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Anne K. Vittoria - Women of Color in a World Apart: An Ethnography of Care Workers and Dementia

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Care, whether viewed as acts of civility, acts of compassion and skill, or acts of close personal interaction, is the fundamental process by which society perpetuates and recreates itself. Despite social need and the undeniable benefit of occupations such as Certified Nursing Assistants (CNAs), these workersmostly female and disproportionally from minority groupsface very low wages, a notable lack of respect, and little public recognition of their abilities. The United States is experiencing what experts call a crisis of care with a current and growing shortage of nurses and CNAs. In U.S. Nursing Centers, the demand for Certified Nursing Assistants, the largest group of employees who operate on the front line of health care, is expected to grow exponentially due to dramatic increases in population aging.

Over the course of a year and a half, Anne K. Vittoria examined the meaning and social construction of care work on an Alzheimers Pavilion located in a geriatric facility in the mid-western United States. Through in-depth ethnographic research focused on the local culture and logic of care, Vittoria documents that, when given autonomy in their daily work in an institution, CNAs and the LPN Charge Nurse constructed a systematic body of knowledge and created a language of careforging a different model of personal care in resistance to the medical model of care. This book challenges the assumptions of the outside world that low-level workers are alienated from their work and have minimal skills. Paradoxically, the Pavilion is both a refuge and a site of struggle for the CNAs; they desire to create a world that is the antithesis of the world in which they live on the outside. Women of Color in a World Apart provides a public forum for the voices of women of color, the development of concepts, and a practical as well as theoretical language of care that could be transformational in connecting the meanings of care with the organization of care.

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Women of Color in a World Apart Care whether viewed as acts of civility acts - photo 1
Women of Color in a World Apart
Care, whether viewed as acts of civility, acts of compassion and skill, or acts of close personal interaction, is the fundamental process by which society perpetuates and recreates itself. Despite social need and the undeniable benefit of occupations such as Certified Nursing Assistants (CNAs), these workersmostly female and disproportionally from minority groupsface very low wages, a notable lack of respect, and little public recognition of their abilities. The United States is experiencing what experts call a crisis of care with a current and growing shortage of nurses and CNAs. In U.S. Nursing Centers, the demand for Certified Nursing Assistants, the largest group of employees who operate on the front line of health care, is expected to grow exponentially due to dramatic increases in population aging.
Over the course of a year and a half, Anne K. Vittoria examined the meaning and social construction of care work on an Alzheimers Pavilion located in a geriatric facility in the mid-western United States. Through in-depth ethnographic research focused on the local culture and logic of care, Vittoria documents that, when given autonomy in their daily work in an institution, CNAs and the LPN Charge Nurse constructed a systematic body of knowledge and created a language of careforging a different model of personal care in resistance to the medical model of care. This book challenges the assumptions of the outside world that low-level workers are alienated from their work and have minimal skills. Paradoxically, the Pavilion is both a refuge and a site of struggle for the CNAs; they desire to create a world that is the antithesis of the world in which they live on the outside. Women of Color in a World Apart provides a public forum for the voices of women of color, the development of concepts, and a practical as well as theoretical language of care that could be transformational in connecting the meanings of care with the organization of care.
Anne K. Vittoria is Associate Professor of Sociology, Gender Studies, Social Psychology, Aging, and Consumer Society at the State University of New York Cortland. Support for this research and writing came from the National Alzheimers Association and the SUNY Dresher Award.
Women of Color in a World Apart
An Ethnography of Care Workers and Dementia
Anne K. Vittoria
First published 2021 by Routledge 52 Vanderbilt Avenue New York NY 10017 and - photo 2
First published 2021
by Routledge
52 Vanderbilt Avenue, New York, NY 10017
and by Routledge
2 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN
Routledge is an imprint of the Taylor & Francis Group, an informa business
2021 Taylor & Francis
The right of Anne K. Vittoria to be identified as author of this work has been asserted by them in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988.
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.
Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe.
Library of Congress Cataloging-in-Publication Data
A catalog record for this title has been requested
ISBN: 978-0-367-37080-0 (hbk)
ISBN: 978-0-367-37081-7 (pbk)
ISBN: 978-0-429-35259-1 (ebk)
Typeset in Bembo
by Newgen Publishing UK
To my parents Mary and Benjamin
And to my grandfather, Jacob Thompson Perkins, the consummate newspaper man, who first inspired me to write.
And to my husband, Theodore John Vittoria, who inspired me, unfailingly, to grow as a person.
Contents
I want to extend a bountiful thank you to the Certified Nursing Assistants, the Charge Nurse and the residents of the Alzheimers Pavilion for accepting me as part of their world for a year and a half. They did not know what to expect and neither did I. The coming of trust was the conduit to understanding. I am indebted to the residents who are deceased now for their uniqueness and spritely comments amid confusion and searching. I am grateful to the CNAs and Charge Nurse for their willingness to talk candidly about their work and allow me to bear witness to their actions. On a several occasions, they volunteered to meet after hours and reflect on the days happenings over a big pot of coffee. As well, I extend sincere appreciation to the members of the residents families who gave their time for extended interviews about their experiences with their loved one and impressions of the care work of the CNAs. Mentors have given many kinds of strategic support during the process of writing this book. As I wrestled with frustrations and blocks, they listened, gave of their time and insights as scholars and sojourners in my life. First and foremost, colleague, mentor and valued friend, Mary Zimmerman, has read the full manuscript several times offering excellent critiques for making the editing and structure of the book clear. A creative sociologist, she has been steadfast in her belief in my work and extraordinary in sharing her time and thoughts, all of which have made this a stronger book. Throughout, her intuitive grasp of the substance of my book has been a great asset.
I thank the early mentors (later friends) who influenced me significantly and opened new worlds: the late Harold Orbach who made social theory come alive; Robert Atchley, who urged me to value my own experience and use my creativity; Carol A.B. Warren, who first introduced me to qualitative methods as a way of studying the human community; Robert Antonio, who exuded a passion for sociological theory; and David Seamon, who gave me a language of place. Over the years, Michael Flaherty, from afar, provided crucial insights related to my developing the manuscript, and that most essential of gifts, encouragement for a sometimes flagging spirit. I am grateful for steadfast friends and colleagues who have accompanied me on this journey and offered supporteach in his or her own wayEugenia Lasley, Penelope Valmassoi, Lisi Krall, Tiantian Zheng, Kassim Kone, Raymond Collings, Leslie Eaton, Jamie Dangler, Kathryn Kramer, Toni Calasanti, Pamela Mayberry, Warren and Betty Jane Robinson, Lyn Norris-Baker, John Demand, Edith Stunkel, Stephani Robson, Paul Windley, Howard Stevenson and Bonnie Johnson. Robin Hizey, who died too young, was a tremendous help to me in transcribing many transcripts. I could not have done it without her. She was a loyal friend and lovely human being whom we all miss.
A very special thank you goes to those colleagues who read the manuscript at different stages and gave wise counsel and detailed suggestions for improving the substance and direction of the narrative. I am indebted to Joel Savishinsky for his meticulous reading and insightful three-page comments in the late stages of my writing. I thank my colleagues, Tiantian Zheng and Kassim Kone who read a very early draft.
I would like to thank an anonymous reviewer who shall be the champion of less is more. I am grateful for his belief in this project, his patience when I sorely needed it, and his stewardship along the way. Through the process of working with this reviewer, I came to a true understanding of ethnographic writing because of how well he knew it.
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