メモ【認知症】

読んではいるのだが、しかし、集中力も速度もなく、一日一本とは言えず…。

• Askham, Janet, Kate Briggs and Ian Norman, 2007, "Care at Home for People with Dementia: ad in a total institution?" Ageing & Society,27,3-24.

This article examines three kinds of social relationship likely to be present when people with dementia are cared for at home by relatives or friends: custodial care, an intimate relationship, and home-life. Using Goffman's three defining aspects of custodial care – routinisation, surveillance and mortification of the self – the paper examines whether these characterised the care of people with dementia at home and, if so, whether they conflicted with the intimate relationship and with home-life. The study involved sustained observations and interviews with 20 people with dementia and their carers in and around London, and qualitative analysis of the data. It was found that all three aspects of custodial care were present although not fully realised, and that they led to difficulties, many of which were associated with the concurrent pursuit of an intimate relationship and home-life. In all cases, daily life was routinised partly to help accomplish care tasks but was found monotonous, while surveillance was usual but restrictive, and prevented both the carers and those with dementia from doing things that they wished to do. Those with dementia were distressed by the denial of their former identities, such as car-driver or home-maker, and by being treated like children. Both the carers and the people with dementia had various ways of balancing custodial care, their intimate relationships and home-life, such as combining routines with other activities, evading surveillance or carrying it out by indirect means, and there were many attempts to maintain some semblance of former identities.

Goffmanがtotal institutionでのcustodial care（保護的ケア）において見られる三つの特徴、routinization, surveillance, mortification of the selfが、在宅での認知症ケアの関係性においても見られるかどうか、また、在宅における特徴は何かということをインタビューとケアの場面の観察に基づいて記述した論文。在宅においては、ケア以外の家族の営みや、ケア提供者と受け手の間に親密な関係性があるために、施設での関係性とはずれてくるよという話。こういったタイプの議論は、結構読んだし、私も書いてきたけど、脈々と行われているんだなと。