Geriatric medicine and the management of transitions into old age: the hospital bed as a site of spatial practice

Abstract

Geographers and gerontologists have developed similar ways of viewing age-related transitionsresisting theories that attempt to fix age stages against a normatively constructed life course. However, in both these literatures the part that spatial practices play in determining transitions has been less well developed. This paper draws on recent theorising in geography and in gerontology to consider transitions, focusing on the hospital bed as a space where age is defined and delineated. Making use of oral history interviews conducted by Margot Jefferys with two groups of geriatricians (the pioneers of geriatrics in the UK) and a new dataset of interviews with South Asian geriatricians, the paper explores the role of the hospital bed as a focus for everyday practices and territorial disputes between doctors as they relate to late life transitions. The paper contributes to knowledge of how, by defining its own professional space and area of expertise, the geriatric specialty played a part in shifting spatial and social transitions relating to medical care in old age between 1950 and 2000. By comparing the two interview sets we consider how the development of the specialty depended on defining in spatial terms where and how conditions for care and cure were managed and how these were envisaged and enacted.

What about the workers? The missing geographies of health care

“…Understanding the experiences of persons managing particular disabilities has resulted in greater attention to identity (e.g. Davidson and Henderson, 2010), and more concerted efforts to engage with health and intersectionality in terms of ageing, sexuality and pregnancy (Bornat et al, 2011;Lewis, 2009;DeLyser and Shaw, 2013), and gendered approaches to rurality, mobility, ethnicity and mental health (Meurk et al, 2013;Bondi and Burman, 2001). Geographers have considered the marginal health status of particular groups, including indigenous communities (Bourke et al, 2013, Leeuw et al, 2012, immigrants (Asanin and Wilson, 2008) and sexual minorities (Fish, 2008;MacDonnell and Andrews, 2006).…”

“…), but little attention is paid to their training and role, other than perspectives from outside health geography (e.g. Batnitzky and McDowell, 2011;Bornat et al, 2011). While policy perspectives indicate an opening for workforce issues, recent debates (e.g.…”