Chinese Journal of Sociology ›› 2023, Vol. 43 ›› Issue (3): 162-186.

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The Limits of Care: An Ethnographic Study of Dementia Care in Nursing Homes

WU Xinyue   

  • Online:2023-05-20 Published:2023-06-14
  • Supported by:
    This paper was sponsored by the National Social Science Foundation of China(21CSH027)

Abstract: This ethnographic study offers insights into the lifeworld and multiple experiences of individuals with dementia residing in nursing homes. Firstly, from the perspective of phenomenological sociology, the study delves into the "disruption of experiences" resulting from dementia, which fundamentally alters the existential situation of patients. This disruption manifests as a fracture of self-coherence and a dissociation of intersubjectivity. When entering a nursing home, patients are further detached from their previous social relationships and world of meaning. Secondly, the article explores how specific ensembles of knowledge and practice in nursing homes shape the dementia experience. Under the current care management system with ADL as its core classification framework, the operational significance of dementia as a category is to a large extent dismantled. However, the stigmatizing label "laonian chidai" (senile dementia) often appears in the daily symbolic interaction process, causing all kinds of discrimination and conflicts. The dilemma of cognitive impairment classification of nursing homes reveals the dialectic relationship between "normal" and "abnormal" in definition and operation. This in turn affects the personhood and living situation of people with dementia. Finally, this article focuses on the daily ethics of dementia care, selecting two typical care scenarios of demand response and physical restraint, to examine how caregivers respond to daily crises and adopt expedient practices. The study suggests that the special care relationship of dementia care provides us with a new perspective on personhood and intersubjectivity.

Key words: dementia care, nursing home, ordinary ethics, personhood, intersubjectivity