Home is Where the Heart Stopped: Panopticism, Chronic Disease, and the Domestication of Assistive Technology

Abstract

ABSTRACTThe notions of housing and the home have shifted considerably over the past decades given the significant changes in technological developments, demographics and the constitution of the family nexus. One of the areas in which architecture, design and planning have been responding relates to the growing needs of an ageing population with increasing leisure time as well as exposure to disability or chronic diseases.Regarding the treatment or rehabilitation from illness, sophisticated medical technologies were once the exclusive domain of hospitals and specialist practices but are becoming increasingly available in the home. The idea behind their recent proliferation is to save money and time for health services as well to allow outpatients a greater participation in their own recovery by avoiding institutional care. Unfortunately, however, studies into the development of assistive technology innovations have largely overlooked the user's changing perceptions about their own needs and towards the ways in which the innovations in question become appropriated into their everyday lives. Additionally, little is known about how they and their extended support network of carers, friends, kin or partners actually perceive the impacts of illness on domestic lifestyles. This paper addresses these issues. It examines the mainstream implementation of telecare in relation to facilitating the independence of older disabled people in their domestic space. From a case study of chronic heart failure sufferers over sixty living in the Barnsley area, we evaluate the expectations, benefits, drawbacks and social meanings concerning a forthcoming pilot installation of such a home-based health monitoring scheme.