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A discourse of silence: professional carers reasoning about death and dying in nursing homes
School of Health and Medical Sciences, Örebro University, Örebro, Sweden & Department of Palliative Care Research, Ersta Sköndal University College, Stockholm, Sweden.
Department of Palliative Care Research, Ersta Sköndal University College, Stockholm, Sweden.
Department of Social and Welfare Studies, Linköping University, Linköping, Sweden.ORCID iD: 0000-0002-2511-1183
Department of Palliative Care Research, Ersta Sköndal University College, Stockholm, Sweden.
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2011 (English)In: Ageing & Society, ISSN 0144-686X, E-ISSN 1469-1779, Vol. 31, no 4, p. 529-544Article in journal (Refereed) Published
Abstract [en]

Nursing homes are a setting in which death and dying is common. How death and dying is articulated and the actions that take place in a nursing home constitute a discourse that guides the staff in their work. The aim of this study was to explore the discourse of death and dying in nursing homes from the perspective and understanding of the staff. The study draws on Foucault's discourse analysis. Data are from five focus-group discussions held with 28 staff of four different nursing homes in Sweden. The findings show that the discourse had three characteristics: (a) dying was silent and silenced, (b) emotions were pushed into the background, and (c) attentiveness to death arose after the moment of the elderly person's death. The structure of the discourse was characterised by a movement between two positions, avoiding and confronting death, the main focus being on avoidance. The articulation and practices of silence highlight a need to regard dying as a process that requires attention. One way to ensure appropriate attention could be to instil the philosophy of palliative care in nursing homes, including training and support for the staff in their work. The study demonstrates that nursing-home staff need more knowledge and support to enable them to feel that they do a good job.

Place, publisher, year, edition, pages
Cambridge: Cambridge University Press, 2011. Vol. 31, no 4, p. 529-544
Keywords [en]
older people, death and dying, nursing home, staff, focus-group discussions, discourse analysis
National Category
Nursing
Identifiers
URN: urn:nbn:se:hh:diva-40568DOI: 10.1017/S0144686X10000905ISI: 000289306000001Scopus ID: 2-s2.0-78650980318OAI: oai:DiVA.org:hh-40568DiVA, id: diva2:1351444
Available from: 2019-09-16 Created: 2019-09-16 Last updated: 2019-09-20Bibliographically approved

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CiteExportLink to record
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Citation style
  • apa
  • harvard1
  • ieee
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  • vancouver
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More styles
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  • de-DE
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  • nn-NB
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More languages
Output format
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