The Politics of Institutional Ethnography of Long-Term Care Practices. Methodological Reflections Based on a Multi-Sited European Study
Institutional ethnography is well suited to understand how practices, policies, organizations within the field of long-term care for older people operate, function, reflect and produce tensions, inequalities and (re)arrangements of the social organization of care. Namely, the approach “examines and explores society and the social from where people are in the local actualities” and “can bring them to light and make them available to people” (Smith 1997, p.41).
At the same time, the discovery work of institutional ethnography is not neutral with respect to the actual people that are part of it, the very participants, the stakeholders of the very power relations and that are being unveiled – e.g. persons with chronic illness, paid and unpaid care workers, managers of care organizations, policy makers at different territorial levels. This is particularly the case within a field that is strongly affected by often hidden or non-recognised power relations, interests and struggles over resources. And it is even more important in a field where research funding is increasingly distributed based on policy-oriented projects, which are expected to produce policy recommendations.
The paper’s methodological discussion and contribution is based on the first steps and findings of cross-national EU-funded research project - LeTs-Care – which encompasses a multi-sited cross-national ethnography of practices of long-term care for older people with disabilities and chronic illnesses. It discussed the tensions emerging from the selection of the fields and its opening, the relationship between the researchers and the actors within and beyond as well, the communication of the objectives and methods of inquiry, the exchanges on the results.