Enhancing care in aging: an anthropological perspective on professional engagement in nursing homes

Author:  Gabriele Di Patrizio,   PhD,  Director of IFOSEP & IRE3A ® In France, the review of political initiatives highlights an increas...

Author: Gabriele Di Patrizio, PhD, Director of IFOSEP & IRE3A^®

In France, the review of political initiatives highlights an increasing awareness of the challenges posed by an aging population(Clot et al., 2021). However, concrete action remains insufficient, hindered by the delay of the 'Aging Well' law, intended to ensure dignified aging, even in dependence.To address this desertification of human resources and the feared "gerontological disaster" (Brami, 2022), it is urgent to enhance the value of care professions and support the professionals working in these institutions.

Professionals are seen as active participants in their nursing home’s project, emphasizing their role as value-producing individuals. Faced with the observation that not all professional actions guarantee success of care provision, it seemed necessary to establish a "model of best practices" to improve elderly“cure and care”. However, these frameworks, while beneficial, may create an illusion of professionalization, as they often dictate right action rather than respond to real challenges. Professions in gerontology require practitioners to synthesize theoretical, procedural, practical data, and personal expertise to adapt cure and care to the specific needs of vulnerable elderly persons(G. Di Patrizio, 2019). Professional actions are relational and ethical demanding commitment and reflexivity in practice.

By adopting an anthropological perspective, we think that gerontology professionals can improve care quality by engaging meaningfully in their roles. We will identify existential characteristics that could help (or could not) to strengthen dedication and effectiveness. The intrinsic professionals' capabilities to be present in their activities, correlated with their skills, are essential for improving the quality of care and elderly well-being in nursing homes, as well as for promoting greater recognition of the professions involved. By focusing on the "way of being" correlated with any "way of doing," our key question is: "With what attendance in the activity do professionals perform their tasks?"

Boltanski, Thévenot, and Chiapello model (Boltanski & Chiapello, 2011; Boltanski & Thévenot, 1991) divides human experiences into realms with distinct values and behaviors.

In our research(G. Di Patrizio, 2024), the seven realms theorized by the authors have been reinterpreted by professionals. Let's list the different worlds from their perspective:

• The project-based realm: Where essential tasks of cure and care are carried out on elderly physiological and relational needs.
• The domestic realm: Personal occurrences that may interfere with work.
• The work realm: The specific framework concerning the nursing home environment.
• The civic realm: Colleagues’ inclination to prioritize collective functioning.
• The mercantile realm: Balancing individual interest with collective needs.
• The judgment realm: Diverging opinions that may harm cooperation.
• The inspiration realm: The importance of a positive attitude for a productive work environment.

The project-based realm represents all the required activities within the nursing home by each professional. It is central for all participants. In practice, this project-based realm is at risk of being disrupted by elements from other worlds, thereby impacting the attendance in the ongoing activity.

From the chosen anthropological perspective,the model of “acting in several realms” becomes that of "acting from several realms". This latter approach fosters professionals analyzing "reflective awareness” and addresses the anthropological risk of "disruption" of the ongoing activity.This model empowers professionals to structure them mentally and psychically as architects of their attendance in their activity. It encourages reflection, anabling individuals to assess the relevance of different anthropological realms during their work.This awareness allows individuals to critically evaluate their roles and responsibilities, enhancing their precious effectiveness. This kind of reflective awareness involves two types of self-analysis:

- First an “Ex-" interpretation: Observing oneself from an external viewpoint.

- Second a "Peri-" interpretation: Considering the impact of various realms.

This self-structuring within tasks is linked to workplace well-being, suggesting that full engagement in activities enhances the accuracy of actions and promotes better health at work. This mindful approach shifts the focus from mere well-being to a deeper notion of "human-being-beauty at work," where self-care and caring-actions coexist harmoniously.This active process aligns personal values and skills with professional activities, fostering a humanization of work that machines cannot replicate. In the workplace, this consciousness is manifested in the pursuit of balance not only in actions but also in recognizing oneself and others, which is essential for finding meaning and one’s identity at work.

Our approach raises the questions of valuing gerontology professions within nursing homes in a different way. As the sector faces significant challenges, applying this model could provide valuable insights and improvements[1]. While the difficulties of working in nursing homes are well-documented(Amyot, 2016), the experiential practice of attendance—where professionals fully and reflectively engaged—can help prevent burnout. This anthropological functioning supports vibrant professionality (Di Patrizio, 2019, op. cit.), enabling professionals to maintain well-being through an aesthetic balance of action and their effectiveness, despite demanding roles in environments that bound to evolve.

Bibliography

1. Amyot, J.-J. (2016). Travailler auprès des personnes âgées (4e éd). Dunod.
2. Boltanski, L., & Chiapello, È. (2011). Le nouvel esprit du capitalisme. Gallimard.
3. Boltanski, Luc., & Thévenot, Laurent. (1991). De la justification : Les économies de la grandeur. Gallimard.
4. Brami, G. (2022). La fin des EHPAD ? Réalités ignorées et vérités rejetées. Vérone éditions.
5. Clot, Y., Bonnefond, J.-Y., Bonnemain, A., & Zittoun, M. (2021). 3. Personnes âgées dépendantes : Soigner le travail. In Le prix du travail bien fait : La coopération conflictuelle dans les organisations (p. 63‑93). La Découverte.
6. Di Patrizio, G. (2019). Les EHPAD entre processus victimaire et rédemption. Recherches&Éducations.
7. Di Patrizio, G. (2024). Understanding Professional Dynamics in Elderly Care through an Anthopological Lens. Global Journal of Medical Research, 24(2), 15‑25. https://doi.org/10.34257/GJMRKVOL24IS2PG25

Global Bibliography of the author

1. Di Patrizio, Dr. G. (2024). Navigating Care Boundaries: Exploring the Limits between Compassionate Care and Neglect 1. Global Journal of Human-Social Science, 11‑20. https://doi.org/ 10.34257/GJHSSCVOL23IS7PG11
2. Di Patrizio, G. (2015, juin 12). La formation professionnelle continue destinée à l’adulte en situation d’emploi : Entre espace d’acquisition et transhumance. Thèse de NR.
3. Di Patrizio, G. (2016). D’une élaboration intersubjective et communicationnelle de la « connaissance de soi » par l’éducation tout au long de la vie. Penser l’Education, 38.
4. Di Patrizio, G. (2017a). Coopérer : Un enjeu formatif et symbolique dans le compagnonnage. Penser l’Education, 41.
5. Di Patrizio, G. (2017b). La formation d’adultes: Entre espace d’acquisition et espace de transhumance. Connaissances & Savoirs.
6. Di Patrizio, G. (2019). Les EHPAD entre processus victimaire et rédemption. Recherches & Éducations.
7. Di Patrizio, G. (2020a). De ‘‘l’entre soi à l’entre-l’autre’’: Émergence du locus du respect en formation. Epistrophè. Revue Internationale d’Éthique Professionnelle en Philosophie et en Éducation. Études et Pratiques [EPREPE] du «Laboratoire de Recherche en Philosophie Pratique» (L.R.Ph.P.), Rhodes : L.R.Ph.P., III, 208‑229.
8. Di Patrizio, G. (2020b). Poétique de l’hospitalité en EHPAD. Connaissances et Savoirs.
9. Di Patrizio, G. (2021, novembre 25). La notion de métier : Entre construction de soi gestuelle transformatrice. Philosophy in Praxis. The philosophical gesture: political, ethical, educational, artistic,engagements. 2nd Biennale on PracticalPhilosophy, Rhodes.
10. Di Patrizio, G. (2022a). Bientraitance « | » maltraitance : Interroger la limite. Éthique & Santé, 19(3), 119‑126.
11. Di Patrizio, G. (2022b). Bientraitance « | » maltraitance: Interroger la limite. Éthique & Santé, 19(3), 119‑126. https://doi.org/10.1016/j.etiqe.2022.06.004
12. Di Patrizio, G. (2022c). Les défis du respect à l’aune du monde moderne. In Vieille-Grosjean, H., et Salomon Tsehaye, R. (Dir), Le respect pensé autrement : 12 variations entre éthique et pédagogie (p. 115‑123). Albiana/Università di Corsica.
13. Di Patrizio, G. (2022d). L’espace médian: Question de territoire et de géométrie du respect ? In Vieille-Grosjean, H., et Salomon Tsehaye, R. (Dir), Le respect pensé autrement : 12 variations entre éthique et pédagogie (p. 203‑223). Albiana/Università di Corsica.
14. Di Patrizio, G. (2023). L’expérience : Conceptualisation d’une notion anthropologique entre M. Heidegger et A. Sen. Epistrophè. Revue Internationale d’Éthique Professionnelle en Philosophie et en Éducation. Études et Pratiques [EPREPE] du «Laboratoire de Recherche en Philosophie Pratique» (L.R.Ph.P.), Rhodes : L.R.Ph.P., V, 2021‑2022, 156‑178.
15. Di Patrizio, G. (2024). Understanding Professional Dynamics in Elderly Care through an Anthopological Lens. Global Journal of Medical Research, 24(2), 15‑25. https://doi.org/ 10.34257/GJMRKVOL24IS2PG25
16. Di Patrizio, G., & Vieille-Grosjean, H. (2019). Le my the personnel au travail: De la « parturité » de la vie adulte. In Doucet, M. & Thériault, M. (Dir), L’adulte en formation... Pour de venir soi : Espaces, passages, débats et défis (p. 339‑357). Presses de l’université du Québec.
17. Di Patrizio, G. (2017). La construction du savoir par le chercheur : Point de vue méthodologique. Questions vives recherches en éducation, N° 28. https://doi.org/10.4000/questionsvives.2387
18. Vieille-Grosjean, H., & Di Patrizio, G. (2015). L’activité humaine au coeur du travail. Phronesis, 4(1), 1‑78.

 

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[1] The model can be applied to:

- Enhance well-treatment

- Improve teamwork dynamics in nursing homes.

- Provide management insights for better guidance of professionals.

- Help professionals optimize self-management by navigating different realms actively.

Published by Global Journals

https://globaljournals.org/GJHSS_Volume23/2-Navigating-Care-Boundaries.pdf

https://globaljournals.org/GJMR_Volume24/4-Understanding-Professional.pdf

                                               

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