Abstract
Old persons in nursing homes suffer from complex diseases, pain and the loss of physical functions and memory. They embody the notion of ‘deep old age’, the ‘fourth age’, as recipients of personal care, medicine, meals and organised activities. People in nursing homes are also part of a society in which media have become a regular feature of everyday life. Based on ethnographic fieldwork in Danish nursing homes, this article explores old persons’ subjective interaction with media technologies and material objects. Embodiment and agency are central analytical concepts for understanding residents’ use of media artefacts when the body is in pain and loses functionality. With theories of domestication and biographical situation, this article reveals how media are important for residents in making an institutional dwelling ‘their home’. Media seem to bridge the gap between institutionalisation and a long life’s preferences and participation in social and cultural worlds. This article forms part of ‘Media and the Ageing Body’ Special Issue.
Keywords
Introduction
A resident explains how it is important for her to keep reading her daily newspaper in order not to give up on life, to avoid getting ‘out of here’ – meaning ‘to die’:
If I drop my subscription [to a national newspaper], I am one step closer to being ‘out of here’. Of course, I am getting out of here. I know that. Anyway, I will not help by saying, ‘Now I give up this, and now I give up that!’ What’s left then? There’s not much left already, but I have to hold onto what’s still there. I do. (93-year-old woman with very poor eyesight)
As a cultural gerontologist (Swane, 1996; Twigg, 2015) in an interdisciplinary media project investigating ageing and media in Denmark, I chose to study the field I find most intriguing – namely, the complex lives of frail, old people. It is nowhere more likely to find the category of frailty embodied than in institutional settings. Nursing homes are available for old persons in need of extensive care due to severe physical frailty and complex diseases including dementia. These persons have experienced multiple losses in their lives – of spouses, children, siblings and friends. By moving into a nursing home, people also lose their neighbours, a familiar environment, their home and most of their material belongings (Gubrium, 1975; Kofod, 2008), autonomy in self-care (Harnett, 2010) – and, in many ways, a lifetime’s routines.
Media have become a feature of everyday life (Deuze, 2011) with a strong influence on culture and society through institutions (Hjarvard, 2008). Yet, there is little knowledge about the importance of media use among frail, old persons. In this study, I set out to explore everyday life in nursing homes through a media lens. This article focuses on the lived experience of media – bracketing institutional structure and care – in order to elucidate practice and meanings ascribed to particular media technologies and artefacts.
Cultural boundaries of old age
To people who never set foot in a nursing home, these institutions are a foreign country, residents the foreign Others. This stigmatising image represents the opposite of the ‘third age’ (Laslett, 1989) – a field of agency, consumption and choice, of active and healthy ageing (Lassen and Moreira, 2014). Chris Gilleard and Paul Higgs (2010) describe the process of becoming subjects of a ‘fourth age’:
It is when people are no longer ‘getting by’ (…) when they become third persons in others’ age-based discourse, within others’ rules, that they become subjects of a fourth age. At this point an ‘event horizon’ is passed, beyond which the everyday round cannot situate a frame of reference from which individual agency is interpreted. (p. 122)
Old people in nursing homes embody what, beside the ‘fourth age’, has been labelled in English ‘deep old age’, ‘old’ old age, ‘defined in the collective imagination by its negativity and otherness’ (Higgs and Gilleard, 2015: vii); ‘that old, “real” old age which we have always feared’ (Higgs and Gilleard, 2015: viii). Higgs and Gilleard examine how the development of care institutions for old people laid the ground for the category of the fourth age. Other cultural studies have revealed how the fear-provoking image of senility, dementia and Alzheimer’s disease has historically played a central role in ageing discourse (Covey, 1988; Swane, 1996).
While in one dimension, a ‘third age’ sets the cultural boundaries of a ‘fourth age’, it is also culturally defined by its closeness to death (Lloyd, 2015; Twigg, 2006). The fourth age functions ‘as a kind of terminal destination’ (Gilleard and Higgs, 2010: 123) – not only discursively; it is corporeal, illustrated by the fact that residents in Danish nursing homes live, on average, 2.5 years, and nearly a third live for less than 1 year (Ældrekommissionen, 2012). Nursing homes are institutions of death and dying.
Institutional bodies and agency
But nursing homes are also institutions in which residents have lived, bodily experiences of being old. They are places with people who do not give up, as the 93-year-old woman states in the initial quotation; they are places with bodies that have managed to keep going for 70–80–90–100 years. The term ‘embodiment’ captures well the complex and dynamic structure of bodies as objective, physical entities that are, at the same time, cultural bodies of subjective experience (Leder, 1990; Schutz, 1962; Tulle, 2015). From this perspective, old people in institutions are not exclusively bodies of pain and dysfunction, not merely objects of negative discourses. Besides being institutional bodies (Wiersma and Dupuis, 2010), obeying institutional structures and routines (Goffman, 1961; Harnett, 2010) and despite cultural and social abjection (Higgs and Gilleard, 2015), nursing home residents act as subjects with intentions and routines from a long life.
Erving Goffman (1961) included nursing homes in his concept of ‘total institutions’ (pp. 4–5). Goffman’s definition of a total institution is a place designed for living and working, where a large number of individuals in the same situation have been cut off from society for a longer period of time in what he describes as ‘closed worlds’. The lifeworlds of nursing home residents have shrunk into tiny closed worlds (Swane, 2005), where ‘a longer period of time’ means for the rest of life. Noticeably, Goffman also describes ‘the inmates’ of institutions as acting subjects who create a meaningful life within the institutional context. Agency is even emphasised as a concept to learn about subjects living through institutions (Jokinen, 2016), an essential point in order to explore the ways in which residents aim to establish a recognisable and meaningful everyday life. Indeed, their actions reach beyond staff work schedules and care plans (Harnett, 2010; Pirhonen and Peitilä, 2015). Culturally, this is impossible since they embody a world discursively stripped of agency and identity (Higgs and Gilleard, 2015). Nevertheless, residents are living the remainder of their lives, albeit at a slow pace – sometimes so slow, with so little action, that it is almost invisible to the eye, perhaps particularly to the scientific gaze.
Studying life in nursing homes through media
It is primarily through care practices and narratives of care that nursing home residents are linked to the social world (Higgs and Gilleard, 2015). Even in cultural gerontological research, interest is mainly in care-related aspects. Despite a societal development in which media have become present in every institution and dimension of life, ageing research and media research have been described as separate worlds (Bolin and Skogerbø, 2013; Syvertsen, 2010). Consequently, the interactions of old people with media in nursing homes remain relatively unexplored (Claessens, 2013).
Studies of mass media in nursing homes
Over the past 25 years, the use of digital technology has resulted in major changes in the media landscape as seen in smart TV, tablets, text messaging, email and so on. However, TV has proven to be the most frequently researched media technology in old people’s lives – and almost the only media studied in nursing homes (Claessens, 2013). This has left the potential complexity in residents’ use of media unexplored.
Statistics (Danish Agency for Culture, 2015) and research (Hajjar, 1998; Van der Goot et al., 2012) document that TV is the dominant medium in the lives of older people, including in nursing homes. However, Östlund has shown that watching TV is not always a passive activity. It helps structure everyday life and contributes to the need older persons have for reflection, reminiscence and immersion into various subjects (Östlund, 2009). Based on qualitative interviews with residents at two Belgian nursing homes, Claessens (2013) analysed their use of TV and radio and their interest in particular programmes. She found that, most often, the use of media takes place in the private residence and that the interviewees preferred local news. Claessens concluded that older people stay true to the TV channels they have been watching throughout their lives, which tracks findings in an American study (Hajjar, 1998). Watching TV in their private residence is described as one of few means for residents to exert control over their daily lives (Van der Goot et al., 2012).
This article aims to understand the role media play for the agency of residents. How do they interact with specific objects, and how are media meaningful in their everyday life in the nursing home? The focus is on residents’ experience with media in their private residence – out of reach of care ‘situations’ that involve staff. In this sense, the analysis brackets institutional structure. Undoubtedly, living in a nursing home helps sustain old bodies; this fact is not to be understated, and it is a presumption for residents’ interaction with media. This study explores the residents’ use of both personal media and mass media (Helles, 2010), looking into their use of technology and artefacts but not through specific a priori media categories.
Ethnographic framework
The majority of nursing homes in Denmark are municipal and not-for-profit, since elder care is the responsibility of local authorities in the Nordic countries. Hence, there is greater uniformity than in other European countries and the United States (Jacobsen, 2016). A residence in a Danish nursing home is a private one- or two-bedroom dwelling with kitchenette, bathroom and door lock, furnished with personal belongings. 1 Outside the private residence, old persons wearing their own clothes and staff (the latter sometimes wearing institutional clothes) mingle in hallways and common rooms with a mix of wheelchairs, walkers, laundry containers, food carts, TVs, DVDs and radios, furniture and plants. Often, television programmes are watched in living and dining rooms and heard from private residences with the door open.
Constructing field and empirical material
Field research took place at three nursing homes around Denmark over six continuous days and evenings in each institution during the winter of 2014–2015. 2 The institutions examined were selected for their variation in geography, size, dementia among residents and the implementation of communication technology. 3 The field research was based on an ethnographic methodology that explores subjective experiences and meanings ascribed to actions in everyday life (e.g. Jackson, 2010; Schutz, 1962). The empirical material that provides the basis of the analysis is constructed through observational notes, photos, video and sound recordings and qualitative interviews transcribed verbatim 4 (Fog, 2004). This article builds on fieldwork and interviews done with 39 residents primarily in their private residences. 5 Interviews were ‘active’ (Holstein and Gubrium, 1995) in that the interviewer and interviewee engaged in conversation together, guided by the range of media objects that were visible or remembered. Particularly when persons with dementia are interviewed, it is essential that the context is concrete and visible (Swane, 1998). Otherwise, both interviewer and interviewee may become uncertain what is being talked about – as in the following excerpt:
I was wondering, do you have a phone?
I believe so, I am not sure. Wait a second. I can’t really remember things like that. It is Alzheimer’s.
Visits to private residences and interviews became possible by spending time in the field. They had to take place when residents were not eating or sleeping, were too tired, ill or in pain or had other appointments and things they wanted to do. The interviews came about by meeting and talking with residents; some interviews continued over several visits. The interviews explored media use from a life history perspective (Gubrium et al., 2000; Randall, 1995) in order to learn how interviewees related to their present media use and preferences.
Ethical considerations concerning persons with dementia
Most studies of older people, including residents in nursing homes, that do not particularly focus on dementia or specialised care often exclude people with dementia as research subjects. Research that involves persons with dementia require special ethical consideration (e.g. Pirhonen and Peitilä, 2015). Yet, deliberately excluding people with dementia can be seen as both unethical and a worse option than inclusion despite the ethical dilemmas it raises (O’Connor et al., 2007, Russell, 1999; Swane, 1996). I have spent many years of research with people suffering from dementia. Spending time with them, talking to and interviewing and trying to understand associations have been central to much of my research (e.g. Swane 1996, 1998, 2005). Hence, after obtaining permission to enter the institution by the manager, I did not feel obliged to depend on staff to select interview subjects. During fieldwork, I entered into dialogue with residents and decided whether it was possible and ethically justifiable to invite them to participate. Overall, taking the time to be present with frail, old people with or without dementia is crucial to include their experiences and perceptions in research.
Analysis and presentation
The total material of photos, video and sound recordings, notes from fieldwork and interview transcripts of the 39 interviews has been analysed in order to explore the complexity and layers of experience and challenges in the residents’ lives with media. The selection of material for this article reveals my scholarly interest in making visible how very old, very ill and severely disabled people in institutions live their lives intentionally and with great effort until the very end. This article’s first theme elucidates the complexity of residents’ media use, as it became clear- through reading, listening to and watching the empirical data- how central a variety of media were in all interviewees’ everyday life. The second theme is inspired by Silverstone’s work on media and domestication; here, the analytical focus is the role that interaction with media plays in making the institutional residence a ‘home’.
The analysis presents more general descriptions of the interviewed residents’ media environment and their subjective bodily interaction with media and meanings ascribed, presented through excerpts from observations and dialogues with eight persons. The choice of cases and excerpts was difficult as the material is rich, and because all the old persons in the study turned out to be engaged with media in their specific ways – be it through radio listening, solving crosswords in magazines, watching movies or television, telephone communication or digital gaming. I have chosen material that was found to be useful in presenting the quality of the findings (Møller et al., 2015) in order to create insight into the biographically anchored complexity and variations in residents’ lives with media and the nuanced layers of meaning it involves. As it turned out, the cases present three women and five men but with no gender perspective applied in the analysis.
A complexity of media technology and objects
The repertoire of media that is available to individual residents is influenced by the subject’s chronological age, the availability of media technology in different historical periods (Westlund and Weibull, 2013) and their introduction to specific media technology and objects in childhood. Virtually all the residents in the three institutions have their own TV, radio, DVD player and telephone – mostly landline and, rarely, cell phone. Many residents subscribe to newspapers and/or weekly magazines and journals from senior clubs related to their former job or union or from social-humanitarian and disease-fighting organisations such as DaneAge, the Red Cross or the Danish Cancer Society. A few residents own a PC, tablet or smartphone, and these persons all used these digital technologies before moving in. Residents generally brought their media artefacts with them, but most could not bring all the possessions they would have liked since institutional dwellings are relatively small.
Per is 85 years old; he has arthritis and has had a blood clot. He talks about pain when handling objects as, with some effort, he signs the document for informed consent:
I don’t write very much anymore, so don’t count on it looking very nice. (…) I have a problem because the arthritis now affects my toes; some of them are twice as thick as they ought to be. (…)
I have heard that it’s very painful.
Yes, it hurts like hell (…). My fingers are quite crooked you know. But it’s better that they’re like this than if they were completely rigid; now, I can, at least, grab things. If it has to be bad, it’s good that it’s not so bad anyway.
Per’s pain is a visual, bodily experience of suffering from arthritis. His adjustment to the pain (De Medeiros and Black, 2015; Leder, 1995) resembles that of other interviewees, who narratively do not pay much attention to impaired and painful body parts – but would rather talk about actions they are capable of doing. Being able to ‘grab things’ means that Per can sit at his desk to do administrative tasks, activities that seem to matter the most to him. He writes appointments in his calendar, concerned to keep it updated. He is happy to receive the annual calendar from ‘Doctors without Borders’ with a ‘Happy New Year and thank you for your support’ letter. Like many interviewees and most adults in Denmark – particularly older adults (Danish Ministry of Culture, 2012) – Per spends a lot of time keeping up to date on the news in the world around him. He watches television and subscribes to two daily newspapers and one weekly magazine. He tells how he began reading the magazine when it was first published in 1938 – at the time, his parents subscribed to it. He kept every issue from the year 1945 on, but he had to give up the rest when he moved into the one-room dwelling:
I get [national newspaper] and [regional newspaper] every day, I can’t do without them. (…) My family has read the same newspaper since 1936. (…)
I had a tremendous bookshelf at home that I had to leave behind. Come over here and have a look! This one is about the invasion on June 6. I was down there with a travel agency fifty years later. There were flowers in all the roundabouts, decorations everywhere. (…)
I see you have many interesting books.
Yes, which ones should I bring?
Yes, how do you choose? I see you have chosen some about the war.
Yes, and some about horses. My wife loved them.
In his theory of bodily action in the social world, sociologist Alfred Schutz captured the importance not only of our relationship with living persons. People who have died are part of one’s biographical situation, which includes both life experience and the bodily here and now (Schutz, 1962). The theory makes it relevant to link Per’s use of media objects to his social world in which reading his newspapers and weekly magazine embody his childhood life with his parents – and his affection for specific books that represent the quality of his relationship to his late wife.
Laust is 90 years old. His room is filled with media artefacts of all kinds, and stuffed birds, porcelain birds and animals inhabit the shelves and cupboards (Figure 1). Laust has two television sets – a huge smart TV in his living room and one, not quite as big, in his bedroom; he has a PC, an iPad and a smartphone. He also has a large magnifying glass with built-in light, a similar but smaller hand-held one and a set of glasses that has two layers of parallel glasses – and his hearing aids, of course:
The first thing you notice is your enormous, impressive screen. What do you watch?
A lot of nature films. Movies in general. I have a hard disk attached and a box. (…) The box is to be able to restart films. (…) My son helps me. He is into technical stuff and all that. (…)
Do you use the magnifying glass?
Yes, I use it every day.
When you look at me, and when you look at the TV, is it okay?
Yes, when I am very close. I have a TV in the bedroom as well. (…) Take a look! [It takes a while even though it is only a few meters’ distance as Laust escorts me, getting up from his chair and walking with his walker].
That is something. Can you play movies on that one as well?
Yes. And, when I am lying in my bed, I can see the subtitles [with his special glasses on that lie on his bed-table].
Well, isn’t that smart. (…) I haven’t seen anything like that before.
Damned if I have, either.
So you can just lay there and watch.
Yes, and [see the] text!
Laust’s life with various media.
Laust’s choice of media objects – for example, his two TV sets and their location in the rooms – demonstrates how media technology and artefacts represent his bodily (and mental) function as well as his dysfunction. His case illustrates (by having solved) a general problem for the interviewees – that they cannot read subtitles 6 because the letters are too small, texts change rapidly and they are unable to hear or lip-read the mumbling of reporters and modern film actors. Returning to the living room, Laust switches to another programme on his smart TV:
That’s National Geographic.
Yes.
Do you watch this channel frequently?
Yes. And, when the box is on, I have a favourite list with nature and sports in German and Danish and Swedish and Norwegian, so I have it all together. It’s really nice.
Were you always particularly interested in nature?
Very, very much, yes. I have walked in the woods a lot. I have been a hunter and an angler.
For many interviewees, nature is a popular subject in TV programmes. Nature is central in Laust’s narrative about his life (Randall, 1995), in evidence from the decorative objects and antlers on his walls.
Drew Leder (1990) has written extensively about the body and taken for grantedness of everyday life. According to Leder, in bodily dis-appearance, the body functions as it usually does and hence goes unnoticed. In bodily dys-appearance, one becomes aware of the body, as painful and dysfunctional body parts draw the attention; the ‘dys’ is a reference to dysfunctionality. ‘These aversive states bring corporeality to explicit awareness for the sufferer’ (Leder, 1990: 84).
Following Leder (1990), incorporating material objects as technical tools in bodily actions is a process of disappearance, as, for example, a phone enables persons to talk together – without attending to the phone as an object (p. 33). In the residents’ everyday life this does not seem to be the case. They do adjust to physical changes and limitations and to use various technical tools in order to interact with their media artefacts. But their movements are slow; the use of objects takes great effort, energy and time (sometimes also to find the object) – to answer the phone, to put on glasses, to grab a book, to adjust the light or to move close to large screens. Laust, for instance, shows and explains how he uses a ‘touch pen’ to interact with his digital devices:
Writing doesn’t work for me on the phone … I’ve got this [touch pen]; this hand doesn’t really work anymore. So I use this to push the …
The keys? [Laust is using the iPad]
Yes, and on the computer as well.
You use it as a sort of finger? Do I get this right? So, you can hit more precisely?
Yes, because, when I use my hand, I am shaking. (…) I am glad I’ve got this.
The bodily interaction with media artefacts, including the process of using specific material tools in this interaction, can be characterised as bodily dys-appearance in Per and Laust’s cases, as for many other interviewees; the interaction with media draws their attention constantly.
In fieldwork and interviews, residents demonstrate and narrate how they use a complexity of media technologies and objects. Mass media play an important role in their everyday life (Westlund and Weibull, 2013), and for some people, TV is the most commonly used mass medium (Hajjar, 1998; Östlund 2009; Van der Goot et al., 2012). In the Nordic countries, older adults watch more television, read more newspapers and listen to the radio more than do younger age groups (Bolin and Skogerbø, 2013). As the two cases show, watching TV is complemented by the use of a variety of other mass media – for example, newspapers and magazines.
Interviewees also have a range of personal media: letters (mainly, from government authorities and organisations), postcards, photos in frames and on the walls and telephones. Very few use email or other web-based communication media. Kurt is 88 years of age, with multiple diseases. He moved in because of his wife’s severe dementia; she lives in another dwelling in the same nursing home. He tells how he talks on the phone every day with their daughters, but most of the time, he communicates by means of his iPad:
Half my time I spend playing.
What do you play?
Wordfeud. (…) It is great fun (…)
With whom do you play?
I play with my daughters – particularly, the youngest. (…). Look here, she sent these three [games] down from New Zealand, where she is right now.
So you have three games going at once?
Oh, a lot more! (…) I am quite good, but the youngest – she always wins! (…)
I also use one [app] named ‘Flight routes’, do you know it?
No, what is it?
You can follow aircrafts. When my daughter tells me she is leaving (…) I can follow it all the way. (…) You can push this button there and see her view from the cockpit!
Wow, that is wild. I didn’t know that!
Haven’t you tried it?
Most residents connect with relatives who are not present face to face (Schutz, 1962). They mainly communicate with children and siblings, if any are still alive, by means of landline phones – often, with enlarged numbers and amplified sound. They mainly respond to phone calls, as they themselves are easy to get hold of in their dwellings. People with dementia tell how difficult it is for them to keep track of numbers and names (and if, as illustrated above, they have a telephone at all). Kurt’s case shows, however, how digital media enable him to stay in close contact with his daughters – even sharing in time – but not space – visual experiences (through the flight routes app). He also tells how playing Wordfeud lets his daughters know that he is all right.
Interviews and observations in residents’ dwellings reveal that their actions involve both personal and mass media. Despite dysfunctional body parts and pain, a complex of media technologies and a vast number of different media objects are important for their agency in everyday life. In the following, we examine how bodily routines with media contribute towards making nursing home dwellings into a ‘home’.
Establishing a home by means of media
In media research, domestication is often referred to as the process of turning a commodity – say, a newspaper, a TV or a tablet into something ‘mine’, that is, the process through which a media artefact is integrated into the bodily routines of daily life (Silverstone, 1994: 174). Switching on the radio in the morning while barely awake, sitting feet up with blanket on and watching the evening news after dinner and so on. A vast body of research has informed multiple aspects of housing including the meanings of home and ageing (e.g. Oswald and Wahl, 2013; Peace, 2015). In the following analysis, rather than following Silverstone in examining the domestication of media artefacts, the perspective is turned around to look at what role media play in the subjective actions of residents to make their private physical space ‘their home’. Two themes of embodying home through media use are analysed: reading as a central home-like activity and feeling calm, safe and relaxed through media.
Keep on reading
In all three nursing homes, there are residents who read books, newspapers and magazines as intensely as they tell that they did before moving in. For a few of the interviewees, reading books in particular is the anchor of their everyday actions in institutional life. Tine is 95 years old. She moved in because she broke both her legs – first one, then the other. Her hearing is terribly bad.
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Tine has an iPad, which she only uses for net banking; she reads her daily newspaper in which she also studies the TV schedule carefully, so she can tape movies that she wants to watch later, and she reads books:
I must have something to read. (…) I lived on the second floor and could hardly get out, and I hardly did anything but read. Everything was delivered to me. Not many people visited me, you know. I just sat and read. And I love that. I regard this room – it is not big – as my home. And that’s why I just want to sit and read.
According to Tine, it is not due to her former social isolation that she reads constantly. She tells how ‘in my home, everybody was reading’. When she became a mother herself, she was concerned about teaching her son to read. Reading books embodies a long life’s quality time both as a family and by herself. That is why she just wants to sit and read.
Gerda is 94 years old. She cannot sit up for long and lies on her bed whenever in her room (Figure 2), and she speaks with some effort, due to a stroke, and is quite difficult to understand. We talk about the many books on her shelves, thematically arranged. She knows titles and authors:
All the ones from Greenland, I collected them when I was young. I always dreamt about it. You can see – there is Greenland. I have read all of them.
Gerda’s world of books.
Gerda has piles of books in her room brought by the library service or gifts from her children who ‘know what I like’, a blend of modern and older literature. She explains how her interest in the literature began in childhood. She first trained as a bookseller due to her interest in reading. Later, as a trained nurse, even with her work life and raising three children, she found time to read books:
That is just how it is. You can’t do without it, can you? (…) I could easily read when I wasn’t working. In between.
Gerda also subscribes to a national newspaper that comes four times a week and the journal of a leftist political party, which comes once a month. When asked if she reads them, she replies,
Yes I do. I have kept them together with my husband. We have always been interested in politics.
Are you still interested in politics?
Yes, for sure, I am. That is obvious when you are interested in the world – there is so much going on.
Gerda denies her arms get tired from holding up books and newspapers because she must lie down when she reads. The bodily action of reading seems to absorb Gerda into the stories she reads and the news from the globalised world she lives in. Reading is a bodily action of recognition of herself as a person who reads – and of being home – the place where she reads.
Night and day – calming the body
Old people spend most of their time at home (Helle, 2013). This may be even truer for nursing home residents, who spend almost their entire life in their residence and the rooms nearby (Swane, 2005).
According to James Lull, the sound of radio or television can imply the feeling of being in your home (Lull, 1990). Some interviewees have their radio turned on even at night. Kurt, a bit embarrassed, says how, during the past 15 years, he slept with the radio turned on and what this routine means to him:
I hardly dare say it. I listen to the radio all night; it comes with earplugs, you know. It [the sound] is from a far distance, but then sometimes it comes through: ‘Oh, well, there is a programme!’. Then, I wake up to listen to it. Otherwise, I don’t know, it is kind of like a background, you know. It has a calming influence on me, and I feel good about it. (…) It is kind of like a security blanket, you might say.
Another resident, Sigurd, 67 years old, uses a wheel chair due to multiple sclerosis and strokes. He describes what listening to music means to him and how music at night substitutes for sleeping pills:
My life, half of it is music. (…) All kinds of music. (…) There’s a cable network on the television, it is on all the time. (…) I wake up and hear these really nice melodies. Then, I wake up for real. And I fall asleep with the music; suddenly, I just sleep. (…) Before I used to get a sleeping pill. I can do without it now. The music is so relaxing.
Feelings of comfort and safety are part of what makes a home (Oswald and Wahl, 2013). Peter-Erik, 66 years old, has Alzheimer’s and lost his wife recently, which is why he moved into the nursing home. He explains about watching the news in his residence (his sentences are not always recognisable in terms of words and construction, which does not enhance the translation from Danish into English):
It makes me calm when I hear these things. Well, that means, then I can see if it is totally silly, excuse the expression, or if it is some nonsense, I check that out as well.
It calms you to watch television and relate to it. Should I understand you this way?
Yes, for sure. Because that is what I like the best, just to know what’s going on. In between, it is not matters that you spend much energy to watch. (…) I like to stay firm. I always did. So, I have a certain knowledge.
Watching the news makes Peter-Erik feel calm, ‘staying firm’, being a person who ‘knows what’s going on’. Agency through autonomy and feelings of belonging is an essential dimension of everyday life (Oswald and Wahl, 2013; Peace, 2015). The interviewee’s choice and efforts in his or her use of various media technologies and objects suggest that media play an important role in creating ‘home’ in the small one- or two-roomed dwellings that have become their personal environment.
Agency through media
Nursing home residents live in a society in which more and more of our time is spent using different media every day (Deuze, 2011). The availability of media technology has changed over the course of history (Westlund and Weibull, 2013). Depending on their chronological age, old people have been introduced to a range of new media technologies and artefacts throughout their lives from the first radios and television sets; newspapers and magazines; landline and cell phones; and, recently, electronic devices, apps and so on.
When one looks at the embodied ‘fourth age’ in nursing homes, the importance of media for a resident’s agency becomes visible. The centrality of media is apparent when one enters a private residence filled with a variety of media artefacts – not only TVs, which studies have found to be the predominant technology of older people, including persons in nursing homes (Hajjar, 1998; Van der Goot, 2013) but other mass media, and they have a variety of personal media as well. The interviewees act by means of their preferred media objects.
The analysis supports the findings of Westlund and Weibull (2013) that media embraced early in life continue to play an important role, for example, subscription to newspapers and magazines that interviewees began to read in childhood and remained loyal to almost a century later. However, some interviewees told how they changed to a different newspaper with smaller pages that are easier to handle when arms, hands and minds lose strength. Some read only headlines because letters of texts are so small. Lamps, touch pens, enlargement glasses, incredibly huge screens in small rooms and enlarged numbers on telephones are all technical tools that make it possible for residents to maintain their routines of reading, watching, communicating and so on. And they do. Most tasks take a long time – searching for the remote control (and which one belongs to which apparatus) and finding the right buttons to push. Not everyone is capable of taping programmes and saving them for later, but a few persons are.
The analysis demonstrates the importance of media for residents in making their dwelling home. They establish the familiar feeling of home through well-known bodily routines such as reading books, solving a favourite crossword in a magazine and so on, as well as feeling safe to the sound of the radio (Lull, 1990), being confident that children and siblings can reach them through a telephone call and feeling at home because books on the shelves and a particular newspaper represent life with a late husband or wife – even parents. Interviewees also describe the autonomy they feel in being able to operate the remote control in their room and watch their TV programme without disturbance (Hajjar, 1998).
Mark Deuze (2011) describes how media tend to become invisible because they are so pervasive and ubiquitous that people do not recognise having them in their lives. However, the major life transition of moving into a nursing home demands difficult decisions with respect to media – for example, emptying bookshelves and the painful experience of throwing away objects that children do not want to ‘inherit’ (Kofod, 2008). When residents have painful backs and fingers, when vision, hearing and, for many, memory and minds are impaired, bodily actions with media demand attention and great effort, which is described by Leder’s term of bodily dys-appearance (Leder, 1990).
All the residents interviewed share an interest in cultural and social life outside their ‘closed world’. By watching and listening to the news and by reading a variety of newspapers and magazines, they stay up to date, even if some do not remember what they read or heard 5 minutes later. Some take an interest in looking through advertisements and checking local activities even if they are not going out. Others expand their world through books and their fictional or non-fictional worlds. Through residents’ actions, media enhance their agency in the nursing home and bridge the gap between living in an institution and a long life’s preferences and participation in social and cultural worlds outside.
Footnotes
Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Velux Foundation, Denmark, through a grant to the University of Copenhagen, Department of Media, Cognition and Communication.