Mindfully Coproduced Care at Home
: older people and district nurses working together

  • Hannah Ingram

Student thesis: Doctoral Thesis


Older people are at the centre of much contemporary UK healthcare policy with its focus on ageing well in place and care delivered closer to home when required. District nurses provide home-based care for older people living with frailty whilst coproduction, as a concept and policy, aims to promote equal collaboration and participation in care services. Research into coproduction for older people is often centred on service design and development, with limited evidence to suggest how coproduction of care manifests at home. This research aimed to explore the nature of care practices at home between older people and district nurses and to understand how care is coproduced and in what ways these practices shape older people’s experiences of care when living with frailty at home.

A focussed ethnographic approach was used to understand the nature of care that was coproduced between older people and district nurses at home. Participants from the South of England included four older people and four district nurse pairings, who had worked together over time with home as the place of care. Data was sourced over eighteen months from a sequence of individual, semi-structured interviews, followed by an observed care encounter with each pairing, and then a final semi structured individual interview. Thematic analysis guided the interpretation of data.

Four themes of crafting connections, care-full places, minding bodies, and heeding time constitute a concept of a mindful coproduction of care. Care at home for older people and district nurses is complex and is shaped by wider cultures of relationality, rationality and responsiveness and is further informed by social, political, and philosophical values. When the influencing cultures and values of care are not mindfully navigated this could risk coaxing, ageist, and depersonalised care. It is a mindful, care ethics approach that offers opportunities for older people and district nurses to successfully work coproductively. Care is mindfully coproduced in tiny moments, in and specific to that moment in time, where a shared understanding of home and the boundaries within it are established and respected, enabling the place of care to remain the place of home for older people. Mindfully coproducing care in district nursing practice may enhance meaningful experiences of care for older people at home.
Date of AwardNov 2023
Original languageEnglish
Awarding Institution
  • University of Brighton
SupervisorDr Kay Aranda (Supervisor), Kitty Suddick (Supervisor) & Nita Muir (Supervisor)

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