Bringing death home: Towards a deeper understanding of the implications of The End of Life Care Strategy for those individuals and organisations providing care in non-specialist settings

Scanlan, Katherine (2018) Bringing death home: Towards a deeper understanding of the implications of The End of Life Care Strategy for those individuals and organisations providing care in non-specialist settings. Professional Doctorate thesis, Tavistock and Portman NHS Foundation Trust/University of East London. Full text available

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Abstract

My research uses a psychosocial approach to reach a deeper understanding of the experience of those providing end of life care in non-specialist settings and places this experience within the wider landscape of contemporary developments in care provision, with particular reference to the End of Life Care Strategy introduced by the Department of Health in 2008. One intention of the strategy is to ensure that those at the end of life have greater choice about where to die, including the option of remaining in a homely environment. An initial hypothesis was that the End of Life Care Strategy does not appear to adequately address the psychological and emotional impact of engaging in the kind of care it proposes. More specifically the view that death is the subject that we are most defended against as human beings, particularly in contemporary western society, is based on psychoanalytic considerations of our relationship with death and has implications and consequences for the individuals and organisations concerned. A free association narrative approach was used to gather data from a small number of carers from care home settings. The data is presented in the form of case studies, end of life stories and a cross-case analysis, revealing emotional complexity and the significance of the relationship each carer has with death and dying. Identifying a range of unconscious defences in response to the carers' close proximity to death and dying I found evidence of a deep engagement with caring at the end of life, confirming personal and professional experience of a third tragic position elaborated within the thesis. Other findings include evidence of a strong vocational commitment to caring at the end of life, a powerful intertwining of personal and professional experience and a deep engagement with the emotional aspects of caring. The findings inform a number of recommendations.

Item Type: Thesis (Professional Doctorate)
Additional Information: Thesis is submitted in partial fulfilment of a Professional Doctorate in Social Work and Emotional Wellbeing awarded by the University of East London, in collaboration with the Tavistock and Portman NHS Foundation Trust
Uncontrolled Keywords: Professional Doctorate in Social Work and Emotional Wellbeing, D60
Subjects: Emotions, Affective Psychology > Grief/Mourning/Loss
Department/People: Children, Young Adult and Family Services
Research
URI: http://repository.tavistockandportman.ac.uk/id/eprint/1927

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