Learning outcomes After studying this course, you should be able to: demonstrate an understanding of the difficult decisions that need to be taken to improve the quality of interpersonal relationships in health and social care contexts appreciate key moral dilemmas in the provision, delivery and management of health and social care services identify ways in which boundaries can be respected in situations where intimate care is being given.
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References 1.4.3 Beveridge’s insurance model and immigration What has this to do with Beveridge? His insurance model assumed that a man would start to contribute at the beginning of his working life and emphasised that he had paid for and was entitled to the benefits he and his family later received. This required a stable population and failed to anticipate the need to recruit men and women of all ages from outside Great Britain. Although they came initially on their own, it was hardly surprising that newcomers would want to bring families and other d 1.4.2 Racism You may want to question whether the term ‘sexism’ is a useful one to help understand the Beveridge vision, but you can probably agree that there is an idea about the family and about the ‘natural’ responsibility of women to do caring work that kept caring off the public agenda. But this still leaves the theme of ‘racism’ and the idea of the ‘nation’. You caught a glimpse of the importance of this a little earlier in Beveridge's confident remark about women having duties to en 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 4.0 Licence Grateful acknowledgement is made to the following sources for permission to reproduce materia 3: Testing the limits Choosing Jim and Marianne as the central case study in the course was a deliberate strategy to enable you to consider conflicts at the very heart of health and social care: the rights of the individual versus the rights of the community the nature of community for people who have no settled abode dilemmas about apportioning limited resources. Following their story is a way of testing the limits of hea 1.4.13 Defining a ‘good death’ Click to view 'The Good Death?'. Read ‘The good 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 A good death? How would you classify these four deaths? The following comments are from the course testers and authors. Vic's death was lonely and probably difficult, in that his breathing was laboured as a result of his disease. Seeing his children after five years and being alert enough to recognise them are positive elements in what seemed to be a sad and difficult life. Li’s death was good in many ways. Her family were with her and prepared, she was not distressed as far as it is possible 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 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. 1.2.9 Nick In our society we tend to expect not to have to face the likelihood of death until our 70s at least, but one group of people who are having to face the prospect of death at a relatively young age are those diagnosed as HIV-positive. Controversy surrounds the issue of whether those at risk of contracting the virus should have the blood test which might give them that death sentence. At the time of writing there is no clear evidence that any treatment can improve the prognosis, even if taken at 1.2.8 Caroline Caroline’s experience was rather different. She was brought face to face with death when she was involved in a fatal car accident. Her friend who was driving at the time was killed outright whilst Caroline escaped unhurt. She found the reality of this difficult to assimilate and felt a sense of guilt. For a long time after the accident – several months – I kept replaying it over and over again in my mind and 1.2.1 Death and Tolstoy Inevitably, the way in which people deal with death, whether by denial or by the construction of a complex system of beliefs and myths, leads to questions about the meaning of life. For Julia Neuberger this is the lesson of death. ‘It is nothing to fear of itself, but it concentrates the mind powerfully in examining what it is we mean by life’ (Neuberger and White, 1991, p. 13). Click to view 'Author(s): Conclusion This free course provided an introduction to studying Health and Social Care. It took you through a series of exercises designed to develop your approach to study and learning at a distance and helped to improve your confidence as an independent learner. References 1.3.7 Models of adjustment Here we have talked about changes of place as having a particular impact on an individual's sense of well-being or self-esteem. Relocation and separation from familiar places just like separation from loved ones can be experienced as a form of loss which can have devastating effects for some people. Some authors have seen changes in self-esteem as the key to understanding how people cope with change. For example, Hopson and Adams (1976) suggest that any transition, whatever triggers it, sets
Activity 8
