Paper short abstract:

This paper explores adult guardianship and related nursing home care during the COVID-19 pandemic in the US. We highlight how leaders in guardianship communities worked under policy restrictions and publicized invisible relations of care that shaped the health of persons in guardianship.

Paper long abstract:

Under conditions of the COVID-19 pandemic, nursing homes have occupied new and increasingly visible terrain in American popular media landscapes. Theorized as “the titanic of cruise ships” (Crotty, Watson, and Lim 2020) replete with staff who “choose” to attend “risky” events (Salcedo 2020), conditions and practices of long term care have once again come to the forefront of a long-standing moral-economic debate about the care of vulnerable adults. In this context, adult guardianship has been reaffirmed as “essential” to meet the basic survival needs of adults in guardianship, while paradoxically the day-to-day work of guardianship has been considerably narrowed. Drawing from dual-sited ethnographic work in Indiana and Tennessee (USA), we explore the transformation of adult guardianship work throughout COVID-19 lockdown phases in America. Using critical regionalism, this paper contextualizes the pandemic within nursing home settings and conditions of guardianship in Midwestern and Appalachian USA. We highlight how leaders in their local guardianship communities endeavored to manage obligations under nursing home visitation restrictions and publicize otherwise invisible relations of care that shaped and, at times threatened, the health, well-being, and quality of life of persons in guardianship. Such an approach spotlights interplay between national and local conditions of guardianship, in turn rendering visible dialectics of capital and culture change in the era of coronavirus (2011:783). We close with a discussion concerning practices and possibilities for the moral transformation of American nursing homes through a critique of moral economy of nursing home care within twinned contexts of guardianship and COVID-19.