Sustaining Care Under Tension: An Ethnography of Pressure and Possibility in Residential Long-Term Care

Please note that this event has moved from 18 February to 13 May.

Ageing populations, rising demand, and chronic workforce shortages place long-term care organisations under mounting pressure.  Under heightened scrutiny, front-line workers are expected to deliver compassionate, person-centred care in resource-limited, emotionally intense environments, requiring them to hold together demands that are competing yet mutually necessary. Drawing on paradox theory, this study examines how these tensions are experienced and navigated over time.

Based on a nine-month ethnography in a public French LTC facility, the multi-method qualitative dataset includes 47 interviews with staff, residents, and family members, 224 hours of shadowing frontline workers, observations from 34 meetings, and analysis of organisational documents. This approach makes it possible to trace how tensions are experienced and negotiated in everyday care work by linking episodes into broader stories organised around specific care issues.

Early analysis points to three broad families of tension: coordinating responsiveness, protecting vulnerability, and accounting for care, which are not only practically organised but also felt emotionally, carried bodily, and interpreted morally. The study begins to trace how these entangled tensions become salient and are negotiated through provisional care arrangements: locally worked-out ways of handling recurring care issues under uncertainty, adapted in everyday practice and reworked as circumstances change. The emerging analysis asks how care arrangements take shape under uncertainty, how they settle or remain contested, and what happens when they come under strain, including who carries the burdens of sustaining them and how these burdens become visible or remain hidden.

The presentation seeks feedback on how to sharpen the phenomenon, compare across stories, and develop possible contributions to paradox theory and adjacent literatures.