Work package 4: Communication of death in nursing homes: a multi-cultural and multi-religious setting

Project summary

This project constitutes work package 4 in Multicultural workforce in nursing homes: Contemporary challenges, opportunities and potentials for the future in the Norwegian municipal care sector MULTICARE.

What are the dominant ways of dealing with emotions, meanings and understandings of the transition from life to death in a secularised ‘moment’ characterized by globalization, migration, multi-culturalism and multi-religiosity (cf. Parkes et al. 1997; Gatrad 2008)? Historically, Western societies have gradually shiftet end of life care and death from containment in the home to treatment in hospitals and nursing homes (Ariès 1976). Death is in a sense a neglected area in secularized cultures, frequently reduced to “a technical phenomenon” which consequentially appears to have “erased the great dramatic act of death” (Ariès 1976:88, 89). Despite a seemingly increasing openness about death in Norwegian mass media and public sphere, there is little knowledge of how ethnic minority and majority health personnel confronted with death at their work in nursing homes experience their possibilities for communicating personal and existential issues (comparative studies; see Nasir 2008; Sneesby 2011; Iranmanesh et al. 2011). This project will fill a gap within palliative care and end of life care research as our objective is to investigate how the death of a patient is handled institutionally, collegially and individually in nursing homes. In order to seize how death is dealt in these three dimensions, we will encourage health personnel to share how they perceive the conditions for communicating deeper personal and existential experiences of being confronted with death at work, as well as producing observational data on practices within the institutions. 

A health care personnel who provides care for people who are in vulnerable situations must be willing to use one’s self as a professional tool. Personnel who care for seriously ill, dying, and bereaved people experience suffering and distress and have been identified as being in peril of burnout and compassion fatigue (cf. Cassell 2004; Renzenbrink 2011). Based on a psycho-social perspective of interdependence of inner (psychic) and outer (social/societal) life (Froggett 2002) our conceptualization of conditions for communication of personal and existential experiences, comprises an intersection of four domains of experience: intra-psychic, inter-personal, organizational/institutional and macro-societal (e.g. Ramvi 2015). A broad definition of the term ‘spiritual’ covers our understanding of the term existential and refers to the dynamic dimension of human life related to the ways actors experience, express meaning, purpose and transcendence, and the way they connect to the moment, to self, to others, to nature, and to the significant and/or the sacred (The European Association for Palliative Care-EAPC).

MULTICARE is funded by the Research Council of Norway through the HelseVel programme. The project is led by Professor Frode F. Jacobsen, Centre for Care Research (CCR West), Western Norway University of Applied Sciences (HVL). MULTICARE is a cross-sectorial and multi-disciplinary project with participant researchers from Center for Care Research (CCR West and East), Uni Research Rokkan, University of Stavanger, University of Tromsø, Stavanger University Hospital and the Netherlands Institute for Health Research (NIVEL).

 

 

Method

Part-study one (PhD project): We will conduct ethnographic fieldwork in two nursing homes in Norway with a multicultural workforce. The focus will be on staff members’ conversations about personal and existential issues concerning death in the staff room and at staff meetings as well as on institutional procedures, structures and rituals connected to the death of a patient. 

Part-study two: We will conduct in-depth interviews with health care personnel of ethnic minority background from nursing homes in Norway. When confronted with death at work, do ethnic minority health care personnel use their self as a tool – in the sense of applying one’s own cultural and/or spiritual capital? In order to build knowledge about potential cultural and religious resources relevant to the interviewees, we will recruit participants who identify themselves with a religious view of life.