Paper short abstract:

I argue that two policies on physical activity in dementia care isolate ‘good’ from ‘bad’ physical activity, thereby neglecting their interweaving in practice and argue that addressing both ‘matters of care’ together, policies may become more care-full.

Paper long abstract:

Policies, in their goals, tend to foreground particular 'goods' or 'bads' that require intervention.

In 2012 the Dutch Inspection of health care urged nursing homes to implement measures to increase residents' physical activity levels to at least 30 minutes per day. Physical activity is herein posited as 'good'; the question is how it may be increased. Simultaneously, policy on 'problem behaviour' in dementia care, that talks of 'wandering' or 'walking away', point to the potentially problematic nature of physical activity in dementia care. The urgent question here is how to reduce it without restricting residents' freedom. Both are matters of care (Puig de la Bellacasa 2011).

In this paper, in the material semiotic tradition, I discuss how these two policies employ different knowledge traditions to highlight different aspects of life on the ward. I argue that by isolating 'good' physical activity from 'bad' physical activity, the policies neglect their interweaving in practice. I present ethnographic examples of practices in which this interweaving is visible: for instance, increasing activity classes decreased wandering; a resident who is taken for a walk, stops searching 'home' afterwards. I argue that, instead of imposing norms on practitioners, addressing both 'matters of care' together, policies may become more care-full.