Twigg , J. Bathing – the Body and Community Care . London and New York : Routledge , 2000 , £16.99 and £55.00 , x + 230pp . ISBN 0415204216 (pbk), 041534208 (hbk) .
This book is an excellent contribution to the current debate on the sociology of the body. It is rich in both theory and empirical data on health care assistants and older people's experiences of bathing. It focuses on the ageing and disabled body in community care, a much neglected topic. The book shows how bathing unites individuals’ experiences of the body, relationships and home. Care-workers transgress the normal boundaries of social life through handling the naked and dependent body. The book is eloquently illustrated with quotes from carers and clients alike on the intimate details of the body and the meaning of home. Having worked as a carer myself, I find Julia Twigg beautifully captures the issues involved in bathing clients within their homes, an occasion that can be both delightful and disgusting for the female carers and their clients. For the clients, baths can be delightful because they are not just about getting clean but about easing the aches and pains of the ageing body, an opportunity to enjoy hot water and foam. Carers find bathing particularly disgusting when bodily excreta and fluids, flaky skin and an erect penis are involved.
The book is divided into nine chapters, moving from theory on the body and cultures of bathing to the social context of community care. For me, Chapter 3, Bathing, washing and the management of personal care besides the final three chapters: Carework as bodywork, Carework as emotional labour, and The power dynamics of care, represent the heart of the matter.
In the early chapters, historical, sociological and anthropological theories are used to analyse the body in terms of food, time, space, architecture, work, gender, emotion, touch and nakedness. Historical and cross-cultural variations in norms of cleanliness show the cultural relativity of bathing, and Julia Twigg provides a fascinating exploration of the different cultures of ancient Rome and modern Japan. The mundane but concrete activity of bathing shows how individual lives and public service provision dynamically interact, and put the missing body back into community care. The problem of the privacy of the home means this is a qualitative interview rather than an ethnographic study. This means the empirical data focus on body materiality only as second-hand body talk from carers and clients. This is my only criticism of the book. As a carer myself, I am aware that there are much rich observational data which could be gleaned from actually watching a carer bath a client but obviously this raises ethical issues for the researcher.
Chapter 3, Bathing, washing and the management of personal care, is an excellent exploration of how help with bathing transgresses the boundaries of the adult body because of issues of nakedness and touch and sets the scene for the material in the final chapters. The concept of the ‘proper bath’ is recognised by both clients and carers but it is not always possible to get right under the water due to equipment. Julia Twigg's interviews capture many sensitive details – one carer described at length how she would pour water down the client's back if the client had to sit on a bath board. The problem of heavy or painful limbs often made it impossible to appreciate the buoyancy of the water. This concept of the proper bath is eloquently contrasted with the discourse of showers as hurried, vigorous and time-saving, and lacking the ability to warm the body.
Throughout the book, there are many sensitive details on touch, intimacy, gender and sexuality. For example, there is an analysis of the washing of genitals from both the carers’ and recipients’ perspective. Caring is seen largely as women's work and most men preferred a female carer. One young disabled man talked of masturbating after his carer had bathed him, but he would never do this in front of her. Sometimes, however, the sexual innuendoes went too far for the female carers. One elderly gentleman had an erect penis as he stood there naked, holding onto two walking sticks shouting ‘I need attention’. Female carers resented this attention and often wore trousers rather than a skirt if dealing with difficult clients. Nearly all the carers in the study used gloves when bathing, not only to protect themselves from faeces and bodily fluids but also to protect themselves from the intense intimacy of bathing work by providing a barrier of professionalism. The emotional labour of bathing is great for the care-workers.
Overall, this is an absolutely excellent study of the sensitive issues of bathing the ageing and disabled body in community contexts such as home and day-centres. It provides brilliant insights into the emotionally and physically strenuous nature of care-work. The paradoxes of bathing the dependent body raise issues of both delight and disgust for carer and client alike, and shows how social policy on community care actually becomes embodied in the lives of individuals.