Power, empowerment, and person-centred care: using ethnography to examine the everyday practice of unregistered dementia care staff.
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| Abstract | :  The social positioning and treatment of persons with dementia reflects dominant biomedical discourses of progressive and inevitable loss of insight, capacity, and personality. Proponents of person-centred care, by contrast, suggest that such loss can be mitigated within environments that preserve rather than undermine personhood. In formal organisational settings, person-centred approaches place particular responsibility on 'empowered' direct-care staff to translate these principles into practice. These staff provide the majority of hands-on care, but with limited training, recognition, or remuneration. Working within a Foucauldian understanding of power, this paper examines the complex ways that dementia care staff engage with their own 'dis/empowerment' in everyday practice. The findings, which are drawn from ethnographic studies of three National Health Service (NHS) wards and one private care home in England, are presented as a narrative exploration of carers' general experience of powerlessness, their inversion of this marginalised subject positioning, and the related possibilities for action. The paper concludes with a discussion of how Foucault's understanding of power may help define and enhance efforts to empower direct-care staff to provide person-centred care in formal dementia care settings. | 
| Year of Publication | :  2017 | 
| Journal | :  Sociology of health & illness | 
| Volume | :  39 | 
| Issue | :  2 | 
| Number of Pages | :  227-243 | 
| ISSN Number | :  0141-9889 | 
| URL | :  https://doi.org/10.1111/1467-9566.12524 | 
| DOI | :  10.1111/1467-9566.12524 | 
| Short Title | :  Sociol Health Illn | 
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