A critical examination of home care: End of life care as an illustrative case

Exley, Catherine and Allen, Davina (2007) A critical examination of home care: End of life care as an illustrative case. Social Science & Medicine, 65 (11). pp. 2317-2327. ISSN 0277-9536

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Official URL: http://dx.doi.org/10.1016/j.socscimed.2007.07.006


Drawing on end of life care as an illustrative case, this paper critically examines the provision of care in the home, identifying a number of inherent tensions. For 60 years the hospital has been the preferred site of care. However, the UK caring division of labour is currently undergoing a process of (re)domestication and the provision of home care is increasingly regarded as a ‘gold standard’ for the organisation of care, in institutional and domestic contexts. In this paper we argue that while ‘home care’ policies serve a range of professional and political agendas, they contain unacknowledged contradictions and strains, creating challenges for both family and professional carers. The realities of home care are examined through reconceptualising qualitative data generated from three research projects concerned with dying in the community. We argue that, whilst previous work has highlighted the burdens the redomestication of care places upon carers, home care philosophies and policies have led to over-romanticised notions of care which privilege the value of caring relationships without acknowledging the dynamic interaction of such social relationships with the actual work of caring. Moreover, such policy trends have created a nexus of social expectations and obligations for which modern society is unprepared. With reference to both end of life care, and home care more widely, we argue that health care planners and professionals need to think more critically about the way care is delivered. Home is not merely about a physical space, but the social and emotional relationships therein. Good ‘home care,’ characterised by attention to patient-centred needs and flexible in design and scope, does not have to be located within the private sphere; relationships may actually be maintained and nurtured by enabling people to have a realistic choice of care in an institution.

Item Type: Article
Uncontrolled Keywords: UK; Home care; Dying; Nursing; Caring division of labour; Sociology
Subjects: B900 Others in Subjects allied to Medicine
Department: Faculties > Health and Life Sciences > Nursing, Midwifery and Health
Depositing User: Paul Burns
Date Deposited: 16 Feb 2017 13:20
Last Modified: 12 Oct 2019 15:26
URI: http://nrl.northumbria.ac.uk/id/eprint/29779

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