When and How Institutions Do Work — The Caring in Homes Initiative

Abstract

This chapter begins by briefly revisiting the conventional critique of the total institution and, as in previous chapters, pointing to its inadequacies in terms of an analysis of the potential of today’s residential institutions to play a part in enabling communities to care. The previous chapter addressed the issue of what constitutes quality in continuing care from the perspective of the nursing profession. Leonie Kellaher now turns our attention to the structures of residential institutions and how these can facilitate quality care. Throughout this book, the preservation of individual identity in the face of physical or psychological dependency has been a recurrent theme. Institutions of all types that intervene to provide care — formal and informal, residential and community based — may threaten this identity. Practicebased research over the past 30 years has shown us ways in which the aspiration to preserve the self within the institution can be attained.