Exploring space and practices of control in long-term residential care violence prevention strategies

Rachel V. Herron, Dale Spencer, Sheila Novek, Laura Funk, Christine Kelly and Katie Aubrecht

Social Science & Medicine, 2024, vol. 355, issue C

Abstract: Long-term residential care (LTRC) should be a safe place to work and to live, but it can be a site of violent situations for older people and staff. In this article, we draw on critical geographies, aging, and violence research to analyze how staff perceive, manage, and control the risk of violence in LTRC. Specifically, we explore the role of space as an instrument of control in places of care; the language of risk and risk containment in these places; and how movement figures into management of the risk of violence. Data included telephone and web-based semi-structured interviews with 29 staff in two Canadian provinces from 2021 to 2023, which were analyzed inductively. LTRC staff described having access to and support from other staff as an important feature of safe places. They also emphasized visibility, opportunities to escape from violent or threatening situations, being cognizant of objects that may be used as weapons and moving some residents to other tables, rooms, or specialized units. Finally, some staff acknowledged tensions between person-centered care and protecting staff and resident safety. Our analysis raises concerns about whether the management of space, objects, and activities employed to promote safety contribute to the care and dignity of older people. By drawing attention to the role of space, place, and risk containment in managing violent situations, we illustrate the important contributions of critical geography in troubling institutional care for older people.

Date: 2024
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DOI: 10.1016/j.socscimed.2024.117091

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