Book review: ways of home making in care for later life

Citation

Eshleman, J. (2023), "Book review: ways of home making in care for later life", Journal of Enabling Technologies, Vol. 17 No. 2, pp. 67-68. https://doi.org/10.1108/JET-06-2023-080

The perspectives in Ways of Home Making in Care for Later Life richly describe and evaluate home and the making of home as active, complex and dynamic, while highlighting the role and importance of the relationships between people, things, places and time(s) which create feelings of safety, stability and contentment. The main premise of the book is that home must be a progressive verb, requiring active and purposeful moulding, shaping and reimagining. The book is broken into three parts which describe the moving imaginaries of home and how they assist with people reconciling “home”, the process of negotiating institutions and how the intersection of care and home must be navigated, and shifting arrangements of how home is not a single place and is an unfolding arrangement of people, things, places, relationships, personal spaces, institutional processes and care.

In Part One, Chapter One introduces the book as a discussion of how normative societal ideals about ageing, care and housing have led to a somewhat stagnant definition and understanding of what home looks and feels like, focussing on how accommodation intersects with care across the lifespan. Chapter Two focusses on stories of home and how the act of narrating one's story helps to shape and create “home” in a reciprocal way between people and their stories. Chapter Three explores how digital media creates opportunities for “digital kinning” to engage in reciprocal care in both lived and digital communities and networks of support. Chapter Four discusses the experiences of three people with dementia and homesickness as a form of home-making and orienting people in their minds, bodies, relationships and environments. Chapter Five is a policy review of how elderly people conceptualise home as a result of policies (of special importance and interest, the role of “ageing in place” policies). Chapter Six concludes this section with a proposal on the role of architectural design for community housing for later life in home-making processes.

In Part Two, Chapter Seven proposes new ways to think about the role of design and ethos in palliative care settings to support homeliness, with a focus on how to address the institutionalisation of end of life care. Chapter Eight compares two self-managed ageing communities in Spain – one with a focus on being transformational and pioneering, and one with focus on preserving a mode of living for as long as possible. Chapter Nine combines policy documents and ethnographic fieldwork to analyse how elements of private home and institution collide and can be reconciled in nursing settings. Chapter Ten explores how people and families make home in hospice in phases, drawn from ethnographic fieldwork in two hospice centres.

Part Three closes with Chapter Eleven and an auto-ethnographic account of the phases and dimensions of living, dying and continuing to live on at home and the processes by which people who are dying and their families actively knit together a future for people in those spaces to carry on. Chapter Twelve explores how migrant families between Sudan and the UK navigate both local and transnational systems of social protection. Chapter Thirteen investigates “the work needed to maintain a sense of home when ‘home’ is under threat” (p. 271), and the concepts of truth and deception in dementia care through ethnographic fieldwork. Chapter Fourteen concludes by comparing how two families adapt to progressing needs of an ageing loved one within the scope of daily relationships and home organising arrangements.

This book is a thoughtful interdisciplinary consideration of what makes home. The answer, captured in this book in beautiful detail and depth, seems to be that home-making is never stable and never finished. There is a core theme of reciprocity of care and home-making, that everyone and everything in a space has a role to play and action to engage with to contribute to and take comfort from the process of home-making. Another core theme is negotiation between people, spaces, time, care, ideas and ideals of home, autonomy and independence, boundaries between professional care and personal home-making, and whether and how they are separated and how they are all entangled. A major strength of the book is how these somewhat different ideas are woven together across the course of the chapters, and how well these not specifically articulated core themes are supported across authors with different kinds of evidence, perspectives and reflective application.

Chapter Nine is especially interesting as it attempts to deconstruct the impact of policy and the direct influence it has on shaping the lived experience of ageing. Specifically, the authors unpick an “ageing in place” policy written on the normative assumption that ageing at home is preferable. This shapes how efforts with services and supports are offered towards the goal of ensuring people will not need to change accommodation to incorporate increasing levels of care or support needs. The authors discuss how the policy in actual practice has created an economically difficult and ultimately unsustainable caring landscape by saving out-of-home care for the very last, most intensive time of need. I found this to be an interesting and extremely relevant economic view of how the cost and intensity of care is shaped in response to how, when and in what conditions people are encouraged or supported to access care in their lifespan.

While I feel the book would have benefitted from incorporating a wider variety of data collection and analysis methods, it certainly provides a rich account of multiple perspectives of the intersections of care and home and how these intersections can (and in some cases, should) be navigated and engaged with by all people, places, things and times involved. While care and policy landscapes are constantly shifting, the focus on the experiences of engaged stakeholders in this space (people ageing and living with dementia, family members, care providers, institutions and communities) give a perspective that should have some longevity in the field. While all fieldwork and data have been collected in one global region, the international transferability is supported in Part One through some consideration of multi-national communities and their digital negotiations of reciprocal care relationships. This book is perfect for academics, students and practitioners in the field of ageing and later life care, dementia care and policy researchers and decision-makers. While at times very abstract and theoretical, family members with ageing loved ones will also benefit from the perspectives set forth which help contextualise some events, feelings and entanglements they are actively navigating if in the process of supporting an ageing loved one. I found the book to be enjoyable to read, thought- and discussion-provoking in my own family and at times painfully relevant to international systems of care.

Julie Eshleman