Ageing

Senior Citizens,
Good Practice and Quality of Life
in Residential Care Homes

Rosemary Elspeth Bland

PhD
University of Stirling 2005

University of Stirling
Rosemary Elspeth Bland
Department of Applied Social Science

Abstract of thesis entitled “Senior Citizens, Good
Practice and Quality of Life in Residential Care
Homes”
Submitted for the degree of PhD
August 2005

Thisthesis is an examination of the definition and implementation of ‘good practice’
in residential care for senior citizens. The central contention is that ‘good practice’ is
a term that has been variously defined. Different groups define it in different ways,
and their definitions have changed over time.
This reflexive qualitative study explores ‘good practice’ in local authority, voluntary
andprivate residential care homes in Scotland from the perspective of policy, practice
and the experience of senior citizens who live in them. The study is based on analysis
of policy documents, historical studies, and reanalysed interview and survey data
from two earlier studies conducted by the author and colleagues.
The thesis shows that the notion of ‘good practice’ that emerges in policyand practice
documents is a confused and often conflicting set of ideas. Historically, the earliest
were driven by concerns over cost. In more modern times, statements about ‘good
practice’ have had a more benevolent intent but are frequently flawed by paternalistic
and ageist assumptions.
It is shown that staff in residential homes typically adopt a different set of attitudes:
theirpreoccupation is with safety and the avoidance of risk. Although benevolent in

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intention, these interpretations of ‘good practice’ are also at variance with what
residents themselves actually want.
Two particular models or styles of care are examined in detail. One of these is the use
of ‘keyworkers’, often implemented in ways that fail to realise its potential. The other
is the ‘hotel’model of care. The potential of this model as an alternative to the
statutory model is explored. The thesis concludes that it is a model that can realise
the goal of enabling residents to exercise independence, choice and privacy while
meeting their needs in residential care.

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Acknowledgements
I should like to extend my thanks to my supervisors, Professor Alison Bowes and
Susan Tester,for their unstinting encouragement, support and guidance, over a very
long period of time. I should also like to thank my family, in particular my husband
Richard, for their support, patience, and understanding.
The thesis is dedicated to my late mother, Elsie Fitch.

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Senior Citizens, Good Practice and Quality of Life in Residential Care Homes

Table of Contents
Chapter One -Introduction ........................................................................................ 3
Chapter Two - Social Attitudes to Ageing ............................................................... 10
Introduction......................................................................................................... 10
An Ageing Society.............................................................................................. 11
Ageing as an economic burden ............................................................................ 14
Perceptions of ageing and senior citizens ............................................................. 17
Age discrimination and the identification of ageism............................................. 20
When does ageing start?Defining ‘old’ chronologically ...................................... 26
Chronological age and social policy - institutional ageism ................................... 27
The influence of biological perspectives .............................................................. 34
The influence of biomedical perspectives ............................................................ 34
Ageing and...