Tikkanen, Ulla
(Helsingin yliopisto, 2016)
The everyday life and bonds of the spousal care of the elderly
There are almost 24 000 Finns over the age of 65 who have made an agreement with the welfare state to be compensated for taking care of their family member in need. This agreement – typically concerning spousal care taking place at the mutual home of the spouses – is part of the current “public care” of the elderly in which the Finnish welfare state partners up with families. The public sector, the private sector and the third sector are all looking for their role and modes of collaboration in the network of care. Services supporting the elderly living at home are developed at the same time as the possibilities for institutional care are diminishing.
The theoretical approach of the study draws on “figurational sociology” by Norbert Elias. In this study it means studying the ways in which people, human bonds and material objects form a figuration of care in which each element is interdependent of other elements and the whole. The aim of the research is to analyse the interrelated bonds in a way that opens up both their process of formation, and the experience of individuals as a part of the whole figuration of care. The study examines how the everyday life of the care of the elderly is formed, how the nature and bonds of care transform over different phases of care, and how various attachments and disruptions organize the figuration of everyday life.
The research materials consist of qualitative interviews, ethnographic observation and a self-filled diary of the caregivers’ week, including their reflections of different days, significant relationships in the network of care and their personal notes. In all, it includes 21 interviews with 11 persons taking care of their spouse (between the ages of 67 and 83 years old) and with three persons in need of care. The empirical data was produced between April 2013 and February 2014.
The research results depict a thick description of the everyday life of the spousal care. In addition to verbal analysis of the significant bonds of care, four different phases of care are presented visually placing the spouse caring and the spouse been cared for in the same visual frame (in the home in which the care takes place). The visual presentation illuminates the processes, practices and organising factors of the everyday life of care over time and space. The state of the bondedness can be described as porous, straining, heavy and sticky, depending on the intensity of needs of the spouse been cared for.
The most important element of the figuration of care is “the demanding body” referring to the transformation of the spouse been cared for, from an actor to a “needy” body constantly demanding something from the caregiver, material surroundings and devices that gradually take over the whole space and life. The most significant material ties are formed to the home in which the care takes place, the assisting devices and medications. The ways in which humans are intertwined with material devices are examined through the metaphors of stick, walker, wheelchair and bed. The most central human bonds in the figurations of care are the one between the spouses and the one between them and the professionals involved. These central bonds are the most consequential in the formation of the figuration of care. The care of the spouse is physically and emotionally sticky full-time nursing that sometimes feels like being a prisoner. However, the caregivers are different and their characteristics make an impact on the way in which the figuration of care evolves.
Taking care for one’s spouse who is gradually getting frail, is depicted as a process of loss and letting go of the personally significant contents of life, including the spouse her- or himself. Elias discusses this as a broken valency, one that tears apart a part of oneself. Discretion, empathy and respect toward the elderly by their family members, the public officials and the nursing staff would ease the caregivers’ burden.
The study speaks for the benefits of the dynamic and holistic perspective of Elias’s figurational sociology in studying care. It enables to understand human interdependencies and needs as a part of a larger figuration of bonds, both human and material. By adding the material aspect in studying the human figuration of care, the study builds a fuller picture of the everyday realities of elderly care than work merely focusing on people.
Keywords: aging, elderly care, family care, figurational sociology, human bonds, interdependency, material sociology, visualisation and welfare services