Power, empowerment, and person-centred care

Using Ethnography to Examine the Everyday Practice of Unregistered Dementia Care Staff

Datos Bibliográficos

ID2249226
AutoresKezia Scales (0000-0002-1110-6797, Center for the Study of Aging and Human Development Duke University USA, autor de correspondencia), Simon Bailey (0000-0001-9142-2791, Alliance Manchester Business School University of Manchester Manchester UK), Joanne Middleton (School of Health Sciences University of Manchester Manchester UK), Justine Schneider (0000-0002-5863-7747, School of Sociology & Social Policy University of Nottingham Nottingham UK)
Año2017
Volumen39
Número2
Páginas227-243
Fecha de publicación2017-02-01
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaSociology of Health & Illness (JOURNAL)
Identificadores de la revistaISSN: 0141-9889 • E-ISSN: 1467-9566
EditorialWiley (PUBLISHER • GB)
DOI10.1111/1467-9566.12524
PMID27891628
OpenAlexW2557619502
IdiomaEN
Citas recibidas13
Referencias citadas38

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

Dementia · Empowerment · Ethnography · Health care · Narrative · Personhood · Phronesis · Political science · Power (physics · Public relations · Sociology · Foucault, Power, and Ethics · Healthcare innovation and challenges · Medicine · Mental Health and Patient Involvement · Nursing · Psychology