The production of death and dying in care homes for older people : an ethnographic account

Abstract

This thesis explores 'death and dying' in care homes for older people. Residents who are admitted to care home institutions are increasingly more likely to be extremely old and frail and it follows that the final product of most care homes is death. Indeed, up to one third of care home residents will die each year. In particular, the thesis explores the gap between the rhetoric of a 'good death' that heads of homes were keen to produce and the practice reality of what happened when a resident was categorised as 'dying' and at the time of death. The study draws on ethnographic data from one year of participant observation in eight care homes in England. Observing the daily life events in care homes for older people has illuminated the strategies that staff and residents deployed to manage 'death and dying' and the complexities of managing the narrow margin between life and death. The materiality of the body is not something that can be controlled or contained easily within a category. The findings highlight performances around death and what purpose these might serve, including the role of symbolism in the production of 'living' and 'dying'. They also show how the ageing body might resist powerful practices. The thesis draws on the literature of symbolic interactionism, the sociology of the body and anthropology to explain how the ageing bodies of residents were managed on their journey to death. The thesis concludes with suggestions on how this type of in-depth study might contribute to practice in those settings which house ageing and deteriorating bodies and which have been marginalised by society.