1 What's in a title? An introduction Because the words ‘care’, ‘welfare’ and ‘community’ are so much a part of everyday language and debate, there's perhaps an assumption that people agree about what they each mean. These are three words that mostly evoke warm and positive feelings. In Activity 1 you're asked to think about opposite points of view. 2.2 1 Social Darwinism and eugenics Nineteenth century reformers combined their new medical diagnoses with a concern to tackle what they saw as the social causes of cruelty and incapacity. Two theories dominated: social Darwinism and eugenics. Social Darwinism drew on Darwin's ideas of natural selection and emphasised the contribution of the fittest and most superior individuals to the survival of the human species. The social Darwinists, who included some of the most prominent thinkers of their time, believed that social Acknowledgements The content acknowledged below is Proprietary (see terms and conditions) and is used under licence. Grateful acknowledgement is made to the following sources for permission to use material: Illustrations: pp 10,14, 19, 21: Brenda Prince/Format; p19 (top): Sally and Richard Greenhill. 1: Introducing Jim and Marianne 1.4.3 Assessing the quality of dying Read the following case studies. They are accounts of deaths which take place in different settings. They have been chosen as examples of different deaths and point up some of the complexities which might exist at the time of death. You may be interested to note that they are all based on actual deaths. One of the course testers thought the accounts would be helpful to students who had limited involvement with death and dying since they gave insight into different types and settings of death. 1.3.11 The significance of the near-death experience The sociologist Allan Kellehear (1995) observes that most studies have had a medical focus, investigating whether near-death experiences could be the result of a lack of oxygen to the brain or another medical or psychological cause. Kellehear suggests that the search for psycho-medical explanations has focused on psycho-neurological and defensive mechanisms emphasising altered status of consciousness or physical functioning and not taken into account the meaning of these experiences. Kellehea 1.3.10 The impact of near-death experiences In many studies (Sabom, 1982; Toates 1999) the main effect of a near-death experience was to reduce a person’s fear of dying. Individuals surviving similar types of near-death crisis without an associated near-death experience did not show the same reduction in fear of death, as Table 2 indicates. 1.3.8 Separation from the physical body Very common is the experience of floating, sometimes on the ceiling, looking down on the body – a sense that the essential part of the person has separated from the physical body. In Michael Sabom’s survey of near-death experiences among non-surgical cases everyone had this sensation, but other studies indicate it is not universal. One woman recorded these feelings in a poem. Hovering beneath the ceiling, I looked down Upon a body 1.3.1 Reactions to near-death experiences A number of people have claimed that they have been at death’s door and can recall some of the sensations. Attempts to speak about near-death experiences (a term used to describe the extra-ordinary experiences some people have when close to death or when deeply unconscious) can meet with incomprehension, fear and hostility from friends as well as medical experts and researchers, many of whom refute the existence of near-death experiences. As Toates (1999, p. 1) says: 2 Working with memories – life storybooks Life story books are used more and more by social workers, residential care staff and some foster parents with young people who, for various reasons, need to find ways to remember and talk about earlier parts of their lives. The books may take a variety of forms: photograph albums, scrapbooks, written accounts and audio and video recordings. They may include drawings, poems, family trees, letters, bus and train tickets, photographs, writing and all sorts of ephemera that evoke the past, or pr Acknowledgements Except for third party materials and otherwise stated (see terms and conditions), this content is made available under a Creative Commons Attribution-NonCommercial-ShareAlike 2.0 Licence Grateful acknowledgement is made to the following sources for permission to reproduce material in this unit: 1.5.2 Duration and frequency We do not know if Katrina's caring responsibilities took up more than 20 hours per week. In a sense, though, whether they did or not is immaterial. What is important is that her schooling was adversely affected. We can speculate that, even if caring accounted for less than 20 hours per week, the emotional impact of being a young carer overflowed into a far larger proportion of her life. 2.4.2 Duration and frequency The second complication associated with identifying carers is related to how much caring they do and how often they do it. This aspect came to the fore when carers were first identified in the 1985 General Household Survey, an annual statistical survey carried out by the Office of Population, Censuses and Surveys in the UK (Green, 1988). From answers to a question in the survey which asked if respondents took on ‘extra responsibilities’ for someone who was ‘sick, handicapped or elderlyâ 6.5 Training at high altitude Many of the world's best endurance athletes train at high altitudes – a long way above sea level – to improve their performance. At high altitudes there is less oxygen in the air and it's believed that the body has to work harder to extract what little oxygen remains. When the athlete returns to lower altitudes, their body retains the ability to use oxygen more efficiently and their performance will have improved. 4.4 Maximum heart rate The other part of an efficient heart is the maximum rate that it can beat. If we think about competitors in a race that takes about five minutes, the athlete whose heart can beat at 200 times per minute for five minutes will probably do much better than one whose heart can only beat at 180 times per minute. This is linked to how much blood is pumped with each beat. If an individual's heart doesn't pump very much blood when they are resting, then the heart rate has to increase so 4.3 Measuring your heart rate The most common way of measuring heart rate is by feeling the pulse at one of the arteries. The pulse is quite literally that – a pulse of blood running through the artery each time the heart does one pumping motion. 2.1 Introduction A rapidly growing branch of medical science has begun to try to measure the physiological impact of grief. Incorporated into this study are the ways in which bodily functions change in response to emotional stimuli. This new area of scientific research has been called ‘psychoneuroimmunology’ and is the study of how different feelings and stresses lead to changes in hormone levels and other metabolic functions within the body. These can often be quantified through blood tests and other phy 1 Is grief a medical problem? Grief is a fertile area for debate and controversy within health care professions, and its significance as something in need of medical attention has been debated by both health analysts and social commentators alike. Is it a ‘natural’ phenomenon that should be respected and acknowledged, but one that requires that the bereaved individual is left alone to experience it in their own way? Or should the bereaved person be assisted with intervention which relies on the presumption that grief 1.4 Service users' views: What services? When people are consulted about the services they have received they express strong views not only about access to services but also about what those services are. For example, the shift from a home help service to a personal care service has raised many concerns. The consultations for the book this unit was based on and other research (see, for instance, Sinclair et al., 2000) both indicate that (unknown to managers) workers sometimes go beyond their allotted tasks in order to meet service u 1.2 Service users' views: Whose views? Several questions arise about the kind of feedback from users that is most relevant for social care organisations to seek and respond to. What about people who are unwilling users of social care services? How important is it that their voices be heard? For example, people may come into contact with services as a result of formal detention in hospital against their wishes, under the Mental Health Act 1983. The views of children, adults and professionals have to be balanced. There are dilemmas
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