In this volume Schillmeier and Domènech have gathered together ten contributions by authors from several countries, based on work that includes original empirical studies, reflections on previous studies, and theoretical examinations. These are gathered around a theme of new technologies for care and their effects on individuals as well as practice, viewed through ‘the poly-theoretical lens of Science and Technology Studies’ (p. 2). There are four basic concerns: the social control, surveillance and accountability that are common concerns for providers and users alike; boundaries and migrations between public and private; the new relationships and subjectivities generated by using these technologies; and the ethical implications of their use in care situations, such in as human/non-human interdependencies. To explore these issues the book is divided into two sections: six chapters on non-institutional (domestic) places of care, and four on institutions.
Turning first to domestic settings, in Chapter 1, Milligan, Mort and Roberts discuss the interaction between care, technology and home, drawing on UK-based empirical data from a larger European study. The authors point to relationships in both physical and virtual spaces, and claim that a new topology of care is having a major impact on how care feels to older people, for example when it circumvents barriers that protect the privacy of home. They illustrate this with a quote from one older participant: ‘technology has no bounds has it?’ (p. 34). In Chapter 2 López extends this line of thought to consider telecare as a kind of panopticon in the home, going beyond visual surveillance since it also involves practices and processes that invisibly regulate behaviour. López's argument is that care delivery is profoundly affected by this turn, because the ‘securitization’ of care spaces means that rather than focusing on older people themselves as the object of care, the real objects become ‘risk profiles’, managed through protocols designed above all to minimise risk. Tweed, in Chapter 3, investigates what telecare brings to the spatiality of home and how people experience and use domestic space. He draws on concepts from phenomenology and environmental psychology, and specifically on the complementarity between the person and the environment, arguing that new technologies inevitably alter existing patterns of use and experience of spaces.
In Chapter 4 Lutz considers ‘clutter’ and how stress upon the risk aspects of cluttered objects in homes has downplayed the complexities of how people accumulate, move around, attempt to redistribute, or re-appropriate objects – described here as ‘clutter technology’. In the ‘thing-rich’ home, objects regarded by others as being in the ‘wrong’ place may be in just the right place from the resident's viewpoint. He argues that as private homes are increasingly equipped with health-care devices and transformed into ‘care facilities’, the socio-technical notion of clutter technology can be more explanatory than a simplistic assumption that clutter = risk. The theme of home as care/workspace continues in Chapter 5, based on an ethnographic study in Denmark. Lindegaard and Brodersen discuss how the health-and-safety and operational needs of care staff can be at odds with the needs and aesthetic sensibilities of the resident, and argue for consideration of the whole of the social-material environment when introducing technologies. Turning to think about non-human care assistants, Paterson (Chapter 6) considers the role of various kinds of robots in the home. Citing Bill Gates’ assessment that robotic care devices will become ubiquitous, Paterson raises the question of form and acceptability: Humanoid or non-humanoid appearance? How ‘sociable’ should a robotic appliance be? What roles will be acceptable? He makes a strong case for the avoidance of ‘uncanny’ simulations of humanity, while working towards devices with more sophisticated movement and intelligent, responsive ‘skin’ that will enable them to work well with people in intimate care.
In the second section of the book, Thygesen and Moser in Chapter 7 make a case for an ethics-in-practice approach to technology in dementia care, drawing on empirical research in Norway. They demonstrate how finding good solutions may well involve testing out different arrangements to find the one most satisfactory to the individual and the situation, and in doing this different values must be constantly weighed and balanced. In Chapter 8 Bendien, Brown and Reavey describe a ‘remembrance museum’ in the basement of a large care home in Rotterdam, based on the premise that social surroundings are crucial in making ‘a place where clients are “made happy”’ (p. 153). Although this is not intended or organised as a therapeutic space, the authors describe the ‘various kinds of small transformations’ (p. 166) that occur as people with dementia engage with the displays and care staff pick up on that engagement.
The intriguingly named Pillow Squirrel of Chapter 9 (Kraeftner, Kroell, Ramsebner, Peschta and Warner) is neither a squirrel nor, really, a pillow. It is a prototype ‘barefoot technology’ device comprising a video display for showing humorous films, with a camera attached to a computer to capture facial expressions. The authors created it in response to the situation of people in persistent ‘vegetative state’, as a counterbalance to what they regard as the inadequacies of neuroimaging technologies in producing reliable information about the emotional awareness of people in this condition. A self-confessed ‘risky bet’, this is an unusually detailed and interesting account of a research project in progress. Finally, in Chapter 10, Hillman, Latimer and White look at different clinical spaces in a UK hospital, moving from Accident and Emergency, though Intensive Care and into Critical Care. As well as apparatus technologies, they consider the medical/diagnostic and managerial/audit technologies that affect processes of inclusion/exclusion in access to services through this transition.
This book offers an interesting and varied collection from authors with different disciplinary backgrounds and different writing styles. Depending on the reader's own particular immersion in the complexities of technologies, space and care, some of the research findings and discussion in this book will come as a revelation: others less so. Although at times a challenging read, there is plenty of material here to provoke discussion and reflection on how technologies can affect where, how and why care takes place – and indeed what ‘care’ will become as technologies advance. I would recommend it for researchers and postgraduate students in sociology and the social sciences, technology and design, and others interested in the future practice of care.
