With her book Bathing: The Body and Community Care , Julia Twigg hopes to bring new insights to carework by placing it in a broader social and historical context.
Nothing could be more mundane than having a bath or shower. But if we find ourselves unable to manage these activities, our day-to-day existence is profoundly threatened.
Much of ordinary life is taken up with the routine round of body care and nurturance: sleeping, washing, dressing, combing, eating, excreting. It marks out the rhythm of our days and provides a bedrock for our lives. We prepare and present our bodies as part of social life, and a sense of bodily comfort and security allows us to feel at ease and at home in the world.
The regularity of these activities is part of what makes them important. But they exist at a level that is rarely brought into conscious articulation or review. Indeed, in modern western societies we largely ignore them, regarding them as trivial, private activities.
It comes as a rude awakening to those who suddenly find themselves unable to manage. But for many older and differently abled people, it is essential that they learn to cope if they wish to remain in their own homes. Providing assistance in this area is one of the key elements of community care, but it is an element that has been very little studied. In my book Bathing: The Body and Community Care, based on research funded by the Economic and Social Research Council, I explore this territory through interviews with older and differently abled people and with their careworkers.
Ambivalence is often expressed on both sides. Help with bathing involves nakedness, touch and forms of closeness that can be at odds with ordinary social relationships - even within the family. It can be an area of conflict and tension as well as of warmth and care. To deal with the enforced intimacy, both sides tend to limit degrees of closeness, both physical and emotional, setting clear boundaries on the nature of the relationship. Older people can feel exposed and diminished by such care, no longer in charge of the day-to-day rhythm of their lives. It is difficult for those used to being up and dressed at the start of the day to find themselves hanging around in nightclothes at noon waiting for the home-help.
Unfortunately, service delivery is dictated by economics. It is ruled by the clock and the need for efficient rosters. But domestic needs operate on their own timescale. They have their roots in social mores and the needs of the body: getting up and dressing, eating meals, going to the bathroom. The result is often a conflict between the demands of efficient service provision and the needs and wishes of the client.
Careworkers face difficulties, too. They deal with situations that can be messy, embarrassing and emotionally demanding, but they receive little help in doing so. Much has been written on managerial issues in connection with community care, but there is very little that addresses the frontline realities of provision. By and large, careworkers are left to their own devices.
Accounts of carework tend to stress the element of "care" in the sense of personal and emotional support. But this overlooks the messier bodily reality of the work, producing an over-etherealised account of the profession. Carework needs to be placed in a broader context and linked to other occupations that deal directly with the body, be they nursing, hairdressing or undertaking.
For many younger workers, helping someone to bathe is the first time they have seen an old person naked. This can come as a shock for people brought up in a culture where ageing bodies are rarely visible. Such sights encourage workers to confront their own mortality. They look at photographs of clients when young - in RAF uniforms and pretty frocks - and puzzle how these can be the same people who look at them now.
Bathing and washing, like other forms of body care, have largely been omitted from social and historical accounts. Part of the aim of my study is to redress this absence and show how these are activities that have meaning and significance. Cultures of bathing are diverse and many-faceted: historically the activity has not been solely linked to hygiene. I have explored some of this diversity in my book, looking, for example, at bathing as an aspect of sociability, as a ritual of purification and separation, and as a rite of passage marking transitions between social and temporal states.
Bathing not only has its history, but its politics, too. Bathing in cold fresh water was part of a Rousseauistic rejection of the ancien regime with its powder and pomade and its superficial codes of cleanliness focused on the face and hands. The freshness of water represented contact with nature and a linking of the bather back to the stoic virtues of ancient Rome. In the 19th century, bathing, washing and the use of soap were implicated in the rise of class conflict in which social distance came to be marked out in bodily habits and odour entered the history of class relations.
This historical background has implications for the way we understand the provision of bathing within community care today, for the meanings of bathing are broader and more multiple than traditional accounts of service provision would suggest. We need to encompass this context if we are to shape successfully the provision of care. Indeed, bathing and washing are not as simple or mundane as they might at first appear.
Julia Twigg is reader in the School of Social Policy, Sociology and Social Research at the University of Kent. Bathing: The Body and Community Care is published this month by Routledge, £15.99.