Training the ageing bodies: New knowledge paradigms and professional practices in elderly care.

In the Scandinavian countries, reablement has become a principle permeating all parts of elderly care, hence potentially transforming care and care work. This article explores the advent of new knowledge paradigms and practices of physiotherapists and occupational therapists transforming reabling care in particular ways, leading to what we term a logic of training emerging in the field. These professional groups have obtained a dominant position as reablement specialists in Norway and Denmark, where our extensive fieldwork was performed as part of a 3-year research project. Taking inspiration from Annemarie Mol's concept of logic, we study how professional practices are organised and infused with specific values, meanings and ideals in situated contexts. We hence explore the logic of training, its abstracted image of the body and rational goal-oriented model for progress measurement and its ramifications when addressing ageing bodies in a complex field marked by the unpredictabilities of the social and lived bodies, administrative rules and temporalities and the quest for empowering and involving clients. The paper concludes by pointing at new contradictions arising when practicing reabling care and particularly points out the tensions arising in care relations, where ambitions on empowering and disciplining the client and the elderly body may collide.

Tinkering with (in)visibilities: Caring for older people with surveillance technologies.

New surveillance technologies have in later years been introduced in care for older people as part of a broader policy agenda of 'sustainable' welfare state retrenchment, promoting ideals of self-sufficiency and empowerment of older people 'ageing in place'. Drawing on newer approaches to surveillance studies, this article explores care workers' active labour in creating (in)visibility in a complex and ongoing process of tinkering, while negotiating political rationales of empowerment and professional accountability. Hence, visibilities are conceived as coded, reflecting different ideals and rationales. Based on extensive fieldwork in Danish eldercare, we analyse two forms of surveillance: virtual homecare and sensor-flooring, where clients are involved and positioned in different ways in accomplishing surveillance. We illuminate how the process of accomplishing (in)visibility does not only involve tinkering with technology, but also with spatial arrangements in the client's home, and with clients' behaviour. Consequently, we underscore how tinkering may turn out to be a difficult and even conflictual task of negotiating professional authority and accountability in ways that resonate with clients' sense of autonomy and policy ideals of empowerment. Our studies underline how the power dynamics of surveillance in care should not be overlooked, even though they are continuously negotiated in care practices.

Regulação em Rede do Ambiente de Trabalho / Network Regulation of the Working Environment

Este artigo trata do conceito de governança em rede como contraponto à compreensão do processo convencional, hierarquizado, de regulação no campo do ambiente de trabalho. A forma como as redes podem estimular mudanças na regulação do ambiente de trabalho é estudada em dois casos na Dinamarca. O primeiro caso se refere à alta incidência de distúrbios músculo-esqueléticos na atividade de manuseio de pacientes encontrados no setor saúde. A rede, desenvolvida de baixo para cima, gerou uma conexão do problema a novas soluções, em particular, com a criação de um novo agente social, o instrutor de transferência,a partir da idéia de que pessoas são transferidas, não levantadas como pesos. O segundo caso trata de um esforço para integrar a promoção da saúde com a forma de se pensar saúde no trabalho, a fim de enfrentar a desigualdade social em saúde. Iniciada de cima para baixo, a rede não conseguiu se estabilizar nem promover com êxito a abordagem integrada da promoção da saúde no local de trabalho. Os dois casos apontam, todavia, para a importância da aproximação de diversos grupos profissionais, quando os esforços pretendem ser verdadeiramente, inovadores e bem sucedidos. Em contraste com as visões que celebram a ausência do Estado, discuti-se também a importância deste como meta-governante nos processos que visam revigorar a regulação.

This article discusses the concept of network governance as a supplement to the conventional understanding of regulation in the of working environment. How networks can stimulate change in working environment regulation is studied in two cases in Denmark. The first case concerns the problem with musculoskeletal strains in the care sector manual handling of people. In Denmark a network has grown from below, and this network has generated a story line that connects the problem with new solutions, in particular the creation of the transfer instructor we transfer people, we dont lift. The second case deals with an effort to integrate health promotion with occupational health thinking; two s (public health and OHS) that for years have been separated in a Danish context. The problem in this case was/is a profound social inequality in health. This network was initiated from above, and has so far not managed to stabilize a network that is able to successfully promote the integrate approach of workplace health promotion. Both cases point at the importance of bridging gaps between various professional groups if the efforts are to be truly innovative and successful. And they point at the importance of the state as a meta-governor in processes that aim at invigorating the regulation; the concept of network governance can be taken to celebrate the absence of the state; our cases dont.