Sociomaterial associations and a ‘looming catastrophe’

In Chapter 1 we explained how we intend to examine the ways in which families make arrangements in life when they are caring for a family member with a diagnosis of dementia. We described our approach as one informed by a relational logic where elements of everyday life take their form and effects only in relation to one another (Law, 1994, 2008; Mol et al, 2010; Moser, 2011; Pols, 2012). Approaching the topic of dementia from a relational stance means that we examine what Law and Mol (1995, p 274) describe as ‘associations’. Law and Mol do not limit the availability of associations just to human actors; they advance the possibility that ‘association is a matter not only for social beings, but also one to do with materials’ (1995, p 274). This means that in this chapter we can broaden our gaze somewhat to examine the context within which families arrange care for their family member diagnosed with dementia. And we can include people, offices, websites, documentation, national plans and even ideas that are operating with a relational logic that makes up dementia care within the location where our study was conducted.

So, while our interest throughout this research project has been on the families and their practices of caring for one of their family members diagnosed with dementia, we also knew from the beginning that formal health services operating from hospitals, clinics, medical offices and community health centres would play some part in those care practices. And these formal services themselves, as well as families so affected, are associated with those discursive associations setting out what dementia ‘is’ and what should, on a population scale, be done about it.

We begin this chapter with an examination of some key historical developments relevant to the work of those who are responsible for planning and providing health and social service support for people living with dementia. We examine those historical developments as materials available to such planners enabling particular ways of organizing social beings – themselves as well as the people living with dementia and their family support.