How Do Consumers (And Their Families) Transition into Elderscapes?
With increasing longevity, institutional elderly care has become a common necessity. Over the twentieth century, elderly care homes have been commodified and marketized, turning into businesses that focus on competition and profit. Moving into a care home is a significant transition for individuals and their families, often filled with apprehension. Care homes are distinct places with strict rules to manage communal living and medical care, called “elderscapes,” inspired by Foucault’s concept of heterotopic places.
How do people experience the transition into care homes? And how do they and their families cope with this new reality? These questions are the focus of a new JCR article by Julia Rötzmeier-Keuper and Nancy V Wünderlich who summarize their work here:
To explore these questions, we conducted in-depth interviews with elderly care consumers, their family caregivers, professional caregivers, and care home managers. Our research shows that the care home environment greatly shapes the experiences of elderly care consumers, often leading to emotional turmoil. To cope, many elderly care consumers try to hold on to their previous identities by keeping their old lifestyles, activities, possessions, and relationships. However, health limitations and the constraints of a care home often make this difficult, causing tensions with professional caregivers and managers.
We observed that elderly care consumers adjust to care homes in four main ways: They form new connections with other residents or staff, reflecting their former social networks. They selectively keep treasured items from their past. They search for new activities within the care home that resonate with their past interests, and they personalize shared spaces, such as treating public areas as their private garden. Sometimes these adjustments lead to happiness. For example, one resident found joy in engaging with care home staff and creating a new identity as an “associated member” of the staff. However, our study shows that navigating identity in a care home does not consistently lead to happiness or satisfaction. Many elderly care consumers feel unhappy as they struggle to preserve their autonomy and identity in this new setting. One elderly care consumer described the adjustment as strenuous and draining: “Sometimes I’m tired of fighting. I’m not tired of living, but I’m tired of life because it’s just exhausting.”
The constraints of the care home also impact family caregivers, who often step in during the elderly care consumer’s adjustment process. Our findings show that family intervention can be a double-edged sword, either helping or hindering the adjustment, depending on the family caregivers’ motivations. While motivations of care can be supporting, feelings of obligation and nostalgia can negatively impact elderly care consumers. For example, family caregivers might intervene when elderly care consumers try new habits, like new clothing styles, to fit in with other residents. Not understanding the elderly care consumer’s reasons behind this change, family caregivers often insist on old, familiar clothing styles out of nostalgia. By assuming that elderly care consumers would be happiest living life as they did before, family caregivers unintentionally hinder the elderly care consumer’s adjustment process.
Our findings highlight the need for greater awareness among care home managers, professional caregivers, and family caregivers about the challenges elderly care consumers face upon entering the care home. The prevailing market logic in care homes often fails to accommodate individual preferences, but many desired outcomes can be supported with sufficient effort. We call on family caregivers to reflect on their motivations for interventions to prevent unintended negative consequences and to be aware of the disruptive power their interventions can have.
Ultimately, our study offers valuable insights for everyone, as we will all experience aging. We emphasize the importance of small, often overlooked details in smoothing the transition from being a receiver of care to a consumer of care in elderly care homes.
Read the full paper here:
