eprintid: 10187895 rev_number: 7 eprint_status: archive userid: 699 dir: disk0/10/18/78/95 datestamp: 2024-02-27 12:01:47 lastmod: 2024-02-27 12:01:47 status_changed: 2024-02-27 12:01:47 type: article metadata_visibility: show sword_depositor: 699 creators_name: Brear, MR creators_name: Manderson, L creators_name: Nkovana, T creators_name: Harling, G title: Conceptualisations of "good care" within informal caregiving networks for older people in rural South Africa ispublished: pub divisions: UCL divisions: B02 divisions: D01 keywords: Ageing, Care ecology, Caregiving, Ethics of care, Familial care, Older people, Sociomateriality note: Copyright © 2024 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC license (http://creativecommons.org/licenses/by-nc/4.0/). abstract: Good care in social policy statements is commonly implied as familial and person-centred, provided by family members and focused on upholding the autonomy, dignity and respect of the care recipient. Policy consideration of the relational nature of caregiving, the sociomaterial determinants of good care, the practical knowledge of caregivers and responsibilities of the state, is limited. Drawing on the ethics of care theory and a care ecology framework, which conceptualises the dynamic interactions between formal and informal care “systems,” we analysed ethnographic data of the interactions of 21 caregivers and their older care recipients in South Africa to understand how they conceptualised good care. Conceptualisations of good care included: having the right, altruistic and reciprocal, motivations; providing care frequently and consistently; and demonstrating hope for a better future through practical action. Caregivers also considered restricting autonomy a feature of good care, when doing so was perceived to be in the care recipient's best interest. Conceptualisations of good care were influenced by but also countered policy and cultural ideals. When they subverted policy values and practices, by overriding autonomy, for instance, caregivers' conceptualisations reflected their practical experiences of caregiving amidst gross material inadequacies, underpinned by deficiencies in the formal care system. We highlight the need for policies, interventions and theories of care that focus broadly on the care ecology and particularly on the “carescape” (formal care system). We advocate relational approaches that consider and balance the needs, desires and rights of caregivers and care recipients, and recognise caregivers' experiential knowledge, rather than person-centred approaches that focus exclusively on the care recipient. date: 2024-03 date_type: published publisher: Elsevier BV official_url: https://doi.org/10.1016/j.socscimed.2024.116597 oa_status: green full_text_type: pub language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 2246032 doi: 10.1016/j.socscimed.2024.116597 medium: Print-Electronic pii: S0277-9536(24)00041-8 lyricists_name: Harling, Guy lyricists_id: GHARL54 actors_name: Flynn, Bernadette actors_id: BFFLY94 actors_role: owner funding_acknowledgements: R21 AG059145 [NIA NIH HHS] full_text_status: public publication: Social Science & Medicine volume: 344 article_number: 116597 event_location: England issn: 0277-9536 citation: Brear, MR; Manderson, L; Nkovana, T; Harling, G; (2024) Conceptualisations of "good care" within informal caregiving networks for older people in rural South Africa. Social Science & Medicine , 344 , Article 116597. 10.1016/j.socscimed.2024.116597 <https://doi.org/10.1016/j.socscimed.2024.116597>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10187895/1/1-s2.0-S0277953624000418-main.pdf