Doctoral Dissertation Research: Innovations in Geriatric Medicine and the Ethics of Eldercare Delivery

University Of California-Irvine, Irvine CA

Investigators

Abstract

Health care experts and policymakers are increasingly concerned with an apparent paradox when it comes to geriatric medicine: while biomedical care is increasingly successful in sustaining human life, the social and familial care of older adults is in short supply. Global and national health initiatives have expanded access to geriatric care for older adults, making medical monitoring and treatment an important part of growing old. This project, which trains a graduate student in how to conduct rigorous empirically-grounded scientific fieldwork, explores how health care interventions for older populations shape relations among the family, state and local government, and markets for paid care labor. University of California, Irvine doctoral candidate Elizabeth DeLuca, supervised by Dr. Michael Montoya, will examine how shifting regimes of health and social care are shaping relations among older adults and those who claim to care for them. The researcher asks how families, caregivers, and municipal officials respond to social pressures and technological changes in the delivery of eldercare; what kinds of moral and ethical claims emerge in the negotiation of eldercare, and how those claims shape the relationship between older adults, families, caregivers, and municipal officials; and to what extent these eldercare arrangements rework relations of kinship, politics, and paid labor. The doctoral student will undertake twelve months of ethnographic fieldwork in two urban districts in Turkey. Turkey represents an appropriate field site for the exploration of geriatric care planning as the number of older adults is expected to double in the next fifteen years. The specific urban field sites were chosen because the municipalities in these districts have developed public health programs targeting the medical monitoring of older adults who live alone. These districts also have relatively large populations of adults over the age of 65. The researcher will conduct extended participant observation in municipal services as well as in-depth interviews with caregivers and healthcare workers, recording their understandings and approaches to care and the aging body. She will follow discourses and practices of elder care through homes, public health services, and political and medical rhetoric, collecting information about how the practices of care contribute to relations of family, state, and labor. This study will provide a timely contribution to the global issue of social and medical care for aging populations by illuminating the complex social, political, and technical arrangements undergirding global demographic transitions and the shifting regimes of care that accompany them. This study also ethnographically investigates the recent development of "healthy city" initiatives that focus on older citizens and will contribute to interdisciplinary social science research on aging and public health. Findings will also suggest how to improve the efficiency and effectiveness of growing infrastructures for long-term care and geriatric medicine, accounting for diverse ethical and moral understandings of care, the body and the family. The project also supports the training of a graduate student.