Abstract
Context: Domestic staff in hospitals and aged long-term care have been shown to perform a range of caring roles alongside their cleaning work. Objective: This paper explores the roles these people and other ‘hotel service staff’ (catering, domestic, maintenance, finance and administrative) play in the rehabilitation of people with brain injuries residing in long-term care settings. Methods: This research draws on in-depth ethnographic data collected in 2014–15 over five months at two neurological long-term care settings in the UK; including interviews and observations of day-to-day happenings in the lives of around 60 brain injured residents and the work of 16 hotel service staff. The data was subject to a situational analysis – underpinned by grounded theory and discourse analysis. Findings: Hotel service staff contribute to and compliment the rehabilitation of patients’ cognitive skills, communication and physical functioning, and provide opportunities for occupation and interaction. The therapeutic accomplishments achieved by involving patients in mundane tasks of everyday life (e.g., gardening, managing money, sharing food), fit with the aims of more ‘formalized’ rehabilitation – to restore patients’ abilities to carry out ‘activities of daily living’. Limitations: This study has been unable to fully explicate how hotel service staff have, or gain, the skills to interact so positively with brain injured residents. The study was confined to two sites and may not be reflective of practice elsewhere. Implications: The study findings highlight how the work and interactions of hotel service staff contribute not only to care but to the rehabilitation of people with severe brain injuries. This has implications for service design as well as health and social care education.
Highlights
Context: Domestic staff in hospitals and aged long-term care have been shown to perform a range of caring roles alongside their cleaning work
This paper examines the contribution hotel service staff make to the care of people with severe brain injuries in specialized neurological rehabilitation and long-term care settings
The findings presented here explore how the work of hotel service staff and their interactions with patients fit each of these domains and echo the findings summarised about relational care in the work of Müller, Armstrong and Lowndes, 2018; Jors et al, 2017; and Schulman-Green et al, 2005
Summary
Context: Domestic staff in hospitals and aged long-term care have been shown to perform a range of caring roles alongside their cleaning work. Implications: The study findings highlight how the work and interactions of hotel service staff contribute to care but to the rehabilitation of people with severe brain injuries. Rehabilitation which focusses predominantly on the conduct and practice of everyday tasks within a meaningful context is considered to be a functional rehabilitative approach, such as that of a neurofunctional approach developed for people with severe brain injury. This approach is characterised as ‘learning by doing and occurs within the client’s natural environment or as close to this environment as possible.’ (Clark-Wilson, Giles and Baxter, 2014, pp.1647). It is this functional aim and practice of rehabilitation in everyday contexts which is a core focus of this paper
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