Culture, Medicine, and Psychiatry

, Volume 36, Issue 3, pp 535–556 | Cite as

Interactions and Relationships in Long Term Care: Photography and Narratives by Direct Care Workers

  • Dena ShenkEmail author
Original Paper


The challenge of hiring and retaining well-trained caregivers for the growing numbers of elders in need of care is a global concern. This study was designed to understand the views of direct care workers and included 15 nurse aides and med techs working in an assisted living and special care assisted living community for people with dementia. Each participant was provided with a digital camera and asked to take photographs “to show what caregiving means to you.” Analysis is based on group discussions about the full set of photographs created by the direct care workers and individual written and oral narratives about four photographs chosen by each participant. The categories generated from these data represent the direct care workers’ perceptions of the approaches to quality caregiving and the relationships involved in doing their jobs well. By focusing on the essential relationships and interactions, rather than primarily on the required care, we can begin to imagine the caregiving experience in terms of a communal rather than an institutional experience. We can then productively turn our focus to the people involved rather than emphasize their roles as providers or recipients of care.


Direct care workers Caregiving Photography Narratives Long term care 



Thanks to my research assistants: Denise Bordeman, for her dedicated participation in the data collection and transcription and Jeena George for her assistance with data summary and qualitative analysis. I also thank the residents, family, and staff of Greenbriar and Safe Harbor, especially the skilled and dedicated direct care workers whose commitment to their work is portrayed here in their discussions of the photographs they created.


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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of AnthropologyUNC CharlotteCharlotteUSA

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