Hanna Stalenhoef

Tying knots and working with frayed edges: unraveling regions as places and imaginaries of care

Health Care Governance, Erasmus University Rotterdam, [email protected]

Supervisors: prof. Roland Bal, dr. Iris Wallenburg, dr. Jitse Schuurmans

Background

I obtained both my bachelor degree in Anthropology at Utrecht University, in which I conducted research on the utilization of a Dutch identity in creating a home in an Australian Nursing Home. During my fieldwork for my thesis, I was intrigued by dementia and the social implications of it; and I had the chance to scrutinize this topic more in depth during the research for my master cultural anthropology.

After graduating, I worked as a junior communication advisor, photographer and as research assistant at Leiden University before starting my PhD at Erasmus University.

Summary PhD Project

In order to grapple with the increasing complexity of care in the home space, shortage of staff and a growing elderly population, healthcare organizations are increasingly working towards the organization of elderly care in regional care networks. This development fits in with the call for ‘regionalization of care’ voiced by the Dutch ministry of health. While a prior reorganization of the healthcare system in 2015 stressed the importance of competition; the current regionalization movement calls for collaboration between elderly- and social care organizations on a more aggregated, regional level.

In the current political structure in the Netherlands, the region is not a clear cut institutional and geographical entity. Yet it sparks many debates and reconfigurations of care; for instance, about the reconfiguration of traditional boundaries between healthcare organizations and existing institutional arrangements. Elderly care is organized at different geographical levels, and regionalization cuts through many existing administrative, cultural, social and financial boundaries. How is this done? And to what effect?

This thesis aims to analyses how the discourse of regionalization takes shape in elderly care in rural areas. It will approach the region both as a local contexts, which shapes the provision of care, and imaginaries which inspires normative ideas about good care, in order to map out how this concept influences how care for elderly people is provided, valued and accounted for.  In order to unravel the complexity of the regionalization discourse, I will build upon ethnographic insights from various case studies, including:

• Task flexibility pilots in the context of a regional carescape
• The influence of accountability structures on the formalization of networks
• The creation and utilization of ‘best practices’ in relation to regionalization
• The role of personal possessions in making a home in a nursing home
• Caring for the family and the land in the Japanese country side