Dirt, decency and the symbolic boundaries of caregiving in residential homes for older people

Abstract

This article draws upon an ethnography of two differently-priced UK residential care homes for older people. Informed by recent scholarship on the materialities of care, together with separate theoretical contributions by Mary Douglas and Émile Durkheim, I examine the spatial and material organisation of care work. I sketch out care workers’ attitudes and practices concerning hygiene and bodily waste, and how these are established and reaffirmed through the marking out of boundaries between materials, spaces and persons. Central to understanding care workers’ erecting of, or inattention to, these boundaries is an awareness of the material, temporal and cultural conditions of work. Variances in the availability of resources, the formal organisation of work and the layout of residential homes affect the care provided to residents. In examining these variances, I identify how care workers’ use of space functions to maintain or undercut not only hygiene and infection control standards but, also, more interpersonal virtues, such as dignity and respect for older people receiving care. I conclude by highlighting how the (mis)treatment of older people is a story of both a deeply inequitable market for care provision and a broader context of oppression, devaluation and dehumanisation.