The boundaries of care
The boundaries of care

Start this free course now. Just create an account and sign in. Enrol and complete the course for a free statement of participation or digital badge if available.

Free course

The boundaries of care

3 Silences and concealment

Anthropologists and psychoanalysts use the term ‘taboo’ to describe forbidden activities, feelings or relationships. All societies seem to have particular rules and rituals to deal with bodily functions, sexuality and death, sometimes expressed in terms of hygiene or religion, and these keep them separated off from everyday life. When social rules function well they are invisible. We only notice them when we have committed a faux pas and caused embarrassment.

Marie very quickly and correctly learnt the rules in this establishment: from the lack of acknowledgement of this aspect of the job she picked up that it was not an oversight that no one had spoken about it. It was not to be spoken about. In another care home down the road a friend of Marie's complained to the proprietor that one of the (male) residents tried to grab her in a sexual way. He told her quite sharply that ‘if she couldn't stand the heat she should get out of the kitchen’. In other words, she was being told not to complain and that her only option, if she didn't like it, was to leave. She found she was working in an occupational subculture where only certain things are permitted to be discussed.

This kind of silence tends to be produced when there are hierarchies in which tasks are delegated to some people rather than others. Dealing with intimate care tends to be a low-status task. It is often referred to as ‘basic’ care as opposed to the more technical tasks within nursing and the planning, educational or therapeutic tasks within residential services. The sociologist Goffman referred to it as 'backstage work'. Hughes, another sociologist, writing in 1971 coined the term ‘dirty work’, which is the work within any society or profession which is delegated downwards and/or concealed (Hughes, 1971). Caring for people's bodies could be regarded as the ‘dirty work’ of care, as well as ‘backstage’ work.

While nurses are taught procedures for carrying out personal care tasks, they are rarely explicitly ‘taught’ how to deal with the emotions these tasks occasion. Learning ‘on the job’ produces a kind of knowledge based on practice rather than theory which is literally difficult to put into words. This helps to keep the work and the skills it involves invisible.


Please note: As part of a review of content, this course will be deleted from OpenLearn on Thursday 11th November 2021.

Print Print

Take your learning further

Making the decision to study can be a big step, which is why you'll want a trusted University. The Open University has 50 years’ experience delivering flexible learning and 170,000 students are studying with us right now. Take a look at all Open University courses.

If you are new to University-level study, we offer two introductory routes to our qualifications. You could either choose to start with an Access module, or a module which allows you to count your previous learning towards an Open University qualification. Read our guide on Where to take your learning next for more information.

Not ready for formal University study? Then browse over 1000 free courses on OpenLearn and sign up to our newsletter to hear about new free courses as they are released.

Every year, thousands of students decide to study with The Open University. With over 120 qualifications, we’ve got the right course for you.

Request an Open University prospectus371