When care is redistributed:: An analysis of the conflict-ridden care-troika between people with dementia, informal caregivers and staff in a nursing home in Denmark.

Abstract

In this article, we explore the relations between people with dementia, their relatives and professional caregivers, which come into existence when a person with dementia moves into a nursing home – what we call a care-troika. When people with dementia move into a nursing home it is not only the physical environment that changes, but also the close, intimate relations. We examine the ambivalent and fragile care-troika that emerges and the new forms of relatedness that arise through these new relations. The article is based on fieldwork in a dementia ward in a Danish nursing home, where conflicts between relatives and staff occurred regularly. The conflicts where often centered on how to provide the best care for the people with dementia. Staff and relatives both had the same goal of providing good care but had very different views on what good care entails. We argue that this fundamental difference of opinion stems from different points of reference, different objects of care and various forms of relatedness. The care that the staff provides is simultaneously institutional, replaceable and loving and their care is aimed at the community of people with dementia. The care of the relatives is on the other hand singular – aimed at one person – loving and irreplaceable. This creates disagreements, which are enhanced by very different perceptions of the persons with dementia’ needs. In conclusion, we call for an institutional focus on this care-troika, and the challenging collaborative relations it entails, when people with dementia move to a nursing home.