Gjødsbøl Iben M, Koch Lene, Svendsen Mette N
Centre for Medical Science and Technology Studies, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5B, 1014 Copenhagen, Denmark.
Soc Sci Med. 2017 Jul;184:116-123. doi: 10.1016/j.socscimed.2017.05.022. Epub 2017 May 10.
This paper approaches institutionalized dementia care as a site of societal disposal, valuation, and care for human life. Drawing upon six weeks of ethnographic fieldwork and ten qualitative interviews carried out in a Danish dementia nursing home in 2014, we analyze how nursing home staff, through everyday care, uphold the value of life for residents in severe mental and physical decline. We argue that life's worth is established when residents gain qualities of personhood and agency through substitution processes carried out by staff. Yet the persistent absence of conventional personhood and autonomous agency in residents (i.e. capacities for memory, consciousness, language, and mobility) evokes experiences of ambiguity in staff and relatives of residents. We close the article with a discussion of this ambiguity and the significance of the nursing home as care institution in the welfare state. Dementia care, we propose, is not only about preserving the lives of people with dementia. At stake in the daily care practices around severely disabled residents in the nursing home is the very continuance of the main principles of the welfare society.
本文将制度化的痴呆症护理视为社会对人类生命进行处置、评估和照料的场所。基于2014年在丹麦一家痴呆症疗养院进行的为期六周的人种志田野调查和十次定性访谈，我们分析了疗养院工作人员如何通过日常护理，维护身心严重衰退的居民的生命价值。我们认为，当居民通过工作人员进行的替代过程获得人格和能动性特质时，生命的价值便得以确立。然而，居民持续缺乏传统的人格和自主能动性（即记忆、意识、语言和行动能力），这在工作人员和居民亲属中引发了模糊不清的感受。文章结尾讨论了这种模糊性以及疗养院作为福利国家护理机构的重要性。我们认为，痴呆症护理不仅关乎维持痴呆症患者的生命。疗养院中围绕重度残疾居民的日常护理实践所涉及的关键问题是福利社会主要原则的延续。
