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"They're just who they've always been" : the intersections of dementia, 'person-centred care', and cultural contexts in Scottish Care Homes

This thesis documents a study which set out to explore the links between culture, dementia and long-term residential care in Scotland. A key aim of the work was to gain insights into manifestations of individual formative culture as part of selfhood in people with dementia in care homes, and how service providers take account of this in constituting „person-centred‟ care processes (which are claimed by virtually every such provider in Scotland). Another aim was to explore the contexts influencing care processes at individual care home/theoretical/government policy levels. Lastly, as a study with a „critical‟ bent, it set out to provide suggestions for future research based on the conclusions reached. In doing this, it involved six care homes, three of which were in large urban centres and three of which were in a remote island group. Sixteen social care workers and nurses took part, as did eleven care home residents with significant dementia. An ethnographic approach to data gathering and analysis, combined with a poststructural discourse analysis in interpreting initial findings, represented the research methods used. It was found that culture as an aspect of selfhood is a much more reducible phenomenon than is represented by traditional metanarratives of diversity, and failure to take account of this can have substantial implications for „person-centred care‟(especially for people who are progressively losing the ability to adapt to new sociocultural environments because of cognitive impairment). Failure to acknowledge these very individual formative sociocultural contexts in people with dementia who are in long-term care, may lead to a failure to acknowledge personhood. Conclusions revolve around the assertion that accepted discourses of cultural diversity, combined with other socially-located discourses linked to the residential care home sector, combine to produce environments in which „knowing the person‟ (and knowing the sociocultural contexts which help define that person), often do not feature highly in so-called „person-centred‟ approaches.

Identiferoai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:659074
Date January 2013
CreatorsMullay, Steve
PublisherUniversity of Aberdeen
Source SetsEthos UK
Detected LanguageEnglish
TypeElectronic Thesis or Dissertation
Sourcehttp://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=227117

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