“Could be a risk couldn’t it”: Decision-making, access to, and the use of functional objects for people with a dementia living in a care home

It is argued the use of functional objects and control over personal possessions are important in supporting, maintaining and cultivating identities. By exploring how objects manifest in the everyday lives of people with a dementia in care homes, this thesis focuses on the interactive nature of human and material worlds, often neglected in care home studies. This ethnographic study included a hanging out period, participant-observations, object-elicitation interviews, in-depth interviews and the examination of documentary sources. I explored who was involved in decision-making relating to personal possessions, who had access to functional objects, how functional objects were used, and by whom. Finally, I examined whether social citizenship was a useful lens to explore such relations. The study findings are that, people with a dementia are excluded from decision-making relating to personal possessions and the future acquisition of objects, they lacked control over their possessions, had few opportunities to use functional objects, were often denied access to functional objects without a formal risk assessment, and had belongings removed from their rooms without their knowledge or agreement. By viewing object-person relations in dementia care through a citizenship lens, the material citizenship framework was developed. The material citizenship framework has the potential to support a rights-based approach to dementia care by using functional objects as an enabler to balance risk management and protection, and empowerment and social citizenship. I argue that object-person relations are important to the advancement of dementia care and citizenship practices.