3.2 Parental competence

Parental competence is not just a matter of the acquisition of parenting skills. It is also an attributed status which relies as much on the judgements of health and social care professionals and the courts as on the behaviour of parents. Judgements, and prejudgements, of the quality of parenting draw on ideas present in the wider society. These ideas are often not made explicit. Booth and Booth's (1994) study of parents with learning difficulties revealed that their problems often mir
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2.1 Institutions and segregation

In this section I'll be compressing most of the history of legislation and provision which came to form the basis of health and social care over the last two centuries into quite a small space! You may want to find out more about particular aspects and developments. If you do, then you'll find the list of references to books and articles at the end of the unit useful.

At one time, poverty, madness, disability and criminality were thought of as unchangeable God-given or demonic states. I
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1.2 Silences and concealment

Anthropologists and psychoanalysts use the term ‘taboo’ to describe forbidden activities, feelings or relationships. All societies seem to have particular rules and rituals to deal with bodily functions, sexuality and death, sometimes expressed in terms of hygiene or religion, and these keep them separated off from everyday life. When social rules function well they are invisible. We only notice them when we have committed a faux pas and caused embarrassment.

Marie very quick
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1: The Beveridge vision

It was not until after the Second World War that the British welfare state took its mature form. In a climate of relief after the war, a climate diffused with an idealism for a new, more just society, welfare legislation had bipartisan support. There was a clear sense of rebuilding a better Britain.

(Bryson, 1992, p. 82)

These words, drawn from an Australian commentator, sum up some of the
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1.4.12 Bad deaths

What about the other end of the spectrum? What constitutes a bad death? Is there less contention about what constitutes a bad death? Extreme pain and discomfort, humiliating dependence and being a burden are obvious, but what about being alone? Many people say they fear dying alone but there are others who would prefer it. Sudden, unexpected deaths are clearly bad for those left behind but are they also bad for those who die in such circumstances? Sudden unexpected deaths used to be considere
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1.4.8 Comment on case studies

Vic was not consulted about his needs and the possibility of his death was never discussed. The uncertainty about his religious needs resulted in a staff member having to make a decision on his behalf and hope that it was the right one. An added dimension to the uncertainty about Vic’s wishes was the relationship which he had with his sons, in which there was a lot of unresolved conflict.

Li did not have a choice about her place of death because she was unable to speak, but previously
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1.4.7 Case study 4: The death of Meg – a home death

Meg was diagnosed with rheumatoid arthritis at the age of 28, shortly after the birth of her second child, a diagnosis which was changed to systemic lupus erythematosis (usually called SLE or lupus), ten years later. This is a rare chronic degenerative condition, which mostly presents in mild forms, but in Meg’s case the condition was severe.

When Meg was first diagnosed with rheumatoid arthritis she was devastated and contemplated suicide, mostly because she was afraid of losing her
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1.4.6 Case study 3: Andrew’s death – a hospice death

Andrew was a 23 year-old car mechanic who had been suffering from indigestion for some months before the GP referred him to a hospital consultant, who after a series of tests diagnosed cancer of the colon, with liver secondaries. At this time Andrew was living alone in a small flat a few minutes’ drive from his parents’ home. Because the treatment which Andrew had agreed to involved a long recovery, he decided to move back home with his parents for a while so that he would have someone to
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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
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1.3.6 Sense of death

For almost everyone, quite early in the experience there was a strong feeling that they were dying or had already died, but this wasn’t preceded by a conscious anticipation of the nearness of death. One survivor of a heart attack said the first thing he realised after losing consciousness was that ‘something funny was going on … I realised I was dead … that I had died. [I thought] I don’t know whether the doctor knows it or not, but I know it.’


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1.3.4 Sense of timelessness

In Sabom’s study, everyone described their near-death experience as if it had occurred in a timeless dimension: people were unable to make any judgement about how long the experience lasted. ‘There was no measurement of time. I don’t know if it was a minute or five or ten hours’, commented one.


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Learning outcomes

By the time you have completed this unit you should be able to:

  • Relate beliefs about death to the meaning people attach to life;

  • Reflect upon the way in which death structures life;

  • Critically evaluate new encounters with death affect perspectives upon life;

  • Assess the quality of dying;

  • Critically examine the notion of a ‘good death’ in relation to individual experience;

  • Recognise the implications of
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Acknowledgements

The content acknowledged below is Proprietary (see terms and conditions) and is used under licence.

Grateful acknowledgement is made to the following source for permission to reproduce material in this unit:

Table 1: Department of Health 1994, On the State of the Public Health: The Annual Report of the Chie
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1.3.2 Unsuccessful presentations

Activity 4: Unsuccessful presentations

0 hours 5 minutes

Can you think of a recent situation where you felt uncomfortable because you did not manage to ‘project’ yourself as you
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1.2.2 Everyday scenes

Activity 3: Openings to everyday scene

0 hours 5 minutes

Think of examples of everyday scenes, at home or a work, which could be radically reshaped by an opening remark


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References

Alzheimer's Disease Society (1996) Information Sheet 1, Alzheimer's Disease Society, Gordon House, 10 Greencoat Place, London SW1P 1PH.
Arias, E.G. (ed.) (1993) The Meaning and Use of Housing, Avebury, Aldershot.
Department of Health (2001) The Children Act Now: Messages from Research, The Stationery Office, London.
Dunlo
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1.2.2 A place for possessions

Figure 1.1
Home decorating!

One of the ways homes come to reflect something of the individual is through the things within them. This per
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1 Attachment to place

In this unit we are going to consider the way in which people identify and become attached to places, buildings, objects, and how this attachment can contribute to personal well-being or how we feel about ourselves (Low and Altman, 1992). Looking at why places become important provides a basis for asking questions about what happens when people have to move, a common occurrence for people in need of care services.

The purpose of this unit is to focus on the psychological environment, ho
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3.3.1 Care: a cautious definition

For study purposes, we do need a definition of care, just as we needed a definition of informal carer. So we propose that in the context of health and social care we define care as:

something that is needed when people cannot function in daily life without the practical help of others.

But, as I have shown, care is a loaded word. It is both a word used by ordinary people to mean love, tende
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3.2 Care labels

Why is it important to explore the way language is used? Two reasons were suggested in Section 1. Definitions are important so that services and support can be targeted to where they are most needed. And words carry several meanings. One student included as an example in her answers to the activity about what care means:

‘In care’ means stigma for children and young people.

This did not
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