Doctoral Dissertation Research: Innovations in Geriatric Medicine and the Ethics of Eldercare Delivery

卫生保健专家和政策制定者越来越关注老年医学的一个明显的悖论：虽然生物医学护理在维持人类生命方面越来越成功，但老年人的社会和家庭护理却供不应求。全球和国家卫生倡议扩大了老年人获得老年保健的机会，使医疗监测和治疗成为变老的重要组成部分。该项目旨在培养一名研究生如何进行严格的以医学为基础的科学实地考察，探讨老年人的医疗保健干预措施如何塑造家庭、州和地方政府以及有偿护理劳动力市场之间的关系。加州大学欧文分校博士候选人Elizabeth DeLuca，由Michael Montoya博士指导，将研究健康和社会护理制度的变化如何塑造老年人和那些声称照顾他们的人之间的关系。研究人员询问家庭，照顾者和市政官员如何应对社会压力和技术变革，在老年人护理的谈判中出现了什么样的道德和伦理要求，以及这些要求如何塑造老年人，家庭，照顾者和市政官员之间的关系，以及在多大程度上这些老年人护理安排返工亲属关系，政治和有偿劳动。博士生将在土耳其的两个城区进行为期12个月的人种学实地考察。土耳其是探索老年护理规划的适当实地地点，因为老年人的人数预计在今后15年内将翻一番。之所以选择特定的城市现场，是因为这些地区的市政当局制定了针对独居老年人的医疗监测的公共卫生方案。这些地区65岁以上的成年人也相对较多。研究人员将在市政服务中进行广泛的参与式观察，并与护理人员和医护人员进行深入访谈，记录他们对护理和衰老身体的理解和方法。她将通过家庭，公共卫生服务，政治和医学修辞遵循老年人护理的话语和实践，收集有关护理实践如何有助于家庭，国家和劳动关系的信息。这项研究将通过阐明支撑全球人口转型的复杂的社会、政治和技术安排以及伴随它们的护理制度的转变，为老龄化人口的社会和医疗保健的全球问题做出及时的贡献。这项研究还从人种学的角度调查了最近发展的“健康城市”倡议，重点是老年人，并将有助于跨学科的社会科学研究老龄化和公共卫生。研究结果还将建议如何提高长期护理和老年医学基础设施的效率和有效性，考虑到对护理，身体和家庭的不同伦理和道德理解。该项目还支持培训一名研究生。

Health care experts and policymakers are increasingly concerned with an apparent paradox when it comes to geriatric medicine: while biomedical care is increasingly successful in sustaining human life, the social and familial care of older adults is in short supply. Global and national health initiatives have expanded access to geriatric care for older adults, making medical monitoring and treatment an important part of growing old. This project, which trains a graduate student in how to conduct rigorous empirically-grounded scientific fieldwork, explores how health care interventions for older populations shape relations among the family, state and local government, and markets for paid care labor.University of California, Irvine doctoral candidate Elizabeth DeLuca, supervised by Dr. Michael Montoya, will examine how shifting regimes of health and social care are shaping relations among older adults and those who claim to care for them. The researcher asks how families, caregivers, and municipal officials respond to social pressures and technological changes in the delivery of eldercare; what kinds of moral and ethical claims emerge in the negotiation of eldercare, and how those claims shape the relationship between older adults, families, caregivers, and municipal officials; and to what extent these eldercare arrangements rework relations of kinship, politics, and paid labor. The doctoral student will undertake twelve months of ethnographic fieldwork in two urban districts in Turkey. Turkey represents an appropriate field site for the exploration of geriatric care planning as the number of older adults is expected to double in the next fifteen years. The specific urban field sites were chosen because the municipalities in these districts have developed public health programs targeting the medical monitoring of older adults who live alone. These districts also have relatively large populations of adults over the age of 65. The researcher will conduct extended participant observation in municipal services as well as in-depth interviews with caregivers and healthcare workers, recording their understandings and approaches to care and the aging body. She will follow discourses and practices of elder care through homes, public health services, and political and medical rhetoric, collecting information about how the practices of care contribute to relations of family, state, and labor. This study will provide a timely contribution to the global issue of social and medical care for aging populations by illuminating the complex social, political, and technical arrangements undergirding global demographic transitions and the shifting regimes of care that accompany them. This study also ethnographically investigates the recent development of "healthy city" initiatives that focus on older citizens and will contribute to interdisciplinary social science research on aging and public health. Findings will also suggest how to improve the efficiency and effectiveness of growing infrastructures for long-term care and geriatric medicine, accounting for diverse ethical and moral understandings of care, the body and the family. The project also supports the training of a graduate student.