Discourses of Care: Enactments of relational work in two dementia care settings

Watts, Helen

Abstract

Care practices and relational work are marginalised, unrecognised and unrewarded. Yet it can also be argued that care work is ‘skilful’, requires competence, is complex and ‘fundamental to the human condition’. This study based on the private spoken interactions between care home workers and residents living with dementia, explores the complexity of caring discourses and provides linguistic evidence of their significance and sophistication.

This thesis contributes to our understanding of, and methodological approaches to, the ways that care is enacted through talk. It takes an appreciative inquiry approach, is multidisciplinary, qualitative and applies discourse analytic techniques to a range of data sets. The data, which includes 20 audio-recorded interactions amounting to just under three and half hours of conversation in all between two care home workers and four residents, was collected in two UK dementia care homes. The detail of a linguistic approach is complemented by attention to context and a participatory research style. This study cuts new ground in the linguistic-based literature by aligning enactments of care and relational work with widely accepted principles of care and dementia care models.

The findings show that carers and residents frequently self-disclose, use endearments and engage in playful talk. Register and style vary, including use of politeness and levelling strategies, and this sheds light on the complexity of the task of interacting with residents in dementia care homes. Such relational linguistic work includes practices which at times involve risk and others that are risk free. In summary, care workers and residents build reciprocal, collaborative, and mutually beneficial relationships during the completion of daily tasks through, although not exclusively, linguistic means, despite the constraints of the care home environment. This finding is innovatory as it demonstrates that relational work is practised through linguistic means by both care home workers and residents. A further contribution to knowledge, is the extension of language-based studies of relational work into social care settings.

Such language practices appear to be central to successful care work practices, a larger study could potentially verify this claim. This study has strong implications for care worker training programmes. It can benefit those who commission, design, manage and deliver care for people living with dementia by increasing their understanding of the importance and benefits of social interaction between care workers and residents. By foregrounding relational practices as central to caring practices and using linguistic evidence to demonstrate their complexity, I argue that care as a relational and linguistic practice demands to be centralised, recognised and rewarded in the care home settings.

• Thesis Type: Thesis
• Deposit Date: Apr 28, 2020
• Publicly Available Date: Jan 8, 2021
• Public URL: https://uwe-repository.worktribe.com/output/5941008
• Award Date: Jan 8, 2021