The analysis of data with nurses reveals two themes and subthemes. 'Marginalisation and oppression of the older person' shows the ways in which nurses perceive older people are relegated to a lower status in the acute care setting, how this is 'contagious' and how 'lack of time' for care for older people is problematic and has become their 'catchcry'.'Stereotyping the older person' depicts some of the ways in which this evolves, for example, through 'Chinese Whispers' (UsingEnglish.com 2006), but has become part of the ageist culture.
The provision of medically administered nutrition and hydration (MNH) for the terminally ill patient is a controversial issue and there has been much debate in the literature concerning this sensitive subject. This article reports on a qualitative research study that explores palliative care nurses' and doctors' perceptions and attitudes to patient nutrition and hydration at the end of life. Participants were from an urban and rural palliative care service. Three main discourses were identified: carers' distress at the non-provision of MNH; palliative care doctors' and nurses' position that terminal dehydration lessened the burden of suffering for dying patients; and polarisation between the acute care setting and the palliative care setting. Overlaying these three main discourses are contesting discourses involving cure vs comfort, and acute care vs palliative care. Importantly, the findings of this study reveal that palliative doctors and nurses believe that medically assisted nutrition and hydration at the end stage of life rarely benefits patients, and as long as adequate mouth care is given, patients do not suffer. However, family members do experience emotional distress in dealing with this situation. In caring for dying people, the nurse's and doctor's role is one of education and communication, involving a team approach to manage this difficult issue.
The body is the empirical quintessence of the self. Because selfhood is symbolic, embodiment represents the personification and materialization of otherwise invisible qualities of personhood. The body and experiences of embodiment are central to our sense of being, who we think we are, and what others attribute to us. What happens, then, when one's body is humiliating? How does the self handle the implications of a gruesome body? How do people manage selfhood in light of grotesque physical appearances? This study explores these questions in the experiences of dying cancer patients and seeks to better understand relationships among body, self, and situated social interaction.
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