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The securitisation of dementia: socialities of securitisation on secure dementia care units

Published online by Cambridge University Press:  26 September 2019

Megan E. Graham Open the ORCID record for Megan E. Graham [Opens in a new window]
Megan E. Graham*
Affiliation:
Department of Sociology and Anthropology, Carleton University, Ottawa, Canada
*
*Corresponding author. Email: megangraham@cmail.carleton.ca
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Abstract

Nearly 50 million people around the world live with dementia, with statistics predicting a steady increase in prevalence for the foreseeable future. There is a need for comprehensive and compassionate dementia care. Long-term care homes have built special care units for people living with middle- to late-stage dementia. Among other services, these care units often use innovative security technologies that monitor and curtail movement beyond unit exit doors. As care-givers and technology developers grapple with the ethical dilemma of autonomy and risk management, researchers are beginning to investigate the social impact of these security technologies. The present research contributes to this line of inquiry. Fieldwork was carried out on two secure long-term care units for people living with dementia. Ethnographic accounts will illustrate how security technology creates socialities of securitisation on a secure dementia unit. Using securitisation theory, I will argue that dementia has been redefined, shifting it from a health issue to a security issue. The discursive construction of dementia as a security issue will be considered in terms of the co-constructed notions of vulnerability, risk, security threat and security challenge with respect to people living with dementia. The paper investigates how securitisation influences the ethics of dementia care.

Keywords

dementiaenvironmentlong-term caresecurityriskethics
Type
Article
Information
Ageing & Society , Volume 41 , Issue 2 , February 2021 , pp. 439 - 455
Copyright
Copyright © Cambridge University Press 2019

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References

Adams, T (2001) The social construction of risk by community psychiatric nurses and family carers for people with dementia. Health, Risk & Society 3, 307–319.CrossRefGoogle Scholar
Algase, DL, Moore, DH, Vandeweerd, C and Gavin-Dreschnack, DJ (2007) Mapping the maze of terms and definitions in dementia-related wandering. Aging & Mental Health 11, 686–698.CrossRefGoogle ScholarPubMed
Balzacq, T (2005) The three faces of securitization: political agency, audience and context. European Journal of International Relations 11, 171–201.CrossRefGoogle Scholar
Balzacq, T (2011) A theory of securitization: origins, core assumptions and variants. In Balzacq, T (ed.), Securitization Theory: How Security Problems Emerge and Dissolve. New York, NY: Routledge, pp. 1–30.Google Scholar
Bantry White, E and Montgomery, P (2014 a) Electronic tracking for people with dementia: an exploratory study of the ethical issues experienced by carers in making decisions about usage. Dementia 13, 216–232.CrossRefGoogle Scholar
Bantry White, E, and Montgomery, P (2014 b) A review of ‘wandering’ instruments for people with dementia who get lost. Research on Social Work Practice 24, 400–413.CrossRefGoogle Scholar
Behuniak, SM (2011) The living dead? The construction of people with Alzheimer's disease as zombies. Ageing & Society 31, 70–92.CrossRefGoogle Scholar
Berridge, C (2017) Selling passive monitoring to manage risk in independent living: frontline workers in a bind. In Adams, S, Purtova, N and Leenes, R (eds), Under Observation: The Interplay between eHealth and Surveillance (Law, Governance and Technology Series). Cham, Switzerland: Springer, pp. 73-90.CrossRefGoogle Scholar
Biggs, S (2018) Negotiating Ageing: Cultural Adaptation to the Prospect of a Long Life. New York, NY: Routledge.Google Scholar
Biggs, S and Carr, A (2017) Organisational levels, strategies and design in the regulation of dementia care. Research Insights 3. Available at http://library.bsl.org.au/jspui/bitstream/1/9479/1/BiggsCarr_Organisations_and_regulation_of_dementia_care_2017.pdf.Google Scholar
Bourdieu, P (1977) Outline of a Theory of Practice. New York, NY: Cambridge University Press.CrossRefGoogle Scholar
Bradford, DK, Kasteren, YV, Zhang, Q and Karunanithi, M (2018) Watching over me: positive, negative and neutral perceptions of in-home monitoring held by independent-living older residents in an Australian pilot study. Ageing & Society 38, 1377–1398.CrossRefGoogle Scholar
Brauch, HG (2003) Security and environment linkages in the Mediterranean: three phases of research on human and environmental security and peace. In Brauch, HG, Liotta, PH, Marquina, A and Selim, ME (eds), Security and Environment in the Mediterranean. Conceptualizing Security and Environmental Conflicts. Berlin: Springer, pp. 35–143.CrossRefGoogle Scholar
Bright, J (2012) Securitisation, terror and control: towards a theory of the breaking point. Review of International Studies 38, 861–879.CrossRefGoogle Scholar
Brightman, M and Grotti, V (2014) Securitization, alterity, and the state: human (in)security on an Amazonian frontier. Regions & Cohesion 4, 17–38.CrossRefGoogle Scholar
Canadian Association of Retired Persons (CARP) (2017) James Acker dies after nursing home beating. April 18. Available at www.carp.ca/2017/04/18/james-acker-dies-nursing-home-beating/.Google Scholar
Casey, D, Lynch, U, Murphy, K, Cooney, A, Gannon, M., Houghton, C, Hunter, A, Jordan, F, Smyth, S, Felzman, H, and Meskell, P (in press) Telling a ‘good or white lie’: the views of people living with dementia and their carers. Dementia. doi: 10.1177/1471301219831525CrossRefGoogle Scholar
Caspi, E (2014) Wayfinding difficulties among elders with dementia in an assisted living residence. Dementia 13, 429–450.CrossRefGoogle Scholar
Clarke, CL (2000) Risk: constructing care and care environments in dementia. Health, Risk, & Society 2, 83–93.CrossRefGoogle Scholar
Clarke, CL and Heyman, B (1999) Risk management for people with dementia. In Heyman, B (ed.), Health and Health Care: A Qualitative Approach. London: Arnold, pp. 228–304.Google Scholar
Door and Hardware Institute (2011) Doors & Hardware: Advancing Life Safety and Security Solutions. January. Available at https://www.dhi.org/shared/forms/PDFforms/Publications/DH_11/Jan11Magazine.pdf.Google Scholar
Elbe, S (2006) Should HIV/AIDS be securitized? The ethical dilemmas of linking HIV/AIDS and security. International Studies Quarterly 50, 119–144.CrossRefGoogle Scholar
Elbe, S, Roemer-Mahler, A and Long, C (2015) Medical countermeasures for national security: a new government role in the pharmaceuticalization of society. Social Science & Medicine 131, 263–271.CrossRefGoogle Scholar
Fleming, R, Goodenough, B, Low, L, Chenoweth, L and Brodaty, H (2014) The relationship between the quality of the built environment and the quality of life of people with dementia in residential care. Dementia 15, 663–680.CrossRefGoogle ScholarPubMed
Foucault, M (1973) The Birth of the Clinic. London: Routledge.Google Scholar
Foucault, M (1977) Discipline and Punish. London: Tavistock.Google Scholar
Goffman, E (1968) Asylums. London: Penguin.Google Scholar
Government of Ontario (2010) Retirement Homes Act, 2010, S.O. 2010, c. 11. Available at https://www.ontario.ca/laws/statute/10r11/v12.Google Scholar
Graham, ME (2017) From wandering to wayfaring: reconsidering movement in people with dementia in long-term care. Dementia 16, 732–749.CrossRefGoogle ScholarPubMed
Halek, M and Bartholomeyczik, S (2012) Description of the behaviour of wandering in people with dementia living in nursing homes – a review of the literature. Scandinavian Journal of Caring Sciences 26, 404–413.CrossRefGoogle ScholarPubMed
Heggestad, AKT, Nortvedt, P and Slettebø, Å (2013) ‘Like a prison without bars’: dementia and experiences of dignity. Nursing Ethics 20, 881–892.CrossRefGoogle ScholarPubMed
Holbraad, M and Pedersen, MA (2012) Revolutionary securitization: an anthropological extension of securitization theory. International Theory 4, 165–197.CrossRefGoogle Scholar
Høy, B, Lillestø, B, Slettebø, Å, Sæteren, B, Heggestad, AKT, Caspari, S, Aasgaard, T, Lohne, V, Rehnsfeldt, A, Råholm, M, Lindwall, L and Naden, D (2016) Maintaining dignity in vulnerability: a qualitative study of the residents’ perspective on dignity in nursing homes. International Journal of Nursing Studies 60, 91–98.CrossRefGoogle ScholarPubMed
Ibek, A (2015) The concept of securitization. Internal Security 7, 173–186.Google Scholar
Innes, A, Kelly, F, Scerri, C and Abela, S (2016) Living with dementia in hospital wards: a comparative study of staff perceptions of practice and observed patient experience. International Journal of Older People Nursing 11, 94–106.CrossRefGoogle ScholarPubMed
International Association for Healthcare Security and Safety (2017) Vendor Marketplace. Available at https://iahss.site-ym.com/?vendormarketplace.Google Scholar
Kamradt-Scott, A and McInnes, C (2012) The securitization of pandemic influenza: framing, security and public policy. Global Public Health: An International Journal for Research, Policy and Practice 7, S95–S110.CrossRefGoogle Scholar
Lester, PE, Gariet, A and Kohen, I (2012) Wandering and elopement in nursing homes. Annals of Long Term Care 20, 32–36.Google Scholar
Lie, M, Lindsay, S and Brittain, K (2016) Technology and trust: older people's perspectives of a home monitoring system. Ageing & Society 36, 1501–1525.CrossRefGoogle Scholar
Lorey, P (2019) Fake bus stops for persons with dementia? On truth and benevolent lies in public health. Israel Journal of Health Policy Research 8, 1–11.CrossRefGoogle ScholarPubMed
Low, LF, Draper, B and Brodaty, H (2004) The relationship between self-destructive behaviour and nursing home environment. Aging and Mental Health 8, 29–33.CrossRefGoogle ScholarPubMed
Margot-Cattin, I and Nygárd, L (2006) Access technology and dementia care: influences on residents’ everyday lives in a secure unit. Scandanavian Journal of Occupational Therapy 13, 113–124.CrossRefGoogle Scholar
McInnes, C and Rushton, S (2011) HIV/AIDS and securitization theory. European Journal of International Relations 19, 115–138.CrossRefGoogle Scholar
Mobley, C, Leigh, K and Malinin, L (2017) Examining relationships between physical environments and behaviors of residents with dementia in a retrofit special care unit. Journal of Interior Design 42, 49–69.CrossRefGoogle Scholar
Mortenson, WB, Sixsmith, A and Woolrych, R (2015) The power(s) of observation: theoretical perspectives on surveillance technologies and older people. Ageing & Society 35, 512–530.CrossRefGoogle ScholarPubMed
Niemeijer, AR (2015) Exploring Good Care with Surveillance Technology in Residential Care for Vulnerable People. Amsterdam: VU University Press.Google Scholar
Øye, C and Jacobsen, FF (in press) Informal use of restraint in nursing homes: a threat to human rights or necessary care to preserve residents’ dignity? Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine. doi: 10.1177/1363459318800175Google Scholar
Peine, A and Neven, L (2018) From intervention to co-constitution: new directions in theorizing about aging and technology. The Gerontologist 59, 15–21.CrossRefGoogle Scholar
Peine, A, Faulkner, A, Jæger, B and Moors, E (2015) Science, technology and the ‘grand challenge’ of ageing – understanding the socio-material constitution of later life. Technological Forecasting and Social Change 93, 1–9.CrossRefGoogle Scholar
Powell, J and Biggs, S (2000) Managing old age: the disciplinary web of power, surveillance and normalization. Journal of Aging and Identity 5, 3–13.CrossRefGoogle Scholar
RehabMart (2017) Patient Safety Alarms, Personal Alarm, Chair Alarm, Bed Alarm, Door Alarms. Available at http://www.rehabmart.com/category/patient_safety_alarms.htm.Google Scholar
Renn, O (2008) Concepts of risk: an interdisciplinary review. Gaia 17, 50–66.CrossRefGoogle Scholar
Rose, N (2007) The Politics of Life Itself. Princeton, NJ: Princeton University Press.CrossRefGoogle Scholar
Russell, G (2018). Dementia diagnosis and white lies: a necessary evil for carers of dementia patients? International Journal of Care and Caring 2, 133–137.CrossRefGoogle Scholar
Salzmann-Erikson, M and Eriksson, H (2012) Panoptic power and mental health nursing. Issues in Mental Health Nursing 33, 500–504.CrossRefGoogle ScholarPubMed
Schäfer, PJ (2013) Human and Water Security in Israel and Jordan. New York, NY: Springer.CrossRefGoogle Scholar
Shield, RR, Tyler, D, Lepore, M, Looze, J and Miller, SC (2014) ‘Would you do that in your home?’ Making nursing homes home-like in culture change implementation. Journal of Housing for the Elderly 28, 383–398.CrossRefGoogle Scholar
Sposaro, F, Danielson, J and Tyson, G (2010) iWander: an Android application for dementia patients. In 32nd Annual International Conference of the IEEE EMBS, Buenos Aires, Argentina, pp. 3875–3878. Available at http://ww2.cs.fsu.edu/~sposaro/publications/iWander.pdfCrossRefGoogle Scholar
Strizel, H (2007) Towards a theory of securitization: Copenhagen and beyond. European Journal of International Relations 13, 357–383.CrossRefGoogle Scholar
Torrington, J (2006) What has architecture got to do with dementia care? Explorations of the relationship between quality of life and building design in two EQUAL projects. Quality in Ageing 7, 34–48.CrossRefGoogle Scholar
Tuckett, AG (2012) The experience of lying in dementia care: a qualitative study. Nursing Ethics 19, 7–20.CrossRefGoogle ScholarPubMed
Tufford, F, Lowndes, R, Struthers, J and Chivers, S (2018) ‘Call security’: locks, risk, privacy and autonomy in long-term residential care. Ageing International 43, 34–52.CrossRefGoogle Scholar
Urban, M (2017) Embodying digital ageing: ageing with digital health technologies and the significance of inequalities. In Heidkamp, B and Kergel, D (eds), Precarity Within the Digital Age: Media Change and Social Insecurity. Wiesbaden, Germany: Springer, pp. 163–178.CrossRefGoogle Scholar
Wæver, O and Buzan, B (2003) Regions and Powers. Cambridge: Cambridge University Press.Google Scholar
Wolcott, H (2005) The Art of Fieldwork, 2nd Edn. Walnut Creek, CA: Altamira Press.Google Scholar
World Health Organization (WHO) (2017) Global Action Plan on the Public Health Response to Dementia 2017–2025. Available at http://apps.who.int/iris/bitstream/handle/10665/259615/9789241513487-eng.pdf;jsessionid=F356578A79115A00E41C970C0DC1E153?sequence=1Google Scholar
York, TW and MacAlister, D (2015) Hospital and Healthcare Security, 6th Edn. Waltham, MA: Butterworth-Heinemann.Google Scholar