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7 - Borders and helpfulness

Published online by Cambridge University Press:  13 May 2022

Christine Ceci
Affiliation:
University of Alberta
Mary Ellen Purkis
Affiliation:
University of Victoria
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Summary

This chapter explores borders, and the relations of helping that happen both inside and outside of these borders, and perhaps most important, about the ‘logic of the between’ (Cooper and Law, 2016, p 207) that works to constitute various and precarious thresholds between these locations. We start with an idea, in many respects rather obvious, that we cannot use a term like ‘help’ with preconceived notions about what help means – that it is not really known in advance what ‘help’ will look like for a particular family. As Büscher and his colleagues (2011) have shown, in the context of evidence that current formal care practices and policies often create rather than resolve problems for families, helpfulness must be rethought in terms of how particular ‘helping’ actions fit, or don't fit, with ongoing family arrangements (Büscher et al, 2011, p 713; see also Lloyd and Stirling, 2011; Stirling et al, 2014; O’Shea et al, 2017; Stephan et al, 2018). Care for family arrangements draws us immediately to consideration of what is ‘between’ these and ‘other’ practices, and that is always something to find out about. In this chapter we develop this idea by drawing on Cooper and Law's distinction between proximal and distal analyses to explore the question of helpfulness through looking at details – materials, knowledges, technologies, policies and people, and importantly, the relations made among all of these – to understand ‘help’ as an effect of complex processes that ‘take up, form and reform all these bits and pieces’ (Cooper and Law, 2016, p 214). To show this idea, we describe processes and events that, in three of the participant families, sometimes led to ‘help’ as an effect, and sometimes did not.

We tie our analysis in this chapter to the idea of profound changes happening over time for families, changes often ending with family members relinquishing responsibility for daily care for the person living with dementia to paid staff in a residential care facility, even while still working out new ways of maintaining a relevant relationship in the spaces available in that new home. This change in living arrangements is profound, it happens in time, it happens differently in different families, and it is a process that draws and informs the attention of many of the ‘helpful’ actions of formal care systems.

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Chapter
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Care at Home for People Living with Dementia
Delaying Institutionalization, Sustaining Families
, pp. 131 - 155
Publisher: Bristol University Press
Print publication year: 2021

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