Albert Banerjee

It’s a scandal! Comparing the causes and consequences of nursing home media scandals in five countries

Purpose – This study aims to explore the causes and consequences of media scandals involving nursing homes for older persons in Canada, Norway, Sweden, the UK and the USA. Design/methodology/approach – This study uses a descriptive case-study methodology which provides an in-depth, focused, qualitative analysis of one selected nursing home scandal in each jurisdiction. Scandals were selected on the basis of being substantive enough to potentially affect policy. An international comparative perspective was adopted to consider whether and how different social, political and economic contexts might shape scandals and their consequences. Findings – This study found that for-profit residential care provision as well as international trends in the ownership and financing of nursing homes were factors in the emergence of all media scandals, as was investigative reporting and a lack of consensus around the role of the state in the delivery of residential care. All scandals resulted in government action but such action generally avoided addressing underlying structural conditions. Research limitations/implications – This study examines only the short-term effects of five media scandals. Originality/value – While there has been longstanding recognition of the importance of scandals to the development of residential care policy, there have been few studies that have systematically examined the causes and consequences of such scandals. This paper contributes to a research agenda that more fully considers the medias role in the development of residential care policy, attending to both its promises and shortcomings.Purpose – This study aims to explore the causes and consequences of media scandals involving nursing homes for older persons in Canada, Norway, Sweden, the UK and the USA. Design/methodology/approach – This study uses a descriptive case-study methodology which provides an in-depth, focused, qualitative analysis of one selected nursing home scandal in each jurisdiction. Scandals were selected on the basis of being substantive enough to potentially affect policy. An international comparative perspective was adopted to consider whether and how different social, political and economic contexts might shape scandals and their consequences. Findings – This study found that for-profit residential care provision as well as international trends in the ownership and financing of nursing homes were factors in the emergence of all media scandals, as was investigative reporting and a lack of consensus around the role of the state in the delivery of residential care. All scandals resulted in government action but such a...

It is a scandal

Purpose – This study aims to explore the causes and consequences of media scandals involving nursing homes for older persons in Canada, Norway, Sweden, the UK and the USA. Design/methodology/approach – This study uses a descriptive case-study methodology which provides an in-depth, focused, qualitative analysis of one selected nursing home scandal in each jurisdiction. Scandals were selected on the basis of being substantive enough to potentially affect policy. An international comparative perspective was adopted to consider whether and how different social, political and economic contexts might shape scandals and their consequences. Findings – This study found that for-profit residential care provision as well as international trends in the ownership and financing of nursing homes were factors in the emergence of all media scandals, as was investigative reporting and a lack of consensus around the role of the state in the delivery of residential care. All scandals resulted in government action but such action generally avoided addressing underlying structural conditions. Research limitations/implications – This study examines only the short-term effects of five media scandals. Originality/value – While there has been longstanding recognition of the importance of scandals to the development of residential care policy, there have been few studies that have systematically examined the causes and consequences of such scandals. This paper contributes to a research agenda that more fully considers the medias role in the development of residential care policy, attending to both its promises and shortcomings.Purpose – This study aims to explore the causes and consequences of media scandals involving nursing homes for older persons in Canada, Norway, Sweden, the UK and the USA. Design/methodology/approach – This study uses a descriptive case-study methodology which provides an in-depth, focused, qualitative analysis of one selected nursing home scandal in each jurisdiction. Scandals were selected on the basis of being substantive enough to potentially affect policy. An international comparative perspective was adopted to consider whether and how different social, political and economic contexts might shape scandals and their consequences. Findings – This study found that for-profit residential care provision as well as international trends in the ownership and financing of nursing homes were factors in the emergence of all media scandals, as was investigative reporting and a lack of consensus around the role of the state in the delivery of residential care. All scandals resulted in government action but such a...

Centring Care: Explaining Regulatory Tensions in Residential Care for Older Persons

Abstract Residential care is a highly regulated sector. Regulations are often a product of scandal, and they reflect an understandable desire to safeguard nursing homes’ vulnerable populations. However, research on Ontario nursing homes reveals significant tensions between regulations and care. Regulations, and the reporting they require, take valuable time away from care, often fail to account for the relational aspects of care, and disempower residents while empowering paperwork. This article describes and seeks to explain these tensions. We find that the current style of regulating follows the logic of neoliberal auditing. This evidences a top-down approach to accountability, which is reductive in nature and focuses on facilities, care workers, and care processes. It thus misses the structural aspects of care that set the conditions for care—funding, ownership, and staffing levels. We do not argue against regulation nor, necessarily, auditing. Rather, we recognize the importance of distinguishing levels of regulation, and make reference to research suggesting that structural regulations need to be prioritized.

Re-Imagining Long-Term Residential Care: An International Study of Promising Practices

“A society that treats its most vulnerable members with compassion is a more just and caring society for all” (WHO 2002:5). Long-term residential care is where many of our most vulnerable members live and, in spite of moves towards aging in place, where many will continue to live in the future. It is also a workplace for thousands of paid and unpaid providers, most of whom are women and many of whom are from minority communities. It is a barometer of values and practices; a signal of economic, cultural and social perspectives, raising issues that go beyond specific services and practices; issues such as human and social rights, the role of the state, responsibilities of individuals, families and governments, work organization and skills; and notions of care. Yet too often it is characterized as failure; failure of the family to care, failure of the health care system to cure and failure of the individual to live independently, perhaps explaining why it has received so little research and policy attention.Instead of focusing primarily on failures, this paper will sketch out an innovative program to identify promising practices for conceptualizing and organizing long-term care, learning from and between countries. It looks to promising approaches to residential care, to work organization within those facilities, to accountability for quality, to financing and ownership in long-term residential care where the goal is to treat both providers and residents with dignity and respect, to understand care as a relationship and to take differences and equity into account. This paper will provide the first interim report of an international (6 countries), interdisciplinary, 7-year study funded by the Social Sciences and Humanities Research Council of Canada’ Major Collaborative Research Initiatives (2.5 million). The study’s research team includes not only academics, but experienced administrators, representatives of providers, unions, and employers from Canada, U.S., Germany, Norway, Sweden, the U.K (see Appendix 1 for the complete research team). The study’s innovative multi-method approach, with site switching, rapid ethnography used for primary data collection will be presented. Its four theme areas will be explained beginning with analytical mapping of residential care in each jurisdiction, providing both a portrait and analysis of each. The challenges of employing key informant interviews in different countries, with team development between countries, and rapid ethnography techniques of residential care facilities in several locations, with protocols and web-based systems ensuring data sharing across the team in a timely and rigorous manner, will be presented. The goals of iterative analysis of theory and data and reflexive analysis methods will be explained. The paper concludes with a dialectical assessment of innovate methods designed to stimulate innovative thinking by constantly bringing fresh eyes to what is commonplace and ordinary to local observers, but completely new to colleagues and partners from another country. The need to confront opportunities for comparison and rigor with openness to new insights and diverse contexts will be outlined. The philosophical underpinnings of the project are that practical implications of theory and the theoretical implications of practices and processes can create conditions for breakthroughs in theory, empirical results, processes of collaboration, policy and practices not only about conceptualization of residential care and their implications but also about ways of doing and sharing research, filling major gaps in knowledge about long-term care.

Disciplining death: hypertension management and the production of mortal subjectivities.

Medicine powerfully mediates the relationship between life and death. This article argues that in the name of health, modern medicine constitutes a pathological mortal subjectivity, encouraging individuals to experience death as disease, to understand mortality as morbidity, and to approach living instrumentally as a means to longevity. This article uses the example of hypertension management to illustrate how this vision of death is transformed into a form of life.Through the analysis of a number of disciplinary technologies — from technical definitions of health to blood pressure monitoring — it illustrates how individuals are incited to relate to death in an antagonistic, impersonal, and technical fashion. While contemporary forms of capital accumulation in the health field require an intensification of such relations, this article suggests that there much to be gained from exploring visions of health that are not at odds with death.

Ordering suicide: media reporting of family assisted suicide in Britain

Objective: To explore the relationship between the presentation of suffering and support for euthanasia in the British news media. Method: Data was retrieved by searching the British newspaper database LexisNexis from 1996 to 2000. Twenty-nine articles covering three cases of family assisted suicide (FAS) were found. Presentations of suffering were analysed employing Heidegger’s distinction between technological ordering and poetic revealing. Findings: With few exceptions, the press constructed the complex terrain of FAS as an orderly or orderable performance. This was enabled by containing the contradictions of FAS through a number of journalistic strategies: treating degenerative dying as an aberrant condition, smoothing over botched attempts, locating the object of ethical evaluation in persons, not contexts, abbreviating the decision making process, constructing community consensus and marginalising opposing views. Conclusion: The findings of this study support the view that news reporting of FAS is not neutral or inconsequential. In particular, those reports presenting FAS as an orderly, rational performance were biased in favor of technical solutions by way of the legalisation of euthanasia and/or the involvement of medical professionals. In contrast, while news reports sensitive to contradiction did not necessarily oppose euthanasia, they were less inclined to overtly support technical solutions, recognising the importance of a trial to address the complexity of FAS.