Landscapes of care

Abstract

The term ‘landscapes of care’ has increasingly taken hold in the lexicon of health geography. As the complex social, embodied and organizational spatialities that emerge from and through relationships of care, landscapes of care open up spaces that enable us to unpack how differing bodies of geographical work might be thought of in relationship to each other. Specifically, we explore the relation between ‘proximity’ and ‘distance’ and caring for and about. In doing so, we seek to disrupt notions of proximity as straightforward geographical closeness, maintaining that even at a physical distance care can be socially and emotionally proximate.

The problems of a ‘dirty workplace’ in domiciliary care

“…Older people may move repeatedly between these various spaces, and Milligan and Wiles (2010) highlight that care is shaped by the place (or 'landscape' to use their term) in which it is performed. Undeniably the place of care is of vital importance for older people, as they are likely to reside there for substantially longer than other parties.…”

“…Undeniably the place of care is of vital importance for older people, as they are likely to reside there for substantially longer than other parties. Thus any problems, such as an unsuitable care-space, are magnified particularly if the older person does not have the resources to change their place of care (for excellent coverage of the issues older people face in their care 'landscape' see McKeever et al 2006, Milligan 2009, Milligan and Wiles 2010. All of these issues deserve greater attention, but were not the subject of this paper.…”

对就地养老的反思——“人”与“地方”关系视角①

“…The term'landscapes of care'has arisen from, and is frequently employed by geographers, to encapsulate these networked dynamics of care. Milligan et al(2010) articulate landscapes of care more generally to be the (sometimes new) spatialities that arise from relationships of care, which traverse the body to the organisational level and include for instance care settings such as hospitals, homes, hospices, daycare centres, homeless shelters and retirement villages. For Barrett, Hale et al(2012) the provision of formal health and social care is an enabling element of ageing in place.…”

“…This breadth of care practices means that people are continually entangled within multiple, interconnected'caring'relationships across space (Pile, 2010). For example, Milligan et al(2010) argue that physical proximity is not a prerequisite for care to happen and offer the example of adult children who live overseas from their ageing parent(s) but maintain daily contact and are involved in arranging, and monitoring, formal caregiving from afar. Atkinson et al (2011) also conceptualise care as having a greater impact beyond individuals themselves through their ability to influence not only emotions and personal resource flows but also as an economic resource which flows from the local to the global level affecting the movement of people, labour and capital.…”

“…安 排 的 必 要 性 (Milligan, 2003;Wiles 2003a;Bowlby, 2012)； 亲属和非亲属关系在家庭中该如何(重 新) 协 调 (Lapierre et al, 2013;Pickard, 2015;Wiles, 2003b)； 对公共和私人边界的侵犯 (Parr, 2003) (Peace et al, 2006)。对家庭和邻里 的开放性解释在环境老年学得到公认， 并且开始获 得学者们广泛的关注 (Lawton, 1985;Rowles, 1978;Wahl et al, 2003)。 例 如 ，Hillcoat-Nallétamby 等 (2014)发现， 就地养老的综合方法应由家庭和社区 共同实施； 还应从整体上考虑家-社区两者相互作 用形成的心理-社会环境对老年人生活质量产生 的影响。他们发现， 老年人留在原居所或搬迁的决 心， "可能更多地是由其对 "人" ， 而不是对 "地方" 的 依恋所决定的" (Hillcoat-Nallétamby et al, 2014 (Kearns et al, 2005)。因此在有关老龄化的官方话语中， 充斥着 "要用有限的资源来充分支撑巨大的社会和保健需 求 及 其 产 生 的 相 关 费 用 "的 假 设 )。在此背景下， 虽然社区或居家养老的理念 值得称道， 但这种地理上分散的照护模式下要实现 标 准 统 一 的 照 护 可 能 会 非 常 昂 贵 (Andrews et al, 2002;Milligan, 2000 (Power, 2010;Wiles, 2011)。也许， 一个可用于解释老年人 之间的相互依存关系而不是照护供给关系的模式 将更具建设性 (Power, 2010;Atkinson et al, 2011)。 走向衰老的身体始终处于照护关系组成的网 络中， 而不是表征公共健康政策合理性和责任感的 由一系列事件组成的线性链上 (Evans et al, 2011)。 大多数有关照护的地理学研究(尤其是有关老龄化) 文献， 都将 "照护" 视为一种 "关心" 的感觉， 和 "照 顾 " 的 相 关 行 动 (Conradson, 2003;England et al, 2011;Bowlby, 2012) (Wiles, 2003a;Dyck et al, 2005;Barrett et al, 2012)。同样地， 家庭也不应该被 视为对老年人进行照护的所谓 "新" 地点， 因为在家 庭里各种照护是一直存在的。在家庭中已存在的 照护关系在其形式和意义上存在差异： 既有终生都 要维持的长期关系， 比如配偶之间或父母与子女之 间的关系； 也有即时的日常身体保健照护关系； 以 及人与非人类生命如宠物， 或者无生命的物体如房 屋等的关系 (Twigg, 1999(Twigg, , 2000Bowlby, 2012)。即 使在家庭变成了照护地点之后， 这些业已存在的关 系也不会消失， 而是在该家庭既有空间格局的基础 上进行重新安排 (Wiles, 2003a)。因此， 照护是基于 特定的关系和背景的， 而且 "这些照护关系的性质、 程度以及形式都会受其所在地点的影响" 。对地理 学家来说， 照护不仅仅涉及人际关系， 而且还有人 与地方关系 (Milligan et al, 2010) (Milligan, 2003;Wiles et a...…”