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1.4.10 Unfinished business

When people die suddenly we can never be sure that they have done and said what they want and are able to do. Meg’s long term-illness gave her a lot of time for reflection and preparation, so that while her death was sudden and she was unable to see her younger son, she also had the opportunity for conversations with people about her death. However, there may have been last-minute wishes that Meg was unable to express.

Li’s sudden stroke may have left her with things unsaid, but her
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1.4.1 Choices in dying

An enormous diversity exists in the way people view and approach death and dying. This diversity continues to be evident when people are faced with the knowledge that their own death is approaching. There is no standard, correct or even best way of dying. Yet there is a concept of a ‘good death’ which will be addressed in this section. As a course team we are somewhat ambivalent about the usefulness of the phrase, but we retain it largely as a reminder that there are important issues to b
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1.2.6 Encounters with death

Although we each die only once, there may be many a brush with death throughout the course of a person’s life. The experience of having been close to death can have a major impact on the way in which a person continues living. For Elaine, the awareness that she might be about to die has affected the way she lives now that her prognosis is good. She describes herself as prepared for death and impatient of those who are not. She also has difficulty entering fully back into life.


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Introduction

This unit examines life stories. It looks at the way in which objects, trends, cultures or disabilities may contribute to a person's identity. This unit also considers the contribution that our own life stories make to who we are, and how remembering and revisiting our past may help us to move forward with our lives.

This material is from our archive and is an adapted extract from Understanding Health and Social Care (K100) which is no longer taught by The Open University. If you
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3.1.1 Update: A move towards patient-centred care?

David Lee of Leeds Teaching Hospitals NHS Trust, commenting on recent changes towards patient-centred care, said ‘The modernisation agenda stemming from the National Health Service Plan (Department of Health, 2000) is requiring major shifts in organisational and cultural thinking. The patient is increasingly being placed first and at the centre of every aspect of health care. In essence, health care and indeed ward routines are now expected to be driven by the needs of patients and users of
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2 A day in the life of a hospital ward

In 1996, we visited Ward 29, one of two gastroenterology wards in the medical unit, and recorded the views of patients and staff. The ward has 24 beds. Its patients were women and men, across a wide age range, suffering from digestive disorders – for example, stomach ulcers, Crohn's disease, ulcerative colitis, cancers of the digestive system or problems with liver function brought on by alcohol abuse. Because it was winter the ward had more elderly people than it would have at other times
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1.8.2 ‘Props’ to support a performance

Heller leaves no doubt about the horror and panic produced by a situation where action was urgently called for, yet there was no framework within which to construct action. He found himself desperately casting around for things to do, falling back on his trusty stethoscope as a way to ‘play doctor’, but finding it inadequate for the circumstances. He was clearly relieved when the drip equipment arrived, giving him a structured role. And even in this desperate situation he was concerned to
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1.7 ‘Care values’ in relationships

In his dealings with Lynne and Arthur, Dev is expected to speak and act in accordance with the basic values of the social work profession. CCETSW guidelines include the requirement that he should:

Identify, analyse and take action to counter discrimination, racism, disadvantage, inequality, and injustice, using strategies appropriate to role and context; and

Practise in a manner that does not stigmatise or d
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1.5.4 The patient’s role

Activity 8: The passive actor

0 hours 5 minutes

The patient is entirely passive in this scene. Does that mean that she has no role and is unimportant to the scene? Does her silence
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1.5.2 Playing doctors, nurses and patients

Activity 7: The doctor role

0 hours 5 minutes

It is easy to see how junior doctors can see themselves as bei
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1.4.3 Structures that both enable and constrain

Life within a society is made possible by structures. They operate at many levels, from the details of daily life (e.g. the routines of getting up in the morning, or the ritual greetings we use when we meet people) to the broader organisation of society (e.g. the channels through which mass media ‘news’ is generated, or the rules under which benefit payments are made). Even the language through which I am communicating now is a structured system of written symbols. But structures not only
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1 Playing roles together

Care relationships are seldom just a matter of ‘doing what come naturally’. For one thing, you may be caring for, or being cared for, by someone you would not otherwise get on with. A care relationship has to adapt to circumstances: it may be brief, as in an acute hospital ward, or it may be very long lasting; it may be flexible according to need or it may involve a high degree of regularity. It is a distinctive relationship with unique elements. Some of the things you and the other perso
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1.2.4 Places and spaces as resources

Attachment to places can be a resource within care relationships, especially where people have a shared history of attachment to places. An older couple may have experienced the ups and downs of moving between places together for much of their lives. Or a daughter may be caring for her mother in the home where she was born and brought up. A shared understanding of the home environment and the support which may be available locally can be invaluable in developing a care relationship. Such know
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References

Care Sector Consortium (1992) Care Awards, Local Government Management Board, London.
Care Sector Consortium (1997) Review of the Care Sector Awards: Values and Principles of Good Practice and their Implementation, CCS, London.
Northern Ireland Statistics and Research Agency (1997) Northern Ireland Annual Abstract of Statistics, No. 15, HMSO, London.
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1.5.3 Labelling

Official language about informal carers is at variance with the way we normally talk about family life. How many children or young people who care – for parents or other relatives – would spontaneously label themselves a ‘young carer’? How many parents would describe their son or daughter in this way? How many people who frame census questions would have thought of including a question to find out, until ‘young carer’ became a category like ‘disability’ or ‘age’ that censu
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Learning outcomes

After studying this unit you should be able to:

  • Appreciate the demands that care relationships place on people.

  • Describe how individuals might experience care.

  • Demonstrate an understanding of the difficulty of identifying carers when there is interdependence in the relationship.


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4 Audio clip 3: Enid Francis

Enid Francis lived in a modern residential area on the outskirts of Derby. She shared a house with her husband, Wally, and two grown-up sons, Mark and John. Her husband had had to give up work eighteen months before his retirement, because of a heart complaint. Their two sons, aged 35 and 32, were both autistic. Enid's day was organised around meeting their needs for care and support. On weekdays, they attended a day centre, which she would have to get them ready for. When they came home in t
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6.6 A few final thoughts

This final section has concentrated on the heart, the lungs and the blood – the body's cardio-respiratory system. We saw briefly how the body takes oxygen in through the lungs, and discussed the importance of this for athletes in various sports. To understand the role of oxygen in the body and its importance to athletes, we had to draw on information that we had discussed in earlier sections about the way oxygen is carried in the blood and the way that the heart pumps blood to different par
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5.1 Introduction

Elite athletes are aware of the importance of heart performance and blood flow and many have specific training programmes to increase the strength and efficiency of the heart. This is not, however, just something that impacts on elite athletes. Even those of us engaged in sport at an amateur level or just for recreation will have experienced the effect of sport on the heart. After intense physical activity our heart pounds and possibly our head pounds too from the blood that is being pumped t
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2.3 The body's different systems

The body has a variety of different internal systems such as the skeleton, the collection of muscles, and the network of arteries and veins. To understand properly how the body works, we need to understand these separate systems as well as the links between them.

Activity 1: What you need to do


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