This is a collection of short stories that traces a chronological movement through one family's experience of the mother's illness. Each piece in the collection is meant to be an independent, free-standing short story. Each story is different, told from distinctive points-of-view, angles, and voices. However, every story covers a span of time within the nine months of the family's experience, in the presented order, as part of a collective movement toward the core. All together, the pieces hope to reflect a mosaic of sorts--one that tells a story that cannot otherwise be told.

No description available.

Scholars have recognized the importance of illness narratives, and some of this work hastargeted terminal-illness stories, but little has directly addressed what distinguishes them from other illness narratives. In most illness narratives, recovery and life beyond the acute incident are a critical part of the overall experience of a disease. But terminal illness always ends with death. It has no “after.” This difference fundamentally changes how the illness is experienced – and how we should analyze a story told about it. Recognizing this distinction is important not only from a narratological perspective, but also for the study of the ways people live while dying and the models of behavior these stories reveal. I offer four ways to consider the specific genre of terminal-illness stories: the desire to tell, a turn to living dyingly, the alternative triumph, and endings-beyond-endings. These four elements recognize that terminal-illness stories are a distinct subset of illness narratives, and thus they can yield important insights unavailable through existing methods of looking at illness narratives more generally. Beyond the expanded narratological knowledge, this understanding is crucial because close listening is an ethical responsibility both to the individual and to those who come after her. Thinking about how and why people tell these stories and what we can get from them helps us see how they function in the world. That, in turn, gives us more concrete ways to think about the abstract ideas around terminal illness, dying, and death. This awareness will let us think more carefully about our master narratives of death and dying and what models of behavior are available to those who are terminally ill and those who care for them, and it can also offer insight into societal structures of health care. Such insights can further the cultural movement toward supporting a so-called good death, part of a larger shift from a biomedical model to a biocultural one that incorporates a patient’s subjective experience. Recognizing these signals can help a dying person and her caregivers think through treatment options, social support, and other aspects of care. Truly hearing the stories told by people with terminal illness helps us create a better ethic of caregiving and a better dying for all of us.

No description available.

This dissertation investigates the effectiveness of and disparities in timely goals of care (TGOC) discussions in nursing homes (NHs), as well as hospitalizations due to infections. Chapter One provided an overview of the dissertation, including its aims and conceptual frameworks. Chapter Two is a systematic review of the current evidence concerning the timing of goals of care discussions in NHs and their impact on end-of-life outcomes. Chapter Three examines the differences in TGOC discussions in NHs for Black. Chapter Four analyzes the association between TGOC discussions and hospitalizations due to infections. Finally, Chapter Five synthesizes all findings. Key findings demonstrate that while effective TGOC discussions are associated with reduced hospitalizations due to infections in NH residents, significant racial and ethnic disparities exist, particularly among NHs with higher proportions of Black residents and those located in socioeconomically disadvantaged areas. These findings highlight the need for improved TGOC practices and targeted interventions to address systemic barriers and ensure equitable end-of-life care.

Pädag. Hochsch., Diss.--Freiburg (Breisgau), 2004.

When a child is diagnosed with cancer, the roles and responsibilities of family members change to accommodate the demands of the illness. The current study aimed to explore the experiences of mothers of children with cancer, focusing on their constructed roles within the family context and their social support. A case study design within the qualitative research approach was employed, underpinned by social constructionism as a theoretical framework. Three mothers were selected, using a combination of purposive and snowball sample techniques. Rich descriptive data were collected from three mothers through semi-structured interviews and reflective essays, and analysed using thematic analysis techniques. Results showed that although mothers of children with cancer experience some common themes, there are contextual differences influencing how they construct their stories. The following main themes were identified in the comparative analysis: events leading to the diagnosis, emotions, life changes, the effect of the illness and coping. / Psychology / M.A. (Psychology)

Student Number : 7916069 - MA research report - School of Human and Community Development - Faculty of Humanities / This qualitative study set out to explore the idea of a good death through in-depth interviews with six terminally ill patients with cancer aged between thirty-seven and fifty-two, in other words in mid-life. Thematic content analysis was used to examine overt and covert themes revealed in semi-structured interviews that had been transcribed verbatim. Significant fear of dying was revealed and although respondents did not seem to have a conscious idea of a good death, they had a clear concept of good dying. Two key components of good dying were not being in pain or distress from physical symptoms, and wanting to drift off into a final “sleep” rather than being fully alert until the end. It was noticeable that, whether or not patients had religious convictions, relatively little attention appeared to be paid directly to what might or might not follow the moment of death itself, for example an afterlife. Preparation for good dying included completing a will, sorting out financial affairs and, for some patients, planning a funeral. At times this preparation also included trying to mend conflicted relationships and make plans for the ongoing care of family members. It is postulated that these preparations helped re-constitute a sense of order that had been shattered by the chaos of being declared terminally ill at a time of life when this was non-normative. Moreover, taking care of practical needs re-established a sense of agency, helped achieve some sense of closure and symbolised a measure of acceptance of their dying status. Respondents did not seem to experience external pressure from others to die in a certain way, although two people were particularly aware of their influence on how others in the family felt and thus tended to pretend to feel better than they did.

Nursing Care for Terminal Patients in Intensive Care Units by Pervell Dunbar Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University August 2015 Although the goal of the ICU has always been to save lives, ICU now additionally provides end-of life (EOL) care. The objective of this project was to provide ICU nurses with a comprehensive awareness of physical, emotional, and spiritual EOL care issues of patients and their families in order to be better equipped to handle EOL care. The framework used was Jean Watson's Caring model (10 Caritas). A literature review revealed a poster previously used by a major health organization as a conversation starter to facilitate decision-making among ICU nurses, EOL patients, and their families related to EOL issues. The purpose of this quality improvement initiative was to introduce and implement an educational EOL tool that would engage patients and family members in meaningful and useful conversations with ICU nurses. Twenty seven ICU nurses were selected by the unit's director to attend a PowerPoint presentation on the use of the EOL educational poster. Four ICU nurses were chosen by the director to be champions for this project. After the presentation, there was a period for questions and answers, and the ICU nurses were requested to give feedback on the presentation. The result from the feedback revealed that EOL care is outside previous practice and may require extra education and support. These comments substantiated similar conclusions from other researchers as described in this paper. With an increase in EOL training for ICU nurses and the implementation of EOL teaching tools like the poster used in this study, ICU nurses may be better able to have conversations with EOL patients and families, thus improving patient care.

The topic of this study, euthanasia, has become a modern-day issue that challenges some of societies traditionally held beliefs towards death and dying. This study drew upon the theoretical insights of Michel Foucault to provide a discursive analysis of the term euthanasia, and the issues surrounding the "right-to-die". It involved an analysis of primary texts from; nursing, general, and legal literature as well as the media between the years 2002-2004. Drawing upon data researched, the study analyses the main discourses regarding the practice of euthanasia for terminally ill individuals. The two competing discourses that emerged were what I have termed the sanctity-of life-discourse and the right-to-die discourse. The aim of the study was to uncover the discourses understanding of "truth" regarding the right-to-die. The analysis revealed that a small percentage of cancer sufferers (5%) die with their pain insufficiently treated and the right-to-die discourse claims that no individual should have to suffer needlessly, asserting the individuals right to autonomy. Directly opposing this is the sanctity-of life-discourse which states all life is sacred and nothing can justify euthanasia as an acceptable practice in society. My findings indicate the need for effective palliative care and pain management when caring for the terminally ill individual. The legal, ethical and moral implications of euthanasia are many and this study discusses the effects these may have on health professionals involved with the care of terminally ill patients. The study revealed an increasing deployment of the right-to-die discourse in the media and revealed concerns regarding the nursing professions lack of preparation to deal with euthanasia if it becomes a legal option in end of life care.