Journeying on to a better place? The processes and experiences associated with working around death and dying in care homes for older people.

This qualitative research was undertaken during a period of change within care homes for the older person in Scotland. The move to single status homes meant that the traditional divide between nursing and residential homes no longer existed. The experiences of workers were largely under-represented in literature and research. Very little was known of carers’, domestics’, cleaners’ and cooks’ reactions to death and dying or indeed their role in dealing with it in care homes. The aim of this research was to examine what workers experiences were. It also sought the contexts and emergent themes that came from conducting semi structured interviews. The research also sought to find out the extent to which there was a common understanding of death experience between homes. Finally, the research sought to find out how involved different workers were in the death and dying of residents. The research highlighted the difficulties methodologically of approaching care homes to take part in the study. The taboo nature of the research was overcome by the use of language and metaphors from street theatre as a way of explaining the processes of gaining access to difficult research sites. As a result thirty six workers were interviewed within six homes the results were analysed using a constructivist grounded theory approach with Caqdas software providing integrated support. Using the constructivist grounded theory of Charmaz (2003 p. 85; 2006) combined with the early work of Lincoln and Guba (1985) overcame some of the problems inherent in positivism and the objectivist stance of traditional grounded theory. Using Lincoln and Guba’s early approach also overcame problems of attributable sources. What was found was that the care home is institutionally bound to movement in two distinct but related ways: firstly, via meal times, ablutions and bed, and secondly in terms of a journey; a subtext, towards decay, debilitation and eventually death. The stages of the journey (routine, pre-death, death, post-death and final journey) act as a distinct microcosm of actions, tasks, feelings and emotions that are encountered within the Home. The final journey of residents did not end when they die, but continues in a rich oral history. Each stage has a key component thus for the stage routine, the management of routine was central, for the pre-death stage there was an overall theme of authorisation, where workers sought permission to ‘give extra care'. The point of death was the organising event of the home, whereas after death there was a physicalisation of the body around which various rituals were carried out, before the body was prepared for embarkation in the stage called post-death. Workers experiences highlight a need to make meaning out of death and dying. This is often highlighted at the last stage, final journey where workers make efforts to remember and reminisce about the dead person. This is worked out in a number of ways for example, the increased use of mobile telephony was used as a way to forewarn workers who were not present at a death. By reminiscing and collective story telling workers are able to ease the transitional journey of residents from dying to dead. Memorialisation is a celebration of the deceased and a reaffirmation of the worker and the care provided by the home. The experiences and processes of workers, show how they have made sense of and developed a way of coping with the increasing amount of deaths that they face due to changes in the regulation of care.

Grantor dc:publisher.institution

Robert Gordon University

Year dc:date.issued

2006

Author dc:creator

• Dempster, Paul G.

Advisor dc:contributor.advisor

• B. West, P. Lishman and J. Love

• Death
• Care-homes
• Elderly people
• Worker experiences
• Caqdas software
• Stages of death

Language dc:language

en

Identifier

oai:rgu-repository.worktribe.com:2807361
https://doi.org/10.48526/rgu-wt-2807361

OAI identifier oai:identifier

oai:rgu-repository.worktribe.com:2807361