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Articles
Published: 2024-12-19

Intra-normativities in technologizing old age care work: Mobile record-keeping, remote homecare and social media use shaping good care

Finnish Institute of Occupational Health
Finnish Institute of Occupational Health
Finnish Institute of Occupational Health
Finnish Institute of Occupational Health
Finnish Institute of Occupational Health
elder care work ethics of care socio-materialism technologization intra-normativity empirical ethics of care

Abstract

Western societies tend to implement new technologies to elder care work to replace routines in order to make services more efficient and transparent as the population ages and public resources diminish. However, we have not paid enough attention to how care practitioners perceive their changed circumstances in elder care work. Drawing on the thematic interviews of 31 care practitioners in Finland, we analyzed how the emergence of mobile record-keeping during homecare visits, use of video visits in remote homecare and social media use in intensive service housing shaped what is perceived as good care. Leaning on empirical ethics of care approach we found that each elder care service context and its technology shape its own intra-normativities. Each intra-normativity brings different values into being in elder care, which impact on work practices and how the relations between care practitioners and clients, and with the wider public are enacted.  

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References

  1. Ajslev, J. Z. N., Højbjerg, H., Andersen, M. F., Andersen, L. L., & Poulsen, O. M. (2019). Occupational identities and physical exertion in (re) configurations of new technologies in eldercare. Nordic Journal of Working Life Studies, 9(4), 19-37. https://doi.org/10.18291/njwls.v9i4.117778.
  2. Bergschöld, J. (2018). When saving time becomes labor: Time, work, and technology in homecare. Nordic journal of working life studies, 8(1), 3-21. http://dx.doi.org/10.18291/njwls.v8i1.104850
  3. Cartwright, L. (2000). Reach out and heal someone: Telemedicine and the globalisation of healthcare. Health, 4(3), 347–377.
  4. Denzin, N.K. (1997). Interpretive ethnography. Ethnographic practices for the 21st century. USA: Sage Publications inc.
  5. Dyck, I. & England, K. (2012). Homes for care: reconfiguring care relations and practices. in Ceci, C., Bjornsdottir, K. and Purkis, M.E. (eds.): Perspectives on care at home for older people. New York: Routledge, 62-77.
  6. Engster, D. (2005). Rethinking care theory: The practice of caring and the obligation to care. Hypatia, 20(3), 50-74. https://doi.org/10.1111/j.1527-2001.2005.tb00486.x
  7. Ertner, M. (2019). Enchanting, evoking, and affecting: The invisible work of technology implementation in homecare. Nordic working life studies, 9(S5), 33-47. https://doi.org/10.18291/njwls.v9iS5.112690
  8. Eskelinen, K. (2017). Partikularismista universalismiin. Toiminnanohjausjärjestelmän ja uuden kotihoitomallin vaikutus kotihoidon lähiesimiesten etiikkaan. [From Particularism to universalism. The impact of enterprise resource planning system and the new homecare model to ethics of supervisors.] Janus, sosiaalipolitiikan ja sosiaalityön tutkimuksen aikakauslehti, 25(3), 224-239. https://journal.fi/janus/article/view/53413
  9. Fazio, S., Pace, D., Flinner, J. & Kallmyer, B. (2018). The Fundamentals of Person-Centered Care for Individuals with Dementia. Gerontologist, 58(S1), S10-S19. https://doi.org/10.1093/geront/gnx122
  10. Fineman, M. (2004). The autonomy myth: A theory of dependency. New York: The New Press.
  11. Frennert, S. (2023). Moral distress and ethical decision-making of eldercare professionals involved in digital service transformation. Disability and Rehabilitation: Assistive Technology, 18(2), 156-165, doi: https://doi.org/10.1080/17483107.2020.1839579
  12. Frennert, S., & Östlund, B. (2018). Narrative review: Technologies in eldercare. Nordic Journal of Science and Technology Studies, 6(1), 21-34.
  13. Gilligan, C. (1982). In a different voice. Cambridge: Harvard University Press.
  14. Halford, S., Obstfelder, A. & Lotherington, A. T. (2010). Changing the record: the inter-professional, subjective and embodied effects of electronic patient record. New Technology, Work and Employment, 25(3), 210-222. https://doi.org/10.1111/j.1468-005X.2010.00249.x
  15. Hamington, M. (2017). Empathy and care ethics. In: Maibom H (ed.) The Routledge handbook of philosophy of empathy. New York: Routledge, pp. 264–272.
  16. Hyysalo, S. (2004). Technology Nurtured - Collectives in Maintaining and Implementing Technology for Elderly Care, Science & Technology Studies, 17(2), 23–43. https://doi.org/10.23987/sts.55164
  17. Hämäläinen, A. (2020). Responses to vulnerability: care ethics and the technologization of eldercare, International Journal of Care and Caring. 4(2), 167-182. https://doi.org/10.1332/239788220X15833753877589
  18. Hämäläinen, A. (2022). The epistemological complexity of ideal care: long-term care professionals’ perspectives. International Journal of Care and Caring, 6(4), 493-509. https://doi.org/10.1332/239788221x16382572220893
  19. Hämäläinen, A. & Hirvonen, H. (2020). Electronic health records reshaping the socio-technical practices in long-term care of older persons, Technology in Society, 62, 1–8. https://doi.org/10.1016/j.techsoc.2020.101316 .
  20. Kohlen, H. (2009). Conflicts of care, hospital ethics committees in the USA and Germany. Frankfurt: Campus Verlag.
  21. Koskela, I., Känsälä, M. & Saari, E. (2023). Teknologian vai ihmisen ehdoilla? Toiminnanohjausjärjestelmän käytön ja hyvän hoivan yhteensovittamisen keinot kotikäyntejä tekevien hoitajien arjessa. [In terms of technology or human being? Reconciling the use of enterprise resource planning system with good care in mundane work of homecare workers] Työelämän tutkimus, 21(3), 362-386. https://doi.org/10.37455/tt.122274
  22. Kovalainen, A. (2021). Crisis of care: A problem of economization, technologization or of politics of care? Chapter 4 in Hansen, L.L., Horn, L. & Dahl, H.M. (eds.) A care crisis in the Nordic welfare states? Policy press. University of Bristol: Bristol, UK.
  23. Kröger, T., Aerschot, L. & Puthenparambil, J.M. (2018). Hoivatyö muutoksessa: suomalainen vanhustyö pohjoismaisessa vertailussa. [Care work in change: A Nordic comparison of Finnish elder care work] YFI Julkaisuja 6. Jyväskylän yliopisto. https://jyx.jyu.fi/handle/123456789/57183
  24. Kröger, T. (2019). Looking for the Easy Way Out: Demographic Panic and the Twists and Turns of Long-Term Care Policy in Finland. In T.-k. Jing, S. Kuhnle, Y. Pan, & S. Chen (Eds.), Aging Welfare and Social Policy: China and the Nordic Countries in Comparative Perspective pp. 91-104. International Perspectives on Aging, 20. Cham: Springer International Publishing. https://doi.org/10.1007/978-3-030-10895-3_6
  25. Lemon, L. & Boman, C. (2022). Ethics of care in action: Overview of holistic framework with application to employee engagement. Public Relations Review, 48(4). https://doi.org/10.1016/j.pubrev.2022.102232.
  26. Levonius, V., & Sivunen, A. (2024). Care workers in elder care: the Four Flows of constituting care organizations on social media. Communication Research and Practice. 10(1),60–75. https://doi.org/10.1080/22041451.2023.2275817
  27. Meyers, DT. (1994). Subjection & subjectivity: psychoanalytic feminism & moral philosophy. New York: Routledge.
  28. Mol, A., Moser, I. & Pols, J. (2010). Care in Practice: On Tinkering in Clinics, Homes and Farms. Bielefeld: transcript Verlag.
  29. Mort, M., Finch, T., & May, C. (2009). Making and unmaking telepatients: Identity and governance in new health technologies. Science, Technology, & Human Values, 34(1), 9-33.
  30. Mort, M., Roberts, C., & Callén, B. (2013). Ageing with telecare: care or coercion in austerity?. Sociology of health & illness, 35(6), 799-812. https://doi.org/10.1111/j.1467-9566.2012.01530.x
  31. Nikunlaakso, R., Selander, K., Weiste, E., Korkiakangas, E., Paavolainen, M., Koivisto, T., & Laitinen, J. (2022). Understanding Moral Distress among Eldercare Workers: A Scoping Review. International Journal of Environmental Research and Public Health, 19(15), 9303. https://doi.org/10.3390/ijerph19159303
  32. Noddings, N. (2013). Caring: a relational approach to ethics and moral education. 2nd ed. Berkeley, CA: University of California Press.
  33. Oudshoorn, N. (2012). How places matter: Telecare technologies and the changing spatial dimensions of healthcare. Social studies of science, 42(1), 121-142. https://doi.org/10.1177/0306312711431817
  34. Persson, M., Redmalm, D. & Iversen, C. (2022). Caregivers’ use of robots and their effect on work environment – a scoping review. Journal of Technology in Human Services, 40(3), 251-277. https://doi.org/10.1080/15228835.2021.2000554
  35. Pols, J. (2010). Telecare. What patients care about. p.171-190. In Mol, A., Moser, I. & Pols, J. (2010). Care in Practice: On Tinkering in Clinics, Homes and Farms. Bielefeld: transcript Verlag. https://doi.org/10.1515/transcript.9783839414477
  36. Pols, J. (2015). Towards an empirical ethics in care: Relations with technologies in health care. Medicine, Health Care and Philosophy, 18(1), 81-90. https://doi.org/10.1007/s11019-014-9582-9
  37. Rantala, E., Taipale, S., Oinas, T., & Karhinen, J. (2022). Digital skills and application use among Finnish home care workers in the eldercare sector. In Digital Transformations in Care for Older People. Taylor & Francis. https://doi.org/10.4324/9781003155317-13
  38. Ruotsalainen, S., Jantunen, S. & Sinervo, T. (2020). Which factors are related to Finnish home care workers’ job satisfaction, stress, psychological distress and perceived quality of care? - a mixed method study. BMC Health Serv Res, 20, 896. https://doi.org/10.1186/s12913-020-Ruotala05733-1
  39. Saari, E., Koskela, I., & Känsälä, M. (2024). Breaking frames to create empathy: interaction between care practitioners and clients in homecare visits. International Journal of Care and Caring, 1(aop), 1-17. https://doi.org/10.1332/23978821Y2024D000000046
  40. Sánchez-Criado, T., López, D., Roberts, C., & Domènech, M. (2014). Installing telecare, installing users: Felicity conditions for the instauration of usership. Science, Technology, & Human Values, 39(5), 694-719. https://doi.org/10.1177/0162243913517011
  41. Sergi, V. & Bonneau, C. (2016). Making mundane work visible on social media: a CCO investigation of working out loud on Twitter, Communication Research and Practice, 2:3, 378-406, https://doi.org/10.1080/22041451.2016.1217384
  42. Slote, MA. (2007). The ethics of care and empathy. New York: Routledge.
  43. Social Welfare Act 2014. 21 c § (1301/2014). https://www.finlex.fi/fi/laki/ajantasa/2014/20141301
  44. STM (2020). Laatusuositus hyvän ikääntymisen turvaamiseksi ja palvelujen parantamiseksi 2020–2023: Tavoitteena ikäystävällinen Suomi. [Quality recommendation to ensure good ageing and improve services: Aiming at age-friendly Finland] Sosiaali- ja terveysministeriön julkaisuja 2020:29, Helsinki. http://urn.fi/URN:ISBN:978-952-00-5457-1
  45. Tufte, P. (2013). Is there time enough? Temporal resources and service performance in the Danish home care sector, Nordic journal of working life studies 3(2), 97-112. https://doi.org/10.19154/njwls.v3i2.2552
  46. Theurer, K., Mortenson, W. B., Stone, R., Suto, M., Timonen, V., & Rozanova, J. (2015). The need for a social revolution in residential care. Journal of aging studies, 35, 201-210. https://doi.org/10.1016/j.jaging.2015.08.011
  47. Tronto, J. (1993). Moral Boundaries: A Political Argument for an Ethic of Care, New York: Routledge.
  48. Waerness, K. (1984). The rationality of caring. Economic and Industrial Democracy 5(2), 185–211. https://doi.org/10.1177/0143831X8452003
  49. Van Dijke, J., van Nistelrooij, I., Bos, P., & Duyndam, J. (2020). Towards a relational conceptualization of empathy. Nursing Philosophy, 21(3), https://doi.org/10.1111/nup.12297
  50. Van Zoonen, W., Verhoeven, J. W., & Vliegenthart, R. (2016). How employees use Twitter to talk about work: A typology of work-related tweets. Computers in Human Behavior, 55, 329–339. https://doi.org/10.1016/j.chb.2015.09.021
  51. Xu, W. (2022). (Non-) Stereotypical representations of older people in Swedish authority-managed social media. Ageing & Society, 42(3), 719-740. https://doi.org/10.1177/0162243907311274

How to Cite

Saari, E., Levonius, V., Koskela, I., Koivisto, T., & Känsälä, M. (2024). Intra-normativities in technologizing old age care work: Mobile record-keeping, remote homecare and social media use shaping good care. Human Technology, 20(3), 468–487. https://doi.org/10.14254/1795-6889.2024.20-3.3