Whose business is dying? Death, the home and palliative care

The process of dying at home brings the nexus between the paternalism of conventional palliative care and a social understanding of end of life care into sharp focus. Away from institutional places of care, issues of ownership, compliance and communal responsibility are heightened. At this interface, palliative care services are confronted with the irony of relinquishing their 'ownership' of dying whilst leading communities to reclaim their principal role in the business of dying. This benign – but enduring – paternalism remains a barrier to a paradigmatic shift towards a more complete understanding of the business of dying. Whilst nascent attempts to promote community engagement in end of life issues are evident in the interface between palliative care and public health, dying remains, for the most part, the remit of health care services. In this article, I contend that the business of dying is incompletely attended. This lack of attention will be partially redressed here by considering the home as a fitting death scene.

Shared material on dying

Shared Material on Dying is a trio/solo work commissioned by Jenny Roche and the Dublin Dance Festival in 2008 from choreographer Liz Roche. Touring widely since its creation, it continues to be a rich research environment for the interrogation by Jenny Roche of the dancer’s first-person perspective in choreographic production and performance. The research perspective drawn from the live performance of this iteration was how the exploration of the same dancing moment might be expressed from multiple perspectives by three different dancers and what this might reveal about the dancer’s inner configuring of the performance environment. Erin Manning (2009) describes the unstable and emergent moment before movement materialises as the preacceleration of the movement, when the potentialities of the gesture collapse and stabilize into form. It is this threshold of potentiality that is interesting, the moment before the dance happens when the configuring process of the dancer brings it into being. Cynthia Roses Thema (2007), after neuroscientist Antonio Damasio, writes that embodied experience is mapped as it unfolds and alters from moment to moment in line with a constantly changing internal milieu. As a performer in this piece, I explored the inner terrain of the three performers (myself included) by externalizing these inner states. This research contributed to a paper presentation at the Digital Resources for the Arts and Humanities Conference, UK 2013.

Numerical investigation of case hardening of plant tissue during dying and its influence on the cellular level shrinkage

Dried plant food materials are one of the major contributors to the global food industry. Widening the fundamental understanding on different mechanisms of food material alterations during drying assists the development of novel dried food products and processing techniques. In this regard, case hardening is an important phenomenon, commonly observed during the drying processes of plant food materials, which significantly influences the product quality and process performance. In this work, a recent meshfree-based numerical model of the authors is further improved and used to simulate the influence of case hardening on shrinkage characteristics of plant tissues during drying. In order to model fluid and wall mechanisms in each cell, Smoothed Particle Hydrodynamics (SPH) and the Discrete Element Method (DEM) are used. The model is fundamentally more capable of simulating large deformation of multiphase materials, when compared with conventional grid-based modelling techniques such as Finite Element Methods (FEM) or Finite Difference Methods (FDM). Case hardening is implemented by maintaining distinct moisture levels in the different cell layers of a given tissue. In order to compare and investigate different factors influencing tissue deformations under case hardening, four different plant tissue varieties (apple, potato, carrot and grape) are studied. The simulation results indicate that the inner cells of any given tissue undergo limited shrinkage and cell wall wrinkling compared to the case hardened outer cell layers of the tissues. When comparing unique deformation characteristics of the different tissues, irrespective of the normalised moisture content, the cell size, cell fluid turgor pressure and cell wall characteristics influence the tissue response to case hardening.

Paediatric death and dying: Exploring coping strategies of health professionals and perceptions of support provision

Without question a child’s death is a devastating event for parents and their families. Health professionals working with the dying child and family draw upon their expertise and experience to engage with children, parents, and families on this painful journey. A delicate and sensitive area of practice, it has strong and penetrating effects on health professionals. They employ physical, emotional, spiritual and problem solving strategies to continue to perform this role effectively and to protect their continued sense of well-being. Aim To explore health professionals’ perceptions of bereavement support surrounding the loss of a child. Methods The research was underpinned by social constructionism. Semi-structured interviews were held with 10 health professionals including doctors, nurses and social workers who were directly involved in the care of the dying child and family in 7 cases of paediatric death. Health professional narratives were analysed consistent with Charmarz’s (2006) approach. Results For health professionals, constructions around coping emerged as peer support, personal coping strategies, family support, physical impact of support and spiritual beliefs . Analysis of the narratives also revealed health professionals’ perceptions of their support provision. Conclusion Health professionals involved in caring for dying children and their families use a variety of strategies to cope with the emotional and physical toll of providing support. They also engage in self-assessment to evaluate their support provision and this highlights the need for self-evaluation tools in paediatric palliative care.

Twitter (probably) isn't dying, but is it becoming less sociable?

Twitter’s demise has been announced so many times over its lifetime that it’s hard to keep track of all the premature eulogies (and this one from a year ago is actually pretty insightful), but there seems to be a new intensity in the circulation of decline narratives at the moment. A couple of weeks ago there was quite a bit of heat on umair haque’s Medium story, in which he proclaimed..

End-of-life care pathways for improving outcomes in caring for the dying

This is an updated version of a Cochrane review published in Issue 11, 2013 in the Cochrane Library. In many clinical areas, integrated care pathways are utilised as structured multidisciplinary care plans that detail essential steps in caring for patients with specific clinical problems. In particular, care pathways for the dying have been developed as a model to improve care of patients who are in the last days of life. The care pathways were designed with an aim of ensuring that the most appropriate management occurs at the most appropriate time, and that it is provided by the most appropriate health professional. Since the last update, there have been sustained concerns about the safety of implementing end-of-life care pathways, particularly in the United Kingdom (UK). Therefore, there is a significant need for clinicians and policy makers to be informed about the effects of end-of-life care pathways via a systematic review.

Duties to the dead and dying

Digital image

Dying for 'Enduring Freedom': Accepting Responsibility for Civilian Casualties in the War against Terrorism

Wheeler, Nicholas, 'Dying for `Enduring Freedom': Accepting Responsibility for Civilian Casualties in the War against Terrorism', International Relations (2002) 16(2) pp.205-225 RAE2008

The Effect of Health and Penal Harm on Aging Female Prisoners' Views of Dying in Prison

With tougher sentencing laws, an increasing number of individuals are finding themselves spending their final years in life in prison. Drawing on a sample of 327 women over the age of 50 incarcerated in 5 Southern states, the present study investigates the relationship between numerous health variables and the Templer Death Anxiety Scale (TDAS). Qualitatively, the article also provides personal accounts from inmates that serve to reinforce death fears when engaging the prison health care system. Participants reported a mean of 6.40 on the TDAS indicating a substantial degree of death and anxiety when compared to community samples. both mental and physical health measures were important indicators of death anxiety. Qualitative information discovered that respondents' concerns about dying in prison were often influenced by the perceived lack of adequate health care and the indifference of prison staff and other instances of penal harm.