“This is my life now”: Lived experiences of residents in care homes in Goa, India
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Date
01/07/2014Author
Menezes, Deborah Christina
Metadata
Abstract
Increasingly, old people in India are moving into institutional settings. There
is a paucity of qualitative research examining the condition of residents in care
homes. This thesis addresses this gap through a detailed qualitative study of three
such homes in Goa, India. It explores the care processes and practices in the care
homes and how far they are attuned to the needs, lives and identities of their
residents. An understanding of the experiences of residents as they have been
undergoing different stages of entering and settling into a residential care setting has
been the main focus of the research, which illuminates the context in which resident
experiences were embedded.
The thesis explores the process of institutional living: the conditions (losses
and changes) that lead older people to enter institutional care; the losses and changes
incurred while entering institutional care; the paradox between induced dependencies
created by institutional control and structures resulting in passive compliance; and
the struggles of the residents to resist these power structures. In documenting life for
the resident in the care homes the thesis shows that their subtle daily forms of
resistance exist within a framework of power. The final empirical chapter discusses
how residents experience different forms of departure, whether as ending this
struggle or beginning a new one.
Data were collected through a combined ethnographic methodology of
participant observation and semi-structured interviews with residents, staff and
management over an eight-month period, in addition to a scoping survey of 37 care
homes in the State. The study retrospectively examines residents’ experiences during
various stages – pre-entry, entry, post-entry and exit – of their residential career, the
drivers and constraints during these stages, and the role of staff and management in
contributing to these experiences. These are presented as narratives – interleaved
stories highlighting (some) important aspects of life in care homes in Goa. I have
included the various responses made by residents to the different stages of their
residential career – their ambivalences as well as their certainties, their anger as well
as their passive acceptance, their dependence as well as their agency – and to
interpret residents as sometimes vulnerable, sometimes invincible, and sometimes
struggling. In doing so, I have provided insights into the ups and downs of life in
care homes in Goa, through exploring paradigms that were crucial to residents’ lives
in my study.
These insights reveal that the dismantling of residents’ individual autonomy
and control occurred prior to their coming into the institution. Once inside the care
home, their lives were further altered by rules, routines and practices of staff and
management. The resident’s identities thus were increasingly being defined by the
institution. The findings further revealed that residents do not always accept passive
dependency but instead struggle to carve their own identity within the institutional
settings and controls they are subjected to. Finally, my findings reveal how
perceptions and preparations for departure from the institution are coping
mechanisms used by the residents and the staff alike, as extensions of their struggle
for survival, freedom, and control.
These findings lead to a greater understanding of how different processes are
intertwined in residential careers for residents in care homes in Goa. The findings
invite a rethinking of conceptions of autonomy and ageing, passive compliance and
agency, and departure and coping, particularly within the context of institutional
living in Goa. This study has thus illustrated the mechanisms in place for older
people entering, settling and leaving care homes in Goa and demonstrated whether
these mechanisms are adequately suited to their needs. The hope is that this
understanding will contribute to the development of improved policy and practice
that better reflects the needs and wellbeing of older people.