Care will look at potential new systems that ensure people can safely interact with the care and health services anywhere in the world, and how this differs across the globe. This will include things such as how to combine private and state care systems, how to look after those who need support for mental and physical health across society and how to keep everybody safe.
MRes Research
Alexandra Johanna Matz and Yanning Zheng
Care is the provision of attention and beneficiary, participatory or respectful actions towards the well-being, recovery and future integrity of all participants of ecosystems, including humans, non-human actors, all species and nature. The provision of these actions also includes to care less about potential overwhelming, harming or negatively influencing factors on the well-being and integrity of the ecosystem's actors, fostering self-care and to maintain the ability to operate with positive feedback loops.
Key Issues
(1) Alienation from nature and other non-human actors and systems
In 2050, the global ecosystem will have deteriorated further. At that time in the future, how should human beings choose a suitable living environment? We need to get closer to and care more about the existing environmental problems such as marine pollution, white plastic crisis or the disappearance of rainforests – from now on. At the same time, it should be noted that we expect a direction that uses less care to promote the positive cycle of the entire system. How to design sustainable and how to design for sustainability to make the entire environmental system operate and purify itself?
Provocations and Point of Views
How might we design opportunities from understanding our historical carelessness about other species or nature to co-create co-existential and adaptable ecosystems of caring?
Examples
· Global warming due to CO2 emissions, which according to the UN have increased by almost 50% since 1990
· Failure of protecting the oceans
· Hydric stress and water scarcity
References
· Architecture and Urbanism for a Broken Planet, ed. by Angelika Fitz, Elke Krasny, and Architektur Zentrum Wien (Vienna [Austria] : Cambridge, MA: Architekturzentrum Wien ; MIT Press, 2019), pp. 25–42.
· Iberdrola S.A. The Big Global Environmental Issues We Need to Resolve by 2030. https://www.iberdrola.com/environment/most-important-environmental-issues. Accessed 21 Nov. 2020.
· Jax, Kurt, Melania Calestani, Kai MA Chan, Uta Eser, Hans Keune, Barbara Muraca, and others, ‘Caring for Nature Matters: A Relational Approach for Understanding Nature’s Contributions to Human Well-Being’, Current Opinion in Environmental Sustainability, 35 (2018), 22–29 <https://doi.org/10.1016/j.cosust.2018.10.009>
· Moriggi, Angela, Katriina Soini, Bettina B Bock and Dirk Roep, ‘Caring in, for, and with Nature: An Integrative Framework to Understand Green Care Practices’, Sustainability, 12 (2020), 3361 <https://doi.org/10.3390/su12083361>
(2) Gender-bias in norms and structures
The current pandemic has unveiled several issues in societal, family structured and in economic contexts related to gender. Former catastrophic events, such as the Spanish Flue in 1918, the world financial crisis in 1932 or 2008 mainly affected male employees. This pandemic leaves more women in short-time work or having lost their work than men and have women taking over disproportionally more load in caring for family members or children. The backgrounds have different causes: women’s representation in industries most affected by COVID-19, such as hospitality, travel or retail is significantly higher. Further, studies show that women are more likely to step back from work or reduce work time to care for children or family members as they are either earning less money in general (gender-pay gap) or are those who work part-time. Design yet missed to help unveiling and challenging the societal, often patriarchal norms and structures which lead to those circumstances.
Provocations and Point of Views
· How might we design to strengthen and support women who proportionally take over more care responsibility in families and challenge the underlying societal norms and economic situations causing this?
· How can we care less about historical norms and present issues such as the payment gender-gap?
Examples
· In Australian science publications editors speak of a 50% less submissions of publication in 2020, compared to a year before, while submissions for publications by men doubled [1].
· In Slovakia, the EU country with the highest gender pay gap, women in the education sector earn ca. 22 % less than men in average.[2]
References
· Isaac, Mohan, ‘Cross-Cultural Differences in Caregiving: The Relevance to Community Care in India’, Indian Journal of Social Psychiatry, 32 (2016), 25 <https://doi.org/10.4103/0971-9962.176763> [accessed21 November 2020]
· Lynch, Russel, ‘Women shoulder burden of Covid’s childcare crisis: Nursery closures and mass job cuts threaten to undo years of gender progress’ <https://search.proquest.com/docview/2449697892/fulltext/B42AD83932B3410DPQ/1> [accessed 21 November 2020]
· Nash, Meredith, and Brendan Churchill. 2020. ‘Caring during COVID-19: A Gendered Analysis of Australian University Responses to Managing Remote Working and Caring Responsibilities’, Gender, Work & Organization, 27.5: 833–46 https://doi.org/https://doi.org/10.1111/gwao.12484
· Topping, Alexandra, ‘UK Working Mothers Are “sacrificial Lambs” in Coronavirus Childcare Crisis’, The Guardian, 24 July 2020, section World news <https://www.theguardian.com/money/2020/jul/24/uk-working-mothers-are-sacrifical-lambs-in-coronavirus-childcare-crisis> [accessed 21 November 2020]
[1] ‘Women shoulder burden of Covid’s childcare crisis: Nursery closures and mass job cuts threaten to undo years of gender progress, writes Russell Lynch - ProQuest’, p. 834 <https://search.proquest.com/docview/2449697892/fulltext/B42AD83932B3410DPQ/1> [accessed 21 November 2020]. [2] Róbert Modranský, Silvia Jakabová, and Michal Hanák, ‘Effect of COVID-19 Locked down on Gender Pay Gap in Slovakia in the Education Sector’, Technium Social Sciences Journal, 12 (2020), 302–15 (p. 302).
(3) Patient-Centeredness, care givers are not cared for enough (emotions of care)
Caring for someone or something is made up of “compassionate actions” (reference) which lead us to put care-receivers into the centre of our actions. Examples range from assisting children in their first attempts to walk or bringing up a baby cat someone set out at a parking lot. However, the act of providing care, especially in professional care is transactionalised (reference), driven towards efficiency in time, cost or return on investment that not only affects care-receivers. Design has forgotten to regard caretakers as equally important. They need be to be trained and educated especially in how to care less about unimportant things, taking on too much, working too long hours and too many shifts. Design needs to help them to care less to care more for their own, so they in turn can care more for others.
Provocations and Point of Views
· How might we design more and lasting visibility and shine a new light of the value of the work of care-givers? To present, care givers are not equally in the centre of attention, training and care as their systemic importance would imply.
· How can we help care givers to care less by focusing more on what is important and to build self-resilience that is needed to care for others?
Examples
· Incidents of patients violently hurting doctors
· Naylor’s comments that 23 in nearly 100 studies published between 1985 and 2001 confirmed that the collapse of medical services during the transition from hospital to home can lead to negative results.
References
• fuelfor. ‘Who Cares?’ 2020. (fuelfor) <https://issuu.com/fuelfor/docs/fuelfor_i_who_cares_i_caregiving_fo> [accessed 17 November 2020]
• Reinhard, Susan C, Barbara Given, Nirvana Huhtala Petlick and Ann Bemis, ‘Supporting Family Caregivers in Providing Care’, in Patient Safety and Quality: An Evidence-Based Handbook for Nurses, ed. by Ronda G. Hughes, Advances in Patient Safety (Rockville (MD): Agency for Healthcare Research and Quality (US), 2008) <http://www.ncbi.nlm.nih.gov/books/NBK2665/> [accessed 21 November 2020]
Yang, Mia, and Rachel Zimmer. 2020. ‘Caregiver Burden’, in Home-Based Medical Care for Older Adults: A Clinical Case Book, ed. by Jessica L. Colburn, Bruce Leff, Jennifer Hayashi, and Mattan Schuchman (Cham: Springer International Publishing), pp. 35–40 <https://doi.org/10.1007/978-3-030-23483-6_6>
(4) Disconnected social relationships: Loneliness, isolation, aging populations
“Stay home, stay safe”, a slogan used in many parts of the world to communicate that staying at home is what will keep people from getting infected with the COVID-19 virus.
While this might make sense from a virological and infectiological point of view, staying home has become an obstacle to many people but, even more, placed a burden on humans who were or have to already primarily stay at home: people in care-homes, communal care and those you are lonely or alone and the elder generations.
How can design develop interventions to care about the loneliness caused by social isolation? In this physical isolation, how do we define, develop and foster the sense of boundary between people? How can design care less about stigmas and taboos, such as being single, close to death or trapped in domestic violence?
Provocations and Point of Views
· How might we design interventions for the positive aspects of warmth and closeness which also allow for enough distance and personal space to approach those lonely or alone, (re-) linking them back into a network of community (Craig "Cosmic loneliness
· and astronomic intolerance of each other"
· How might we design fast and effective responses to the peak in depression and anxiety in the pandemic in order to reduce mental health implications that go alongside isolation, insecurity or burden.
Examples
· Share of deaths associated with COVID-19 in Care homes are e.g. 50% in Germany or 40% in Sweden [1]
· Up to 50% of older adults go through periods of feeling lonely, 5% are “feeling constantly lonely” [2]
· High levels of loneliness were reported in more than one‐third of adolescents and almost half of the 18–24‐year‐old youth felt lonely during lockdown
· 25% Young adult students in China showed “at least mild anxiety symptoms” during the first wave of the pandemic [3]
References
· Gratton, Lynda, and Andrew Scott. 2016. The 100-Year Life (London: Bloomsbury Information)
· Kofman, Yasmin B and Dana Rose Garfin, ‘Home Is Not Always a Haven: The Domestic Violence Crisis amid the COVID-19 Pandemic.’, Psychological Trauma: Theory, Research, Practice, and Policy, 12 (2020), S199–201 <https://doi.org/10.1037/tra0000866>
· Kotwal, Ashwin A, Julianne Holt‐Lunstad, Rebecca L Newmark, Irena Cenzer, Alexander K Smith, Kenneth E Covinsky, and others, ‘Social Isolation and Loneliness Among San Francisco Bay Area Older Adults During the COVID ‐19 Shelter‐in‐Place Orders’, Journal of the American Geriatrics Society, 2020, jgs.16865 <https://doi.org/10.1111/jgs.16865>
· Marchini, Simone, Elena Zaurino, Jason Bouziotis, Natascia Brondino, Véronique Delvenne and Marie Delhaye, ‘Study of Resilience and Loneliness in Youth (18–25 Years Old) during the COVID‐19 Pandemic Lockdown Measures’, Journal of Community Psychology, 2020, jcop.22473 <https://doi.org/10.1002/jcop.22473>
[1] Hoffmann, Christy, ‘We Need to Reform the Care Sector, with Workers at Its Centre | World Economic Forum’ <https://www.weforum.org/agenda/2020/07/how-can-we-care-for-the-care-sector/> [accessed 21 November 2020]. [2] Max Zubatsky, Marla Berg‐Weger, and John Morley, ‘Using Telehealth Groups to Combat Loneliness in Older Adults Through COVID ‐19’, Journal of the American Geriatrics Society, 68.8 (2020), 1678–79 (p. 1678) <https://doi.org/10.1111/jgs.16553>. [3] Maria Elizabeth Loades and others, ‘Rapid Systematic Review: The Impact of Social Isolation and Loneliness on the Mental Health of Children and Adolescents in the Context of COVID-19’, Journal of the American Academy of Child & Adolescent Psychiatry, 59.11 (2020), 1218-1239.e3 (p. 1236) <https://doi.org/10.1016/j.jaac.2020.05.009>.
(5) How can we uncare while non-human care givers such as machines will continue to care?
In the future, artificial intelligence will inevitably be closely involved in human life. When robots intervene in human care systems, what do we expect from them? We long for a more empathetic nursing process, we long for warm care, and we long for more emotional communication. But when robots with autonomous learning capabilities try to have emotions, will they create new emotions that are different from human emotions? When a robot has emotions, can it be defined as a human to some extent? How should we design future caring nursing robots to conform to the context of human society?
Provocations and Point of Views
· How can we design the future of care-work to extrapolate the value in human work's beyond pure repetitive task execution, so we do not ask anymore whether human work will be replaced by machines but that we can uncare to be able to care more?
· If robots replace humans in the future and start to care more, will they have new emotions different from the human world due to the automatic learning system? Could there be more emotions or new senses evolving?
Examples
1. This requires rigorous ethical reflection to ensure their design and introduction do not impede the promotion of values and the dignity of patients at such a vulnerable and sensitive time in their lives.
2. Questions such as “What should we want from a robot ethic?”
a. the ethical systems built into robots.
b. the ethical systems of people who design robots
c. the ethics of how people treat robots.
3. Value-sensitive design (VSD)
References
· Bertolaso, Marta and Marta Rocchi, ‘Specifically Human: Human Work and Care in the Age of Machines’, Business Ethics: A European Review, 2020 <https://doi.org/10.1111/beer.12281>
· Hudson, Matthew, ‘Beware Emotional Robots: Giving Feelings to Artificial Beings Could Backfire, Study Suggests’, Science | AAAS, 2017 <https://www.sciencemag.org/news/2017/03/beware-emotional-robots-giving-feelings-artificial-beings-could-backfire-study-suggests> [accessed 21 November 2020]
· Leite, Iolanda, André Pereira, Samuel Mascarenhas, Carlos Martinho, Rui Prada and Ana Paiva, ‘The Influence of Empathy in Human–Robot Relations’, International Journal of Human-Computer Studies, 71 (2013), 250–60 <https://doi.org/10.1016/j.ijhcs.2012.09.005>
Diagrams
Starting from the definition of care, we investigated about attributes of what good care means. Then, we assigned four keywords corresponding to each of the attributes. These keywords represent anchor points for further discussion and research, where possible tension exists. Building on these keywords, we elaborated which areas in the field of care reveal a lack of being taken care of. Converging from several issues identified our diagram highlights seven issues.
Unpicking the issues further, and supported by further literature, we used a classification system to break down reconnect the issues. This unveiled a strong connotation towards the notion of caring less and the positive effects this could have in approaching issues. For all issues which we selected, we found a common, key provocation to be asked: How Can We Care More by Caring Less?
We hope that this question can trigger some thought: Does this refer to a sustainable recycling model? Or is it reminding us to pay attention to the group hiding in a corner? It still implies that when we no longer pay attention to the care system in the future context, there will be incredible new forces to replace the status of human beings.
With this question in mind, we re-examined the seven issues, and selected five issues we believe most relevant to understand where design can make a difference and close a gap towards care.
Fig. 1: Attributes of Good Care and Related Keywords, Linked to Key Issues in Care
The diagram "Attributes of Good Care and Related Keywords, Linked to Key Issues in Care" (fig. 1) shows the relevant attributes of good care. In the first diagram we proposed twelve attributes (green) around the topic of care. For each attribute we listed four keywords (blue). We determined a total of 48 keywords related to care which could assign 7 related issues which are connected to the corresponding keywords. The issues numbered (1-5, black colour) are the key issues in care to be looked at.
Fig. 2: Classification of Care Issues
The “Classification of Care Issues” diagram (fig. 2) depicts the location of care related issues in the organizational form of a classification. The three top-level categories of topics are: space, humanity and time, and located the locations of 5 important issues. After that, we determined the care problems in various fields and assigned sub issues under each topic. At the same time, it should be noted that these five issues all refer to our key question of "How Can We Care More by Caring Less?".
Annotated Bibliography
The Care Collective, et al. The Care Manifesto: The Politics of Interdependence. 2020, pp. 1-20.
Recently published, this book is using articulated language to describe the issues of carelessness in various contexts that (re-) surface in the current pandemic, such as politics, globalization or down to the detailed contexts of very narrowed relationship-structures and the matter of care in those. In the introduction (pp 1-20), the authors highlight that those issues partially have been long existing before the pandemics or where foreseeable to become stronger in a pandemic – yet there were not taking care of, not seen coming. A central quest to the reader is to think about possible scenarios if we, rather than being carless, put care into the center of all our actions and taking into account both caretakers and care givers[1] ?
“The Lancaster Care Charter.” Design Issues, vol. 35, no. 1, 2019, pp. 73–77, doi:10.1162/desi_a_00522.
Paul Rodgers, Giovanni Innella, Craig Bremner et al in their charter advocate for a new, holistic view on the practice of design. They argue that design should turn away from the notion of colonizing [2] audiences and target groups to rather, jointly with caring forces, empower everybody who is part in an engagement to build continuous, caring relationships using “caring gestures, actions and objects” of both “human and non-human” [3]. The authors repeatedly stress the importance for designers to look beyond the human and the close fields of observation but beyond: inclusive
Frankfurt, Harry. “The Importance of What We Care About.” Synthese, vol. 53, no. 2, 1982, pp. 257–72, https://www.jstor.org/stable/20115802.
While the paper was written 40 years ago, it contains valuable insights on why humans care from a more philosophical view. According to the author, caring is very different from liking or wanting something or someone. In care, there is always a relation between what we “care about” and what we “think is best” for us to do [4]. He also highlights that the act of caring varies in its strength and persistence [5] and is a form of being invested into something or with someone [6], which also makes us vulnerable to loosing what we care for [7]. Further, Frankfurt adds the notion of time to care, writing that we cannot care over a very long time [8]. Setting care into relation to the object we care about, it is the object we care about which makes it important to us [9] and that we usually do not choose objects to care by evaluating how much that object is worth, e.g., in monetary values but how worthy the “activity of caring” is to us [10].
[1] The Care Collective and others, The Care Manifesto: The Politics of Interdependence, 2020, p. 5. [2] Rodgers, Paul and others, ‘The Lancaster Care Charter’, Design Issues, 35.1 (2019), 73–77 (p. 75) <https://doi.org/10.1162/desi_a_00522>. [3] Rodgers, Paul and others, p. 74. [4] Harry Frankfurt, ‘The Importance of What We Care About’, Synthese, 53.2 (1982), 257–72 (p. 257). [5] Frankfurt, p. 263. [6] Frankfurt, p. 260. [7] Frankfurt, p. 260. [8] Frankfurt, p. 261. [9] Frankfurt, p. 269. [10] Frankfurt, p. 271.
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