2025/03/21 by Fawn Harrad-Hyde, Christopher Williams, Natalie Armstrong · 1 voice
Health Professions · Medicine · Psychology · #Geriatric Care and Nursing Homes #Palliative Care and End-of-Life Issues #Grief, Bereavement, and Mental Health
paper · doi:10.1016/j.socscimed.2025.118012
openalex publication_date 2025/03/21 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/02
Older people living in care homes are susceptible to deteriorations in their health. At times of deterioration, care home staff play a crucial role in considering the potential benefits and burdens associated with either caring for the resident in the home or transferring them to hospital. Using data collected through interviews with 30 care home staff and 113 h of ethnographic fieldwork in care homes in England, we consider the ways that care home staff can perceive deteriorating care home residents to be, often simultaneously, vulnerable (or ‘at risk’) and dangerous (or ‘a risk’) in both the hospital and the care home. Drawing on the work of Mary Douglas, we suggest deteriorating care home residents can be considered to be ‘matter out of place’ and can therefore be considered as ‘placeless’ in whichever setting they receive care. Instead of asking whether deteriorating residents are in the ‘right place’ to receive care, we might instead ask whether healthcare services are the ‘right shape’ to support to deteriorating care home residents and their complex needs. • Care home residents often experience deteriorations in their health. • Care staff play a crucial role in deciding whether to transfer residents to hospital. • Staff perceive residents as vulnerable and dangerous in hospitals and care homes. • Deteriorating residents are viewed as matter out of place in both settings.