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Reinventing the nursing home: metaphors that design care

Drawing on findings from team nursing home ethnographies in Canada, the UK, Sweden and the US, this chapter argues that new designs for nursing home care draw from a social imagination limited by contemporary ideals of individualism, practices of consumerism and structures of inequality. As newly built or renovated nursing homes are designed to support better care for frail older adults, a contradictory mix of policy aims has emerged, including improvements to economic efficiency and sustainability, better standards of care and wellbeing for residents, and efforts to create appealing, hospitable environments. The research brings critical attention to walls, gardens and furnishings, arguing that they not only shape the everyday life of frail old age but also reveal tensions between what residents and those who provide care require, what is designed for them and what is expected of them.