Relations between formal and family care: divergent practices in care at home for people living with dementia

Abstract

Good ways to think about how family care practices and those of the formal system relate is a theoretical and practical problem of longstanding. Few would disagree that the ways that families and formal care systems handle daily life are different, with extensive research efforts undertaken over many decades addressed to these issues - yet problems in relations persist. In this chapter the philosophical work of Isabelle Stengers is used to open up and rethink this problem. Specifically, divergences in family and formal care practices are analysed through Stengers’ conceptualization of an ‘ecology of practices.’ In Stengers’ view, what makes a practice diverge is also what makes it a particular practice; overriding these differences and imposing similarity, such as efforts to ‘professionalize’ family caregiving, can damage the practice so aligned. Instead Stengers’ figure of the diplomat shows how diverging practices that have common interests - but not necessarily the same interests - might relate. One family’s experiences in daily life with dementia is used to show the relevance of this ecological theorizing of divergence in practices, and to make a case for the need for diplomatic relations between practices that leave ‘borders’ and thus practices intact.