Christine Milligan - Theres No Place Like Home: Place and Care in an Ageing Society

THERES NO PLACE LIKE HOME: PLACE AND CARE IN AN AGEING SOCIETY

Geographies of Health

Series Editors
Allison Williams, Associate Professor, School of Geography and Earth
Sciences, McMaster University, Canada
Susan Elliott, Dean of the Faculty of Social Sciences,
McMaster University, Canada

There is growing interest in the geographies of health and a continued interest in what has more traditionally been labeled medical geography. The traditional focus of medical geography on areas such as disease ecology, health service provision and disease mapping (all of which continue to reflect a mainly quantitative approach to inquiry) has evolved to a focus on a broader, theoretically informed epistemology of health geographies in an expanded international reach. As a result, we now find this subdiscipline characterized by a strongly theoretically-informed research agenda, embracing a range of methods (quantitative; qualitative and the integration of the two) of inquiry concerned with questions of: risk; representation and meaning; inequality and power; culture and difference, among others. Health mapping and modeling, has simultaneously been strengthened by the technical advances made in multilevel modeling, advanced spatial analytic methods and GIS, while further engaging in questions related to health inequalities, population health and environmental degradation.

This series publishes superior quality research monographs and edited collections representing contemporary applications in the field; this encompasses original research as well as advances in methods, techniques and theories. The Geographies of Health series will capture the interest of a broad body of scholars, within the social sciences, the health sciences and beyond.

Therapeutic Landscapes
Edited by Allison Williams
ISBN 978 0 7546 7099 5

Sense of Place, Health and Quality of Life
Edited by John Eyles and Allison Williams
ISBN 978 0 7546 7332 3

Primary Health Care: People, Practice, Place
Edited by Valorie A. Crooks and Gavin J. Andrews
ISBN 978 0 7546 7247 0

CHRISTINE MILLIGAN
Lancaster University, UK

First published 2009 by Ashgate Publishing

Published 2016 by Routledge
2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN
711 Third Avenue, New York, NY 10017, USA

Copyright 2009 Christine Milligan

All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers.

Christine Milligan has asserted her right under the Copyright, Designs and Patents Act, 1988, to be identified as the author of this work.

Notice:
Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe.

British Library Cataloguing in Publication Data
Milligan, Christine, Dr.

Theres no place like home : place and care in an ageing society. -- (Geographies of health)

1. Older people with disabilities--Care--Cross-cultural studies. 2. Older people with disabilities--Home care. 3. Older people with disabilities--Institutional care. 4. Caregivers--Great Britain--Case studies. 5. Caregivers--New Zealand--Case studies. 6. Medical personnel-caregiver relationships.

I. Title II. Series

362.40480846-dc22

Library of Congress Cataloging-in-Publication Data
Milligan, Christine, Dr.

Theres no place like home : place and care in an ageing society / by Christine Milligan.

p. cm. -- (Ashgates Geographies of health series)

Includes bibliographical references and index.

ISBN 978-0-7546-7423-8 -- ISBN 978-1-3155-5112-8 (ebk.) 1. Social work with older people. 2. Older people--Care. I. Title.

HV1451.M555 2009

362.6--dc22

2009020355

ISBN 978 0 7546 7423 8 (hbk)
ISBN 978 1 3155 5112 8 (ebk)

At age 84, my father-in-law was diagnosed with dementia, he was a non-smoker who drank alcohol only sparingly at celebratory and other special social events. The onset of his dementia followed closely on the heels of medical surgery. Until that time he had lead a fit and active life and would often pass the time doing woodwork in his garden shed or helping out a friend or neighbour. On more than one occasion he could be found chopping wood for the old chap who lived further along the road he lived in. My mother-in-law was 82 at the time; she had (and still has) partial hearing and a long-standing and incurable sight impairment. Despite these physical impairments, she was a fit and active woman who undertook the main caring role during the two years of my father-in-laws dementia all but the last six months of which took place in their own home. She was regularly supported in this caring role by two of her non-resident adult children until my father-in-laws health deteriorated to the extent that a 24 hour nursing home care became the only realistic solution. My husband, despite being a non-resident carer, took a significant role in caring for his father, fulfilling many of the intimate caring and personal hygiene tasks that more commonly fall to female family members.

Support from the formal care services at that time can, at best, be described as disorganised and chaotic. Some services were put in place whether required or not and others that were needed were not available. Despite numerous phone calls to cancel deliveries of incontinence pads, for example, they continued to arrive on a weekly basis. At one point, the spare bedroom in my mother-in-laws home was piled from floor to ceiling with boxes of these pads. While incontinence is no laughing matter, my father-in-law was at least guaranteed to remain clean and dry! While it is possible to see some humour in this situation, my later research revealed that in other areas, those who desperately needed these resources had to do without, creating distress and humiliation for all concerned. Tuck in services aimed at helping my mother-in-law to get her husband ready and lifted into bed arrived at 7.00 p.m. at night leaving her with the unenviable task of trying to keep her husband from trying to climb back out of bed when no help was readily available to get him back into it. New paid care workers would arrive at the house with absolutely no formal training in either basic hygiene or care techniques. In one instance a care worker was found attempting to empty the contents of the commode down the kitchen sink. We began keeping a diary of events and in one month, we noted that over seventeen different paid care workers arrived on my mother-in-laws doorstep. Her confusion became so extreme, that on one occasion she showed a (rather confused) woman collecting for charity into my father-in-laws downstairs bedroom, thinking she was yet another in a long line of care workers. Her distress about the quality of care services lead us to contact an NHS arbitrator, whose role was to negotiate with these services in an attempt to bring order to the apparent chaos of care delivery.