A Relational Approach to an Analytics of Resistance: Towards a Humanity of Care for the Infirm Elderly – A Foucauldian Examination of Possibilities
DOI:
https://doi.org/10.22439/fs.v0i0.5344Nøgleord:
Foucault, epistemology, resistance, governmentality, neoliberalism, medicalization, eldercareResumé
This paper develops a Foucauldian analytics of resistance in relation to components of a system of governance – a governmentality. Techniques of resistance that can transform a governmentality towards the development of a new politics of truth require the design of techniques of resistance to counter directly oppressive techniques of biopower and disciplinary power, in turn to produce new regimes of practices or counter-conduct that can engender a new mentality and set of discourses to convey it. Strategies of resistance towards transformative change in the governance of a population as well as of the self therefore require development following, and in relation to, an analytics of governance. I thread these points through a particular case, the problem of care for the infirm elderly in the United States, focusing specifically on nursing homes by critically synthesizing issues from inter-disciplinary literatures and casting them in terms of governmentalities. I frame the problems of eldercare broadly in terms of interrelated neoliberal and (western) scientific mentalities and associated discourses, and then examine the associated techniques of biopower, disciplinary power, and regimes of practices to identify roots of problems, explain failures of policies, and crucially, to frame the design of techniques of resistance to produce new regimes of counter-conduct. I suggest avenues of resistance in relation to existing governmentalities on the terrain of inter-firm relations and everyday life in nursing-home care, all currently entangled with government policies, economies of documentation, and dehumanizing scientific practice.
Referencer
A. Amin and J. Roberts, "Knowing in Action: Beyond Communities of Practice," Research Policy, vol. 37, (2008), 353-369
https://doi.org/10.1016/j.respol.2007.11.003
A. Amin and P. Cohendet, Architectures of Knowledge, (New York: Oxford University Press, 2004)
https://doi.org/10.1093/acprof:oso/9780199253326.001.0001
A. Powell, "Hacking in the Public Interest: Authority, Legitimacy, Means, and Ends," New Media and Society, vol. 18 (2016), 600-616
https://doi.org/10.1177/1461444816629470
A. Preston, "The Birth of Clinical Accounting," Accounting, Organizations and Society, vol. 17 (1992), 63-100
https://doi.org/10.1016/0361-3682(92)90036-R
A. Saldanaha, "Heterotopia and Structuralism," Environment and Planning A, vol 40 (2008), 2080-2096
https://doi.org/10.1068/a39336
A.G. Hopwood and P. Miller (eds.) Accounting as Social and Institutional Practice (New York: Cambridge University Press, 1994)
A.L. Morrone and J. Smoller, "Cost Tracking for Nursing Homes, CPA Journal, vol. 73 (2003), 50-51
Anonymous, "See Me," http://www.nursinghomealert.com/share-this-poem
B. Cruikshank "Welfare Queens," in F. Schram and P.T. Neisser, Tales of the State (New York: Rowman & Littlefield, 1997), 113-124
B. Ehrenreich and A. Hochschild (eds.), Global Women (New York: Holt, 2002)
B. Neilson, "Ageing and Globalisation in a Moment of So-Called Crisis," Health Sociology Review, vol. 18 (2009), 349-363
https://doi.org/10.5172/hesr.2009.18.4.349
B. Rosenberg, Ageing, Community, and Neoliberal Governance (London: Routledge, 2016); S. Katz, Disciplining Old Age (Charlottesville: University of Virgina Press, 1996)
B.C. Farmer, A Nursing Home and its Organizational Climate (Westport, CT: Auburn House, 1996)
B. Rosenberg, "Social Spaces for Seniors," Journal of Sociology, vol. 51 (2015), 467-477
https://doi.org/10.1177/1440783312474083
B. Vladek, Unloving Care (New York: Basic Books, 1980)
B. Vladek, "Unloving Care Revisited," Journal of Social Work in Long-Term Care, vol. 2 (2003), 1-9
https://doi.org/10.1300/J181v02n01_01
B.K. Seblega, N.J. Zhang, L.Y. Unruh, G.-M. Breen, and T.T.H. Wan, "Changes in Nursing Time Staffing Levels, 1997-2007, Medical Care Research and Review, vol. 67 (2010), 232-246
https://doi.org/10.1177/1077558709342253
C. Berdes and J.M. Eckert, "Race Relations and Caregiving Relationships," Research on Ageing, vol. 23 (2001), 109-126
https://doi.org/10.1177/0164027501231006
C. Duhigg, "At Many Homes, More Profit, Less Nursing, New York Times, September 23 (2007), http://www.nytimes.com/2007/09/23/business/23nursing.html?pagewanted=1%3Erssyahoo&ei=5089&en=ba37662c8b5c6589&ex=1348200000&partner%3Cbr%20/&emc=rss&_r=0
C. Edwards, L. Gandini, G. Forman (eds.), The Hundred Languages of Children (Santa Barbara, CA: Praeger, 2012)
C. Harrington, "Residential Nursing Facilities in the United States," British Medical Journal, vol. 323, (2001), 507-510
https://doi.org/10.1136/bmj.323.7311.507
C. Harrington, C. Hauser, B. Olney, and P.V. Rosenau, "Ownership, Financing, and Management Strategies of the Ten Largest For-Profit Nursing Home Chains in the United States," International Journal of Health Services, vol. 41 (2011), 725-746
https://doi.org/10.2190/HS.41.4.g
C. Harrington, J. Choiniere, M. Goldmann, F.F. Jacobsen, L. Lloyd, M. McGregor, V. Stamatopoulos, and V. Szebehely, "Nursing Home Staffing Standards and Staffing Levels in Six Countries," Journal of Nursing Scholarship, vol. 44 (2012), 88-98
https://doi.org/10.1111/j.1547-5069.2011.01430.x
C. Harrington, B. Olney, H. Carrillo, and T. Kang, "Nurse Staffing and Deficiencies in the Largest For-Profit Nursing Home Chains and Chains Owned by Private Equity Companies," Health Services Research 47 (2012), 106-128
https://doi.org/10.1111/j.1475-6773.2011.01311.x
C. Hawes ad C.D. Phillips, "The Changing Structure of the Nursing Home Industry and the Impact of Ownership on Quality, Cost, and Access," in B.H. Gray (ed.) For-Profit Enterprise in Health Care (Washington, D.C.: National Academy Press, 1986), 492-541
C.H. Schmitt, "The New Math of Old Age," U.S. News & World Report, vol. 133, no. 12 (2002), 66-72
C.L. Estes, The Aging Enterprise (San Francisco, Jossey-Bass, 1979)
C.M. Grogan, "The Medicalization of Long-Term Care," in C.M. Mara and L.K. Olson (eds.) Handbook of Long-Term Care Administration and Policy (Boca Raton, FL: CRC Press, 2008)
https://doi.org/10.1201/9781420013245.ch4
C.W. Lidz, L. Fischer, and R.M. Arnold, The Erosion of Autonomy in Long-Term Care (New York: Oxford University Press, 1992)
D. Haraway, "Situated Knowledges," Feminist Studies, vol. 14, (1988), 575-599
https://doi.org/10.2307/3178066
D. Harvey, A Brief History of Neoliberalism (New York: Oxford, 2005)
D.A. Boehm, "The Safety Net of the Safety Net," Medical Anthropological Quarterly, vol. 19 (2005), 47-63
https://doi.org/10.1525/maq.2005.19.1.047
D.G. Stevenson and D.C. Gabrowski, "Private Equity Investment and Nursing Home Care," Health Affairs, vol. 27 (2008), 1399-1408
https://doi.org/10.1377/hlthaff.27.5.1399
D.S. Cloutier, A. Martin-Matthews, K. Byrne, and F. Wolse, "The Space Between," Social and Cultural Geography, vol. 16 (2015), 764-782
https://doi.org/10.1080/14649365.2015.1020336
E. Anderson and J. Spiers, "Alone in Eden," Western Journal of Nursing Research, vo. 111, no. 12 (2015), 24-25
E. Goffman, Asylums (Chicago: Aldine, 1961)
E. Laclau and C. Mouffe, Hegemony and Socialist Strategy (New York: Verso, 2nd edition, 2001)
E. Tulle (ed.), Old Age and Agency (New York: Nova Science, 2004)
E. Tulle-Winton, "Growing Old and Resistance," Ageing and Society, vol. 19 (1999), 281-299
https://doi.org/10.1017/S0144686X98007193
E.A. Miller, V. Mor, D.C. Grabowski, and P.L. Gozalo, "The Devil is in the Details," Journal of Health Politics, Policy and Law, vol. 34 (2009), 93-135
https://doi.org/10.1215/03616878-2008-993
Economist, "Private Equity Buys into Care Homes," The Economist; November 25 (2010), http://www.economist.com/node/17581666
G. Agamben, D. Heller-Roazen (trans.) Homo Sacer (Stanford: Stanford University Press, 1995)
G. Kolata, "Costs for Dementia Care Far Exceeding Other Diseases, Study Finds," Nytimes.com, Oct. 27 (2015), http://www.nytimes.com/2015/10/27/health/costs-for-dementia-care-far-exceeding-other-diseases-study-finds.html
G. Raj-Reichert, "Safeguarding Labour in Distant Factories," Geoforum, vol. 44 (2012), 23-31
https://doi.org/10.1016/j.geoforum.2012.05.007
GAO, Nursing Homes (Washington, D.C., United States Government Accountability Office Report to Congressional Requesters, GAO-10-710, 2010)
H. Bradby, "International Medical Migration," Health, vol. 18 (2014), 580-596
https://doi.org/10.1177/1363459314524803
Highbeam Business, "Skilled Nursing Care Facilities Market Report," Highbeam Business (2012), http://business.highbeam.com/industry-reports/business/skilled-nursing-care-facilities
I.M. Young, Inclusion and Democracy (New York: Oxford, 2000)
J. Braithwaite, Regulatory Capitalism (Northampton, MA: Edward Elgar, 2008)
https://doi.org/10.4337/9781848441262
J. Braithwaite, T. Makkai, and V. Braithwaite, Regulating Aged Care (Northampton, MA: Edward Elgar, 2007)
J. Goodwin, "Drug Abuse," AARP Bulletin, July/August (2014), http://www.aarp.org/health/drugs-supplements/info-2014/antipsychotics-overprescribed.html
J. Gubrium, Living and Dying at Murray Manor (New York: St. Martin's Press, 1975)
J. Hendricks, "Governmental Responsibility: Adequacy or Dependency for the USA Aged," in D.G. Gill and S.R. Ingman (eds.), Eldercare, Distributive Justice, and the Welfare State (Albany, NY: State University of New York Press, 1994), 255-285
J. Lave and E. Wenger, Situated Learning (New York: Cambridge University Press, 1991) and E. Wenger, Communities of Practice (Cambridge: Cambridge University Press, 1998)
J. Roberts, "The Manufacture of Corporate Social Responsibility," Organization, vol. 10 (2003), 249-265
https://doi.org/10.1177/1350508403010002004
J. Rothenberg-Aalami, "Coming Full Circle?," Global Networks, vol. 4, (2004), 335-354
https://doi.org/10.1111/j.1471-0374.2004.00097.x
J. Silver-Greenberg and R. Gebeloff, "Arbitration Everywhere," New York Times, October 31 (2015), http://www.nytimes.com/2015/11/01/business/dealbook/arbitration-everywhere-stacking-the-deck-of-justice.html?_r=0
J.F. Childress, "If You Let Them They'd Stay in Bed All Morning," in R.A. Kane and A.L. Kaplan (eds.) Everyday Ethics (New York: Springer, 1990), 79-89
J.K. Gibson-Graham and J. Cameron "Community Enterprises: Imagining and Enacting Alternatives to Capitalism," in S. Healy and J. Hillier (eds.) The Ashgate Research Companion to Planning Theory (Burlington, VT: Ashgate, 2010), 291-298
J.K. Gibson-Graham, J. Cameron, and S. Healy, S, Take Back the Economy (Minneapolis: University of Minnesota Press, 2013)
J.L. Howsden, Work and the Helpless Self (Washington, D.C.: University Press of America, 1981)
J.L. Powell, "Social Theory, Aging, and Health and Welfare Professionals," Journal of Applied Gerontology, vo. 28 (2009), 699-682
https://doi.org/10.1177/0733464809335596
J.L. Powell and A. Wahidin (eds.), Foucault and Aging (New York: Nova Science., 2006)
J.L. Powell, and S. Biggs, "Foucauldian Gerontology," Electronic Journal of Sociology, vol. 7 (2003) and J.L. Powell, Social Theory and Aging (Lanham, MD: Rowman and Littlefield, 2006), 93-116
J.N. Henderson, "The Culture of Care in a Nursing Home," in J.N. Henderson and M.D. Vesperi (eds.) The Culture of Long Term Care (Westport, CT: Bergin & Garvey, 1995), 37-54
J.S. Hanan, "Home is Where the Capital Is," Communication and Critical/Cultural Studies, vol. 7 (2010), 176-201
https://doi.org/10.1080/14791421003759166
J.S. Ulsperger and J.D. Knotternus, "The Social Dynamics of Eldercare," Sociological Spectrum, vol. 28 (2008), 357-388
https://doi.org/10.1080/02732170801898422
J.S. Ulsperger and J.D. Knotternus, Elder Care Catastrophe (Boulder: Paradigm, 2011)
K. Mitchell and C. Lizotte, "The Grassroots and the Gift," Foucault Studies, vol. 18 (2014), 66-89
https://doi.org/10.22439/fs.v0i18.4652
K. Thomas, "Medicare Star Ratings Allow Nursing Homes to Game the System," New York Times, August 24 (2014), http://www.nytimes.com/2014/08/25/business/medicare-star-ratings-allow-nursing-homes-to-game-the-system.html
K.R. Kaffenberger, "Nursing Home Ownership," Journal of Aging & Social Policy, vol. 12 (2000), 35-48
https://doi.org/10.1300/J031v12n01_04
L.K. Olson, The politics of Medicaid (New York: Columbia University Press, 2010)
https://doi.org/10.7312/olso15060
L. McDowell, "Roepke Lecture in Economic Geography – The Lives of Others: Body Work, the Production of Difference, and Labor Geographies," Economic Geography, vol. 91 (2015), 1-23
https://doi.org/10.1111/ecge.12070
L. Mehl-Madrona, Narrative Medicine (Rochester, VT: Bear and Company, 2007)
L.J. Cutler and R.A. Kane, "Transforming nursing homes," InformeDesign, vol. 5, no. 9 (2007), https://www.pioneernetwork.net/Data/Documents/TransformingNursingHomesnformedesignnewsletterKaneCutler.pdf
L.-W. Chen and D.G. Shea, "Does Prospective Payment Really Contain Nursing Home Costs?", Health Services Research, vol. 37 (2002), 251-271
https://doi.org/10.1111/1475-6773.022
M. Brady, "Ethnographies of Neoliberal Governmentalities," Foucault Studies, vol. 18 (2014), 11-33; T. Li, "Fixing Non-Market Subjects," Foucault Studies, vol. 18 (2014), 34-48
M. Dean, Governmentality (Los Angeles: Sage, 2010)
M. Devitt B. Checkoway, "Participation in Nursing Home Resident Councils," The Gerontologist, vol. 22 (1982), 49-53
https://doi.org/10.1093/geront/22.1.49
M. Foucault, "Power and Strategies," in C. Gordon (ed.), C. Gordon, L. Marshall, J. Mepham, and K. Soper (trans.) Power/Knowledge (New York: Pantheon, 1980)
M. Foucault, "Two Lectures," in C. Gordon (ed.), C. Gordon, L. Marshall, J. Mepham, and K. Soper (trans.) Power/Knowledge (New York: Pantheon, 1980)
M. Foucault, "Of Other Spaces," Diacritics, vol. 16 (1986), 22-27
https://doi.org/10.2307/464648
M. Foucault, R. Hurley (trans.), The History of Sexuality, vol. I (New York: Vintage Books, 1990)
M. Foucault, R. Hurley (trans.), The History of Sexuality, vol. I (New York: Vintage Books, 1990)
M. Foucault, A.M. S. Smith (trans.) The Birth of the Clinic (New York: Vintage Books, 1994)
M. Foucault, "Sex, Power, and the Politics of Identity," in S. Lotringer (ed.), L. Hochroth and J. Johnston (trans.), Foucault Live (New York: Semiotext(e), 1996)
M. Foucault, "The Ethics of the Concern for the Self as a Practice of Freedom," in P. Rabinow (ed.), R. Hurley and others (trans.) Michel Foucault/Ethics (New York: The New Press, 1997)
M. Foucault, D. Macey (trans.), Society Must Be Defended (New York: Picador, 1997)
M. Foucault, "The Subject and Power," in J.D. Faubion (ed.), R. Hurley and others (trans.) Michel Foucault/Power (New York: The New Press, 2000).
M. Foucault, "Questions of Method," in J.D. Faubion (ed.), R. Hurley and others (trans.) Michel Foucault/Power (New York: The New Press, 2000)
M. Foucault, The Hermeneutics of the Subject (New York: Picador, 2005)
M. Foucault, M. Senellart (ed.), G. Burchell (trans.) Security, Territory, Population (New York: Picador, 2007).
M. Foucault, M. Senellart (ed.), G. Burchell (trans.) The Birth of Biopolitics (New York: Palgrave, 2008)
M. Kitchener and C. Harrington, "The U.S. Long-Term Care Field," Journal of Health and Social Behavior, vol. 45 (2004), 87-101
M.A. Mendelson and W. Mendelson, Tender Loving Greed: 2009 Notes (Prescott, AZ: One-Off Press).
M. Mennel, T. Mendelson, K.A. McElhaney, and B. Marquard, The Roadmap Toward Effective Strategic Social Partnerships (Deloitte University Press: 2013 online)
N. Ettlinger, "Governmentality as Epistemology, Annals of the Association of American Geographers, vol. 101 (2011), 537-560. https://doi.org/10.1080/00045608.2010.544962
N. Ettlinger and C. Hartmann, "Post/neo/liberalism in Relational Perspective," Political Geography, vol. 48 (2015), 37-48. https://doi.org/10.1016/j.polgeo.2015.05.009
N. Foner, The Caregiving Dilemma (Berkley: University of California Press, 1994)
N. Foner, "Hidden Injuries of Bureaucracy," Human Organization, vol. 54 (1995), 229-237. https://doi.org/10.17730/humo.54.3.g5350404082264q3
N. Fraser, Scales of Justice (Malden, MA: Polity, 2008)
M. Huxley, "Historicizing planning, problematising participation," International Journal of Urban and Regional Research, vol. 37 (2013), 1527-1658. https://doi.org/10.1111/1468-2427.12045
M. Power, The Audit Society (New York: Oxford University Press, 1997
P. Span, "Overmedication in the Nursing Home," New York Times, January 11 (2010), http://newoldage.blogs.nytimes.com/2010/01/11/study-nursing-home-residents-overmedicated-undertreated/?_r=0
P. Whitehouse, D. George, J. Wigg, and B. Joseph, "From Demedicalisation to Renaturalisation," in J. Gilliard and M. Marshall (eds.), Transforming the Quality of Life for People with Dementia through Contact with the Natural World (Philadelphia: Jessica Kingsley, 2012), 55-69
P.C. Aka, L.M. Deason, and A. Hammond, "Political Factors and Enforcement of the Nursing Home Regulatory Regime," Journal of Law and Health, issue 1 (2011), 1-43
P.L. Cochran, "The Evolution of Corporate Responsibility," Business Horizons, vol. 50 (2007), 449-454. https://doi.org/10.1016/j.bushor.2007.06.004
P.M. Pittman, A.J. Folsom, and E. Bass, "U.S.-Based Recruitment of Foreign-Educated Nurses," American Journal of Nursing, vol. 110, no. 6 (2010), 38-48. https://doi.org/10.1097/01.NAJ.0000377689.49232.06
Pioneer Network, "Positive Outcomes for Culture Change – The Case for Adoption," Tools for Change, vol. 1, no. 2, https://www.edenalt.org/wordpress/wp-content/uploads/2009/06/Tools_for_Change-Adoption_v3.pdf
R. Charon, "Narrative Medicine," Journal of the American Medical Association, vol. 286 (2001), 1897-1902; R. Charon, Narrative Medicine (New York: Oxford University Press, 2006)
R. Fairbanks II, How it Works (Chicago: University of Chicago Press, 2009). https://doi.org/10.7208/chicago/9780226234113.001.0001
R.K. Lippert, "Neo-liberalism, Police, and the Governance of Little Urban Things," Foucault Studies, vol. 18 (2014), 49-65. https://doi.org/10.22439/fs.v0i18.4651
R. Mead, "The Sense of Ending," The New Yorker, May 20 (2013), 92-103
R. Pradhan and R. Weech-Maldonado, "Exploring the Relationship Between Private Equity Ownership and Nursing Home Performance," Advances in Health Care Management, vol. 11 (2011), 63-89. https://doi.org/10.1108/S1474-8231(2011)0000011007
S. Benhabib (ed.), Democracy and Difference (Princeton, NJ: Princeton University Press, 1996)
S. Biggs, and J.L. Powell, "A Foucauldian Analysis of Old Age and the Power of Social Welfare," Journal of Aging and Social Policy, vol. 12 (2001), 1-20. https://doi.org/10.1300/J031v12n02_06
S. Brownie and S. Nancarrow, "Effects of Person-Centered Care on Residents and Staff in Aged-Care Facilities," Clinical Interventions in Aging, vol. 8 (2013), 1-10. https://doi.org/10.2147/CIA.S38589
S.G. Post, The Moral Challenge of Alzheimer's Disease (Baltimore: Johns Hopkins University Press, 1995)
S. Katz, Disciplining Old Age (Charlottesville: University of Virgina Press, 1996)
S. Katz, "Busy Bodies," Journal of Aging Studies, vol. 12 (2000), 135-152. https://doi.org/10.1016/S0890-4065(00)80008-0
S. Katz and B. Green, "The Government of Detail," in S. Katz, Cultural Aging (Toronto: Broadview Press, 2005)
S. Llewellyn, "Boundary Work," Accounting, Organizations and Society, vol. 23 (1998), 23-47. https://doi.org/10.1016/S0361-3682(96)00036-0
S. Murphy, "'Compassionate' Strategies of Managing Homelessness," Antipode, vol. 41, (2009), 305-325. https://doi.org/10.1111/j.1467-8330.2009.00674.x
S.F. Schram and B. Silverman, "The End of Social Work," in S.F. Schram, The Return of Ordinary Capitalism (New York: Oxford University Press, 2015), 109-133. https://doi.org/10.1093/acprof:oso/9780190253011.003.0005
S.H. Lopez, "Culture Change Management in Long-Term Care," Politics and Society, vol. 34 (2006), 55-79. https://doi.org/10.1177/0032329205284756
S.H. Lopez, "Efficiency and the Fix Revisited," Qualitative Sociology, vo. 37 (2007), 225-247. https://doi.org/10.1007/s11133-007-9062-0
T. Diamond, Making Gray Gold (Chicago: University of Chicago Press, 1992). https://doi.org/10.7208/chicago/9780226144795.001.0001
T.F. Tierney, "Anatomy and Governmentality," Theory and Event, vol. 2, (1998).
T.M. Luhrmann, "'The Street Will Drive You Crazy'," American Journal of Psychiatry, vol. 165 (2008), 15-20. https://doi.org/10.1176/appi.ajp.2007.07071166
T.M. Kitwood, Dementia Reconsidered: The Person Comes First (Philadelphia: Open University Press, 1997)
T.S. Jost, "The Necessary and Proper Role of Regulation to Assure the Quality of Health Care," Houston Law Review, vol. 25 (1988), 525-598
W.H. Thomas, Life Worth Living (Acton, MA: VanerWyk and Burnham, 1996)
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