To the many manifestations of the complexity of care in a nursing home environment, it appears that we can add laundry services as a marker of a nursing home’s overall care quality. Viewing care through the lens of laundry turns out to be remarkably successful at least in the hands of Pat Armstrong and Suzanne Day, of York University. This book represents work by researchers from North America and Europe who reflect on the insights gleaned during a seven-year research project, “Re-imagining Long-Term Residential Care: An International Study of Promising Practices”.
Everyone can relate to how important laundry is in daily life and how personal clothing choices contribute to our own personal identity. With these two basic principles in mind, the authors have presented thoughtful discussions taken from their research in nursing homes in many countries. Armstrong and Day state that while their original intent was not to focus on “laundry” per se, it became apparent that laundry became a unifying theme that had significant meaning to residents, families, and staff. The authors chose to write the book “guided by feminist political economy, informed by theories of care”.
Nursing homes, residents, and families all want person-centred care in a home-like environment that is safe and effective. Trying to find a balance so that these objectives can be met underlies the many challenges our nursing homes face every day. This book explores these challenges by illustrating how the effective processing of laundry by staff in their respective facilities – and which results in residents’ having clean clothes on a timely basis – can contribute to a nursing home’s finding the appropriate balance between social and health concerns to ultimately meet the need for person-centred care. For example, there is thoughtful discussion about “for profit” and “not for profit” nursing homes and how these homes tend to handle laundry differently with more outsourcing of laundry services in for-profit homes compared to the not-for-profit homes. Wash, Wear, and Care presents accounts from staff interviews that provide insight into the varied ways in which nursing homes manage and process laundry and how the result affects the staff and the residents. These accounts offer an insightful look at the many competing factors that result in a balance – or imbalance – in the type of care a nursing home provides.
It is very important that nursing homes strive to deliver person-centred care safely in a home-like environment. Among other qualities, this book also discusses the importance of personal autonomy and respectful care, along with a healthy staff. It balances this discussion with the realities of managing costs, risks, infection control, and the needs of a nursing home’s often diverse workforce. Armstrong and Day discuss all these aspects broadly and honestly through concrete examples where nursing homes have succeeded – or failed – in incorporating these principles fairly. The homes that have continued to do their own laundry and have dedicated staff tend to perform better at ensuring that residents’ laundry is not lost and that families are content, adding to the person-centred care environment. Other facilities that have chosen to outsource laundry in order to save money often experience complaints from residents and their families. The narrative maintains the reader’s interest by always connecting these difficult discussions back to “laundry” and “clothing”. Homes that focus on “laundry” tend to think of this task as an essential service as opposed to the homes that focus on “clothing” which often leads to practices that are more person-centred.
Upon completion of this book, it struck me that if nursing homes can successfully provide clean clothes and laundry in a timely manner such that residents and family feel that their personal integrity is intact, and all staff (including the laundry staff) are pleased with the process, we might have an answer as to how nursing homes can satisfactorily provide person-centred care in a home-like environment provided by satisfied staff. If the thought processes and policies that allow laundry to be processed expeditiously could be duplicated for important services, such as meal service and bathing, we might be able to continue to enhance and deliver on the objective of providing truly exceptional person-centred social and health care.
Wash, Wear, and Care will appeal to a wide audience including administrators, directors, and managers of nursing homes or other health care facilities. Health care professionals and staff who are interested in a gaining a broader perspective on the challenges faced by nursing homes and other health care institutions will find much of interest in the book. Similarly, the book has something to offer policy-makers and researchers who are interested in understanding and evaluating all of the competing variables that must be considered when addressing the all-important question of how to provide exceptional health and social care.
The appeal of this book is that it artfully takes a topic with which we are all highly familiar (laundry) and uses it as a focal point to illustrate several important, complex issues facing our nursing homes today. This connection to laundry allows the reader to understand these challenges in such a way that imparts meaning to each of us and helps us understand the complicated concept of providing truly person-centred care. Ultimately, this book illustrates that we all have a responsibility to work together as a team to change the culture of caring so that some of our frailest seniors receive the type of care that they need and deserve.
