Independence, privacy and risk: two contrasting approaches to residential care for older people

One of the main reasons older people give for their reluctance to consider residential care as a way of meeting their support needs is the fear of losing their independence. Research has confirmed that such anxiety is well-founded. This paper explores how far two different approaches to residential care enable older people who become residents to maintain their autonomy and independence. It traces the historical development of residential care and of hotels, using a case study of a private residential home run by former hoteliers to compare its approach to ‘the residential task’ with that adopted in local authority homes. Attention is focused on the translation of the core values of independence, privacy, dignity, choice and rights into a daily reality for residents. It is suggested that there are both structural and individual factors which account for the differences observed. The paper draws tentative conclusions as to why a ‘service’ rather than a ‘social care’ approach may be more successful in enabling older people to preserve their autonomy and privacy after moving into a care home.