Thesis Database

 

Thesis Database

Author
Minke Rol
Year

2021

Supervisor
Kristine Krause
Esther Helmich
Key Words
Dementia care,
Hospital ethnography
Material semiotics
Problem behavior
Good care
Alternative orderings
Socio-material awareness
Thesis

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

Author

Minke Rol

Year

2021

Supervisor

Kristine Krause
Esther Helmich

Key Words

Dementia care,
Hospital ethnography
Material semiotics
Problem behavior
Good care
Alternative orderings
Socio-material awareness

Thesis

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.

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