Bureaucratic Rituals in Nursing Homes: The “CARE Model” and Culture Change

By Jason S. Ulsperger, J. David Knottnerus and Kristen Ulsperger.

Published by The International Journal of Aging and Society

Format Price
Article: Print $US10.00
Published online: July 17, 2014 $US5.00

This paper references Structural Ritualization Theory (SRT) to describe alternatives to bureaucratic practices in nursing homes. SRT examines ritualized symbolic practices considering factors of repetitiveness, homologousness, salience, and resources. Recent research using the theory implies that taken-for-granted work rituals which nursing home employees engage in unintentionally facilitate the abuse and neglect of residents (Ulsperger and Knottnerus 2011). Bureaucratic demands shape many of these rituals. This creates a situation where alternative rituals have the potential to lower the maltreatment of institutionalized elders. This paper discusses these divergent actions collectively as the Centralized Alternative Ritual Enactment (CARE) model. Complementing the culture change movement, the CARE model has the possibility of helping to elevate the quality of care provided to long-term care recipients.

Keywords: Cultural Perspectives, Long-term Care, Elder Abuse

The International Journal of Aging and Society, Volume 3, Issue 3, July 2014, pp.21-32. Article: Print (Spiral Bound). Published online: July 17, 2014 (Article: Electronic (PDF File; 399.576KB)).

Dr. Jason S. Ulsperger

Associate Professor of Sociology, Behavioral Sciences, Arkansas Tech University, Russellville, Arkansas, USA

Dr. J. David Knottnerus

Regents Professor, Sociology, Oklahoma State University, Stillwater, Oklahoma, USA

Kristen Ulsperger

Visiting Lecturer of Sociology, Behavioral Sciences, Arkansas Tech University, Russellville, Arkansas, USA