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
1.3.8 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 1.3.4 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. 1.3.3 Ineffability Most people who speak of their near-death experience say they have great difficulty putting it into words because, as one person put it, ‘There is no feeling you experience in normal life that is anything like this’. 1.3.2 Recurrent themes When the accounts of people who have described a near-death experience are looked at side by side it is possible to identify some common features. This isn’t to say that all of these features are present in every account, but that amidst variations there are certainly recurrent themes. The following list is compiled from a variety of studies, including the important study undertaken by Sabom (1982), himself initially sceptical. 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: 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 1.2.7 Margaret Margaret was in her thirties when she learnt she had breast cancer. Some three years later, after the removal of the affected breast, she was leading a very busy life working full-time at the Open University, studying part-time for an OU degree and running a family. Fitness activities such as jogging and various sports had become very important in her life. She was also very involved in cancer research fundraising activities. She described the impact of her brush with death in this way: 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. Learning outcomes After studying this unit you should be able to: outline how encouraging people to talk about the past can be a way of helping them to manage change in their lives and establish identity in the present; demonstrate an understanding of the basic principles in life story work which could apply at any age or stage of life; appreciate that life story work is as much about dealing with the present and preparing for the future as it is sorting out feelings 1.5.4 The patient’s role 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 1.5.2 Playing doctors, nurses and patients It is easy to see how junior doctors can see themselves as bei 1.5.1 Agreeing who to be So far I have focused on one-to-one interactions. Yet ‘defining a scene’ is often a group effort. Goffman says this involves teamwork, with all participants, in effect, agreeing to act and speak within an overall frame of reference. He suggests that it works like a theatrical play in which everyone has taken on a part within the scene. To play your part means setting aside all those aspects of yourself which are not relevant to your role. The scene works only because everyone plays their 1.2.2 Everyday scenes Think of examples of everyday scenes, at home or a work, which could be radically reshaped by an opening remark 1.2 Defining the scene Let us first consider what kind of ‘scene’ the home help was proposing that she and Reg should play out together. When the home help asked, ‘What do you want me t Learning outcomes After studying this unit you should be able to: demonstrate your understanding of the importance of negotiating the meaning of care relationships; identify ways in which people play the roles of ‘carer’ and ‘receiver of care’. 1.3.5 Coping with relocation We have seen that attachment to place can be important in terms of developing and maintaining feelings of security and a sense of self-identity However, care for some people involves relocation. Changes of place often involve people in coping with other types of change such as: changes of role (for example from being a homeowner to being a resident of a home; or from being a hospital resident to being a resident in the community) 1.3.4 Change on a daily basis: Day unit care The importance of maintaining continuity of people and places is important in both cases. Many people attend day care services and find that the change is a stimulating experience, widening their daily contacts and allowing them to become part of another group. The issues of continuity of experience raised here will be familiar to day care workers. Click below to hear an audio clip describing Redwood Day Unit. 1.3.3 Change on a daily basis: shared care for the elderly In the case of Mr Bright care is shared between his wife and formal carers and changes in the place of care are primarily to give Mrs Bright a break and Mr Bright a change of scene. Click below to hear an audio clip describing a day in the life of Mr and Mrs Bright. 1.3.1 The impact of surroundings Thinking about attachment to places leads us to think about just the opposite: how do people feel when they have to change places and move from one situation to another? Some people are always on the move while others seem to stay put for long periods of their lives. For children and adults receiving care services moving between places may be a common occurrence. These moves may be:
daily, part of a shared pattern of care where a person
Activity 8: The passive actor
Activity 7: The doctor role
Activity 3: Openings to everyday scene
