In this Insight we examine the day-to-day interactions between personal care workers and residents, including:
• the ways in which guidance and the organisational response to regulatory demands provide structure for care interactions
• tensions arising in the regulated contexts, particularly between person-centred care and the emotional demands of care work
• two alternative strategies, ‘misattention’ and a ‘puzzle’ approach, that may be adopted to balance the demands of regulation and emotional connection in dementia care practice.
Throughout, we draw on evidence based on three care provider organisations, including direct observations of care practice and interviews conducted with senior managers, facility managers and direct workers across eight residential care facilities. We conclude that best practice in regulated environments allows for the negotiation of professional distance, empathy and problem solving strategies.