Keepers: Workers in Total Institutions

Recommended for anyone who has ever paused to consider the brutalising effects of some of our sealed-door caring worlds. --Paul Sayer Nursing StandardIn the tradition of Studs Terkel. --Andrew Rutherford Criminal Justice and the Pursuit of DecencyDr. Glouberman has done us a good turn in making us look at the contemporary version of the Inferno. --Times Literary SupplementPowerful ... a strong re-indictment of our outmoded methods of long-term care. --Health Services JournalIn Keepers noted medical ethicist and patients rights advocate Sholom Glouberman draws on a series of interviews with workers at various types of total institutions--nursing homes prisons hospitals for children with severe disabilities psychiatric hospitals and long-stay hospitals--to paint a vivid picture of life within the walls of such facilities. Those interviewed tell of their struggles to deal with bureaucracy insufficient resources burn-out sexism prejudice and the patients and prisoners themselves while at the same time trying to adequately respond to the needs of the kept. Each chapter opens with a brief section by Dr. Glouberman that puts the interview in context. The result is a rare and fascinating look behind the closed doors of total institutions.This edition of Keepers is a revised version of the first edition published in 1990.The short stories in this book are based on experiences that I had some years ago--they are derived from actual meetings with people who worked in total institutions. I visited a cross section of long-stay institutions in many towns and provinces across the country including everything from maximum security prisons to hospitals for children with severe disabilities. I taped long interviews with about 60 people who worked in them. Although the interviews were carefully transcribed they were relentlessly edited to try to capture how people were affected by their work in institutional settings. These prisons nursing homes and institutions for the severely disabled contained not only the people who lived in them but also the workers who came there every day. I tried to reveal the character of the workers and the impact of the institutions on their lives by selecting from the situations they described and also by carefully choosing from the words they used. The stories are my constructions based on the tapes. I spent months editing and rewriting them. The genre has recently come into prominence--an amalgam of fact and fiction. In this case I wanted to shake our understanding of these long-stay environments and the workers in them by creating a more intimate understanding of their work and lives. --from the Preface by the author