From ‘problem behavior’ to ‘prikkeligheid’: On the ways care workers navigate socio-material arrangements on a dementia ward
Dementia often comes with agitation, occasionally even verbal or physical violence, this has increasingly been referred to as ‘problem behavior’, as it was on my field site. The explicit use of the term ‘problem behavior’ led me to wonder about its implications for dementia care. I followed care practices by becoming a care worker myself (participatory observation) and talked about these practices in semi-structured interviews with my colleagues (the care workers).
Because care workers talk about their practice (and in practice) with particular terms, my account of this practice started with an analysis of the word ‘prikkel’. I then demonstrated how institutional care for people with dementia is seldom an individual endeavor. Therefore, I argued for a ‘relational ordering’ (Driessen, 2019, p. 28) of dementia and ‘problem behavior’. by showing that a particular ‘prikkel’ cannot be isolated from the resident who is affected by it or from other ‘prikkels’ and other residents.
I aimed to demonstrate how ‘problem behavior’ of individual residents on a ward is not a problem with a quick fix, rather it takes place in an arrangement in which it is distributed over several elements in that arrangement. The socio-material environment of the arrangement is dynamic and exposes its navigation by care workers as a precarious choreography. By that I offered an alternative perspective on dementia care in the nursing home, and specifically an understanding of ‘problem behavior’ that aims to do justice to its complex dynamics.
From ‘problem behavior’ to ‘prikkeligheid’: On the ways care workers navigate socio-material arrangements on a dementia ward
Dementia often comes with agitation, occasionally even verbal or physical violence, this has increasingly been referred to as ‘problem behavior’, as it was on my field site. The explicit use of the term ‘problem behavior’ led me to wonder about its implications for dementia care. I followed care practices by becoming a care worker myself (participatory observation) and talked about these practices in semi-structured interviews with my colleagues (the care workers).
Because care workers talk about their practice (and in practice) with particular terms, my account of this practice started with an analysis of the word ‘prikkel’. I then demonstrated how institutional care for people with dementia is seldom an individual endeavor. Therefore, I argued for a ‘relational ordering’ (Driessen, 2019, p. 28) of dementia and ‘problem behavior’. by showing that a particular ‘prikkel’ cannot be isolated from the resident who is affected by it or from other ‘prikkels’ and other residents.
I aimed to demonstrate how ‘problem behavior’ of individual residents on a ward is not a problem with a quick fix, rather it takes place in an arrangement in which it is distributed over several elements in that arrangement. The socio-material environment of the arrangement is dynamic and exposes its navigation by care workers as a precarious choreography. By that I offered an alternative perspective on dementia care in the nursing home, and specifically an understanding of ‘problem behavior’ that aims to do justice to its complex dynamics.
