praktiseres. Der opstår også nye professionelle områder -en paedagogisering af fagligheden, som når kompetencer i motivation og coaching traeder i forgrunden (se fx Meldgaard Hansen & Kamp, 2016;Mik-Meyer og Jär-vinen 2012). Der er imidlertid ofte tale om uklare og svaert afgraenselige faglige områder, og det kan betyde, at der opstår mange tavse og usynlige dele af det professionelle arbejde (Suchman, 1995).…”

“…Metoderne spaender fra snaevert medicinsk informeret undervisning af brugerne i selvbehandling til forsøg på rehabilitering med udgangspunkt i kronikerne og deres hverdagsliv og livsstil. Sundhedspaedagogiske tilgange spiller derfor en vigtig rolle i de professionelles arbejde (Christensen & Fluge, 2016;Meldgaard Hansen & Kamp, 2016).…”