We have been studying practices of caring in the domains of healthcare and social work for more than 30 years. We have seen and keep seeing many practices, situations and processes that present us with puzzles. These can be understood and solved, either easily or with some effort, using existing theoretical or practical perspectives, but these leave us unsatisfied. We feel that many of these perspectives remain on the outside, are not sufficiently empirically grounded, ideologically open and morally sensitive. For these reasons, they fail to get to the heart of what we think we are seeing in healthcare and social work. What exactly do we see, hear, perceive when we study actual practices, situations, processes or organisations? What do residents, patients, clients, pupils and their relatives value as good care, help and support? What practices do practitioners engage in who are acknowledged to be good practitioners by residents, patients, clients and pupils and their relatives, as well as by their colleagues and managers? What makes social workers good social workers, nurses good nurses, youth workers good youth workers, doctors good doctors? And managers good managers and teachers good teachers? Also, what makes care, help and support good enough, and what is deficient or lacking when we see care, help and support that are not so good? Asking these questions is not to criticise existing care practices, let alone caregivers, but to search for how to adequately and appropriately perceive, describe and, when necessary, evaluate these practices. This book is about practices of care, help and support in the domains of healthcare and social work – and other domains too, such as education and the ‘care for the world’. We approach these practices as instances of the practice of care, in the sense in which care ethics uses the word ‘care’: the effort to sustain life when it is weak, fragile, dependent or not yet fully developed, especially when it is in danger, threatened, in pain or broken.

In search of good care

We have just mentioned puzzles, but this is not to say that we have no clues, answers or solutions. Much of this book is about the insights we have gained. We categorise them collectively as ‘relational caring’, especially the ‘practising of presence’, a specific conceptualisation of relational care, namely, a strongly relational one (for more on relational caring and strong relationality, see Chapter 10).