Editorial: The importance of place in older people's care: three papers developing the geographies of nursing work

Abstract

The practice development section of this particular edition of International Journal of Older People Nursing focuses on the importance of place in older people nursing. The papers develop the argument that, rather than being a trivial or abstract phenomenon, place matters to nurses, their practices and importantly patients. Moreover, they demonstrate how place can be recognized, operationalized and hence, brought to the fore in gerontological nursing research. Notably, in doing this, the practice development section also brings together and progresses, two significant fields of research, ‘geographical gerontology’ (otherwise known as geographies of ageing) and an emerging ‘geographies of nursing’ in the consideration of the potential geographies located in nursing work. For over three decades, geographical gerontology has provided a range of valuable ‘contextual’ information to clinical and professionally focused gerontological research. Much, but not all, of this has been focused on the design of ageing environments, the interactions between older people and their environments, demographic trends and population movement. Consequently, even if readers do not recognize the specific disciplinary title, many will be familiar with these subjects. More recently however, changing perspectives, including the greater use of qualitative methods and a more frequent focus on more intimate spatial scales such as homes, institutions and inter-personal relationships, have meant that the interests of geographical gerontology and nursing research increasingly coincide (see Andrews & Phillips, 2005). The focus of the three papers presented here augments this particular disciplinary convergence by making some clear connections to professional practice debates. The result, it is hoped, is that the papers demonstrate the potential for geographical gerontology to provide critical and direct evidence for practice. Geographies of nursing, however, are a relatively recent body of work in the wider field of nursing research, the common feature of these studies being their central conceptual emphasis on space and/or place (see Andrews, 2006) and some re-readings and extensions of the meta-paradigm of nursing environment (see Andrews & Moon, 2005). Because this field of research is in its relative infancy, commentators have yet to debate the particular contributions of a geographical perspective in nursing research to specific specialties of nursing work. Moreover, neither have they addressed connections to the fundamental concepts that underpin professional caring practices. The papers in this section thus begin to address these issues with respect to gerontological nursing, coaxing the ‘spatial turn’ in nursing research to its next logical stage. Most importantly, of course, is the contribution of these disciplinary movements to gerontological nursing and research. It would be naive to think that these papers might revolutionalize research and practice in the care of older people. However, we would like to think that some of the suggested directions for research are followed up by researchers, if only that a focus on place might help them look at their existing problems and issues in a slightly different light, perhaps ‘tweaking’ their research foci and questions if a conceptual emphasis on place provides them with fresh insights. In this sense then, we hope that these papers provide some useful leads into the relevant geographical literatures, debates, concepts and theories. To make these disciplinary progressions and connections, we have assembled a truly multidisciplinary team. Janine Wiles, who works in a geography department, is one of a new generation of ‘critical’ geographical gerontologists/health geographers. Through a broad-based review, her paper defines and introduces place and its varied roles and meanings for older people. The next paper sharpens the focus on practice and specifically how place is located in the concepts and locales of gerontological nursing practice. In order to get to the heart of nursing practice concerns, a team approach was taken in the production of this more lengthy piece. The co-authors include two health geographers – Blake Poland and Gavin Andrews – based in nursing and public health departments respectively; two sociologists – Pascale Lehoux and Karen-Lee Miller – based in health administration and public health departments; two gerontological nurses – Dorothy Pringle and Katherine McGilton – based in nursing departments and David Holmes a nurse and critical sociologist also based in nursing. Having made these arguments, the final ‘visionary’ paper sets the wide-ranging research agenda for research on place and older peoples’ nursing care. It is written by Malcolm Cutchin, a health geographer and gerontologist, currently based in a department of occupational science. We hope that the ideas presented prove to be useful to readers and although they might appear to be novel or new, it is certainly worth remembering that ideas about places and their role in healing and health care can be traced to Nightingale and even earlier (Andrews, 2003; Gesler, 2003). In this sense then, the papers provide a contemporary spin on what might be considered to be a fundamental and core issue in nursing and health professional work.