The costs of care: An ethnography of care work in two residential homes for older people

This thesis is an ethnography of care work conducted in two differently priced private residential homes for older people in Southern England. Drawing upon around eight hundred hours of participant observation and interviews undertaken with thirty care workers, I examine the everyday interactions, routines, and rituals of care work. I identify how political-economic factors, working conditions, material resources, and workplace cultures produce particular kinds of care and I consider the contribution which social theory can make to sharpening our understanding of the care industry. I begin by exploring how work is divided-up, scheduled, and allocated to care workers and how, by defining what activities are of value, these forms of organising work shape the content and nature of caregiving. I extend this analysis of the everyday rituals and routines of care work by focusing in particular on care workers’ attitudes and practices concerning hygiene and bodily waste, and dying and death. Here, care workers’ ideas about the private and the public, the dirty and the clean, and the profane and the sacred, are established and reaffirmed by marking out boundaries between materials, spaces, and persons. The research shows how the availability of material resources, by facilitating or impeding such symbolic work, shapes care workers’ ability to show respect and moral regard towards the individuals in their care. Whilst it is undeniable that the funding of care is directly linked to the quality of the service provided, this research argues that we also need a cultural and material architecture of care that is sensitive to our need for moral and symbolic treatment