Confused, Angry, Anxious? by Bo Hejlskov Elvén
Author:Bo Hejlskov Elvén
Language: eng
Format: epub
ISBN: 9781784504946
Publisher: Jessica Kingsley Publishers
Published: 2016-01-18T16:00:00+00:00
DEMANDS AS A PEDAGOGICAL TOOL
The first part of this principle, ‘Pedagogy and care involve making the right demands’, is easy to relate to. If it weren’t true, there would be no need for schools, universities or care homes. All pedagogical work is about getting people to do things they wouldn’t have done if they hadn’t been part of a context. This of course also applies to care of older people. Older people receive support in their own homes or a place in a care home because they no longer can do what they used to do. Otherwise it would be enough for them to receive practical help in the form of cooking and cleaning.
Philosopher Martha Nussbaum says that all pedagogical work and all work in care is based to some degree on taking away the basic right to self-determination. This is an interesting perspective. And it is easy to understand her thinking. Because of course we don’t allow people with dementia to decide entirely what they want to do, how often they shower, brush their teeth or take a walk. After all, they are in a care home because they haven’t been able to manage everyday life well enough on their own. This means that as staff we have quite a heavy responsibility. Nussbaum is of the opinion that it doesn’t have to be a problem in itself that we take away a person’s autonomy. But we must have a good reason for doing so. Always.
The arguments that we have found in our work to be relevant in this regard are:
•Avoidance of danger. People with dementia illnesses should preferably be where we can keep an eye on them. This is not particularly controversial. They can easily get lost and get seriously hurt or even killed if left to go about on their own. The basic principle in Sweden, for example, is that people may not be locked up as long as there is no court order giving the right to do so, either a criminal sentence or through special laws on psychiatric care. It is understandable that, to avoid danger, we still make it difficult for the residents in a care home to leave, for example by placing a dark mat in front of the door going outside, as described earlier in Chapter 3. This is the same argument we use when we resort to emergency measures, for example when we take hold of someone to prevent them from running straight into the traffic.
•Care. We use the care argument when we require good hygiene, for example. When avoiding danger, we may use some fairly far-reaching methods, bordering on domination and control. This is not possible when using the care argument. Grabbing hold of a person who is heading into the traffic would not be seen as excessive, but brushing someone’s teeth with force, as in Gunlaya’s case, is definitely crossing the line in many people’s view. On the other hand, we can use various tricks and even some manipulation when invoking the care argument.
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