Transitions: Exploring the Frontier

2014 ◽  
Vol 70 (1) ◽  
pp. 57-65 ◽  
Author(s):  
Inge B. Corless
Keyword(s):  
End Of Life ◽  
Life Experiences ◽  
Family Members ◽  
Death Awareness ◽  
The Subject ◽  
The Rich ◽  
Deathbed Visions ◽  
Near Death Experiences

End-of-life experiences go by various terms, including near-death experiences (NDEs), deathbed visions, deathbed phenomena, deathbed coincidences, and nearing death awareness. Deathbed escorts is the term applied to the vision of deceased family members or friends who inform the dying person that they will be accompanied in the transition from life. In this article, I examine the subject of NDEs and deathbed escorts, starting with the rich body of work provided by Robert and Beatrice Kastenbaum. A subject of some interest to Robert Kastenbaum, he explored this frontier in his many writings on dying, death, and bereavement. Ever the pioneer and having made the ultimate transition, he may yet be exploring new frontiers.

Nursing Home Staff Members’ Experiences With and Beliefs About Unusual End-of-Life Phenomena

2020 ◽  
pp. 003022282098123
Author(s):  
Stephen Claxton-Oldfield ◽  
Natalie Richard
Keyword(s):  
Nursing Home ◽  
End Of Life ◽  
Family Members ◽  
Nursing Home Staff ◽  
Staff Members ◽  
Specific Event ◽  
Transpersonal Experiences ◽  
Deathbed Visions ◽  
Life Phenomena

Twenty-two members of a nursing home took part in a study examining their experiences with and beliefs about unusual end-of-life phenomena (EOLP). Nearly all the staff members had witnessed and/or been told about residents holding on for someone to arrive or for a specific event to occur before dying (95% and 91%, respectively). Other commonly witnessed/reported EOLP included residents having sudden, unexpected moments of lucidity, sensing or feeling the presence of deceased residents, residents’ dreaming about deceased relatives, friends or pets, and deathbed visions. More than three-quarters of the staff members regarded EOLP as transpersonal experiences, as comforting to dying residents and their family members, and as part of the dying process. Fourteen staff members described experiences they had had with EOLP in the nursing home. The most frequently described experiences involved the appearance of apparitions. Seventy-seven percent of the staff members expressed an interest in learning more about EOLP.

scholarly journals Home Hospice Versus Other Places of Death and Caregiver Stresses

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 418-418
Author(s):  
Elizabeth Luth ◽  
Holly Prigerson
Keyword(s):  
End Of Life ◽  
Hospice Care ◽  
Life Experiences ◽  
Family Members ◽  
Hospital Death ◽  
Home Death ◽  
Multivariable Regression ◽  
The Relationship ◽  
Support Family ◽  
The U.S

Abstract As of 2017, more individuals in the U.S. die at home than in any other location. Hospice care was designed to provide support for people who are dying and their families. However, dying persons may have rapidly emerging needs that home hospice does not immediately meet, thereby, exposing family members to be “first responders.” Thus, home death may result in distress and burden for dying individuals’ family members, even when hospice is involved. This study uses multivariable regression analysis to explore the relationship between place of death and stressful end-of-life experiences in a sample of 185 patients with advanced cancer. We also analyze which end-of-life experiences are associated with death location. Compared to home hospice death, we found dying in a hospital was associated with fewer caregiver exposures to, and reports of fearfulness and helplessness in response to, stressful end-of-life events. Compared to home hospice death, hospital death was associated with decreased frequency of choking, falls, confusion/delirium, and feeling the patient has had enough. It was also associated with less fearfulness about choking and falls and less hopelessness about falls, the patient having enough, and thinking the patient was dead. Our results suggest home death with hospice care, often involves undesirable experiences that result in more caregiver fear and helplessness than dying in a hospital without hospice care. Research is needed to understand how to best support family members through stressful end-of-life experiences even when supported by home hospice services.

Unusual perceptions at the end of life: limitations to the diagnosis of hallucinations in palliative medicine

2016 ◽  
Vol 7 (3) ◽  
pp. 238-246 ◽  
Author(s):  
Allan Kellehear
Keyword(s):  
End Of Life ◽  
Palliative Medicine ◽  
State Of The Art ◽  
Research Work ◽  
Prevalence Data ◽  
Cultural Approach ◽  
Disease States ◽  
Current State ◽  
Deathbed Visions ◽  
Near Death Experiences

The diagnosis of hallucination for unusual perceptions such as deathbed visions, near-death experiences, or visions of the bereaved, is unhelpful in palliative medicine both academically and clinically. This paper reviews the broad prevalence data about unusual perceptions in the general population as background to identifying the more narrow epidemiological source from which the much smaller focus on hallucinations seem to emerge. Major debates and limitations of current hallucination research are reviewed to show that current academic and clinical certainties are largely confined to unusual perceptions that can be readily linked to psychopathology, quite specific organic disease states and psychoactive drug use. Current state-of-the-art in hallucination studies does not warrant broad or uncritical use of this type of diagnosis in end-of-life care. Conclusions from interdisciplinary (as opposed to single discipline) hallucination studies suggest that the way forward for clinical and research work in palliative medicine may lie in a more biographical and cultural approach to unusual perceptions at the end of life.

Informal caregiver experiences at the end-of-life of individuals living with dementia with Lewy bodies: An interview study

Dementia ◽  
2021 ◽  
pp. 147130122110384
Author(s):  
Melissa J Armstrong ◽  
Slande Alliance ◽  
Pamela Corsentino ◽  
Angela Lunde ◽  
Angela Taylor
Keyword(s):  
End Of Life ◽  
Dementia With Lewy Bodies ◽  
Life Experiences ◽  
Family Members ◽  
Lewy Bodies ◽  
Poor Sleep ◽  
Disease Course ◽  
Life Period ◽  
Caregiver Experiences ◽  
The Impact

Individuals with dementia with Lewy bodies (DLB) commonly die from dementia-related causes, but little is known regarding caregiver experiences during the end-of-life period in DLB. This reflects a critical knowledge gap given the high frequency of informal caregiving for individuals with dementia, high caregiver burden in DLB, and the fact that most individuals with DLB die from this disease. Investigators conducted telephone interviews with family members of individuals who died with DLB in the last 5 years. Investigators used a qualitative descriptive approach to analyze interview transcripts. Participants included 15 children, 13 spouses, and 2 other family members. Interviews averaged 31 min. Major themes included caregivers as the main drivers of care for individuals with DLB throughout the disease course and at the end of life, the impact of DLB features (e.g., fluctuations, hallucinations, and delusions) on end-of-life experiences, experiences relating to the caregiving role, death and post-death experiences, and supports employed by caregivers in the end-of-life period. End-of-life experiences for caregivers of individuals with DLB built on the accumulated burden of the disease course, where caregivers were often responsible for driving DLB care—from making the diagnosis to educating healthcare professionals and double-checking medical decisions. While some end-of-life experiences were consistent with those described in dementia palliative care more generally (e.g., financial stresses, poor sleep, being overwhelmed, and needing increased education and support), many DLB features specifically affected end-of-life caregiver experiences, such as the presence of delusions. Improving caregiver experiences at the end of life in DLB will require improved diagnosis and care for individuals with DLB throughout the disease course and also better strategies for treating behavioral symptoms. More research is needed regarding drivers of quality end-of-life experiences for individuals with DLB and their families and how drivers and strategies may differ between dementias.

Much Ado About Fried Chicken: Abetting Aspiration or Respecting Autonomy?

2019 ◽  
Vol 28 (3) ◽  
pp. 1356-1362
Author(s):  
Laurence Tan Lean Chin ◽  
Yu Jun Lim ◽  
Wan Ling Choo
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Multidisciplinary Team ◽  
Biopsychosocial Model ◽  
Family Members ◽  
Clinical Decisions ◽  
Goals Of Care ◽  
Complex Needs ◽  
Aspiration Risk ◽  
Patient Centric

Purpose Palliative care is a philosophy of care that encompasses holistic, patient-centric care involving patients and their family members and loved ones. Palliative care patients often have complex needs. A common challenge in managing patients near their end of life is the complexity of navigating clinical decisions and finding achievable and realistic goals of care that are in line with the values and wishes of patients. This often results in differing opinions and conflicts within the multidisciplinary team. Conclusion This article describes a tool derived from the biopsychosocial model and the 4-quadrant ethical model. The authors describe the use of this tool in managing a patient who wishes to have fried chicken despite aspiration risk and how this tool was used to encourage discussions and reduce conflict and distress within the multidisciplinary team.

Fakir Baykurt’un Almanya öykülerinde Türk göçmen çocukları

2016 ◽  
Vol 3 (1) ◽  
pp. 5-28
Author(s):  
Efnan Dervişoğlu
Keyword(s):  
Social Sciences ◽  
Migrant Workers ◽  
Life Experiences ◽  
Main Theme ◽  
Social Dimensions ◽  
Home Life ◽  
Literary Forms ◽  
The Social ◽  
The Subject ◽  
Life Education

Almanya’ya işçi göçü, neden ve sonuçları, sosyal boyutlarıyla ele alınmış; göç ve devamındaki süreçte yaşanan sorunlar, konunun uzmanlarınca dile getirilmiştir. Fakir Baykurt’un Almanya öyküleri, sunduğu gerçekler açısından, sosyal bilimlerin ortaya koyduğu verilerle bağdaşan edebiyat ürünleri arasındadır. Yirmi yılını geçirdiği Almanya’da, göçmen işçilerle ve aileleriyle birlikte olup işçi çocuklarının eğitimine yönelik çalışmalarda bulunan yazarın gözlem ve deneyimlerinin ürünü olan bu öyküler, kaynağını yaşanmışlıktan alır; çalışmanın ilk kısmında, Fakir Baykurt’un yaşamına ve Almanya yıllarına dair bilgi verilmesi, bununla ilişkilidir. Öykülere yansıyan çocuk yaşamı ise çalışmanın asıl konusunu oluşturmaktadır. “Ev ve aile yaşamı”, “Eğitim yaşamı ve sorunları”, “Sosyal çevre, arkadaşlık ilişkileri ve Türk-Alman ayrılığı” ile “İki kültür arasında” alt başlıklarında, Türkiye’den göç eden işçi ailelerinde yetişen çocukların Almanya’daki yaşamları, karşılaştıkları sorunlar, öykülerin sunduğu veriler ışığında değerlendirilmiş; örneklemeye gidilmiştir. Bu öyküler, edebiyatın toplumsal gerçekleri en iyi yansıtan sanat olduğu görüşünü doğrular niteliktedir ve sosyolojik değerlendirmelere açıktır. ENGLISH ABSTRACTMigration and Children in Fakir Baykurt’s stories from GermanyThe migration of workers to Germany has been taken up with its causes, consequences and social dimensions; the migration and the problems encountered in subsequent phases have been stated by experts in the subject. Fakir Baykurt’s stories from Germany, regarding the reality they represent, are among the literary forms that coincide with the facts supplied by social sciences. These stories take their sources from true life experiences as the products of observations and experiences with migrant workers and their families in Germany where the writer has passed twenty years of his life and worked for the education of the worker’s children; therefore information related to Fakir Baykurt’s life and his years in Germany are provided in the first part of the study.  The life of children reflected in the stories constitutes the main theme of the study.  Under  the subtitles of “Family and Home Life”, “Education Life and related issues”, “Social environment, friendships and Turkish-German disparity” and “Amidst two cultures”, the lives in Germany of children who have been  raised in working class  families and  who have immigrated from Turkey are  evaluated under the light of facts provided by the stories and examples are given. These stories appear to confirm that literature is an art that reflects the social reality and is open to sociological assessments.KEYWORDS: Fakir Baykurt; Germany; labor migration; child; story

M. V. Nadkarni. Farmer's Movements in India. New Delhi: Allied Publishers Pvt. Ltd., 1987.237 pp.,Price: (hardbound edition) Rupees (Indian) 100.00.

1988 ◽  
Vol 27 (3) ◽  
pp. 333-335
Author(s):  
Khwaja Sarmad
Keyword(s):  
Tamil Nadu ◽  
Rural Poverty ◽  
Price Policy ◽  
New Delhi ◽  
Root Cause ◽  
The Subject ◽  
The Rich ◽  
Land Holdings ◽  
Set Up ◽  
Agricultural Price

This book is a comprehensive analysis of farmers' movements in India with a focus on the movements in Tamil Nadu, Maharashtra, Punjab and Karnatka. It examines the economic, social and political aspects of the farmers' struggle for a better deal within regional and national perspectives and evaluates the potential impact of these struggles on economic development in general, and on rural development, in particular. In a most competent way the author has presented the current state of the debate on the subject. He deals exhaustively with the subject of agricultural price policy and argues against the proposition that favourable price-setting for farm products is adequate to alleviate rural poverty. A better way to tackle this problem is to improve the per capita output in the rural sector, since the root cause of the problem is not unfavourable terms of trade but the increasing proportion of land holdings, which are economically not viable. Agricultural price policy is analyzed within the context of class relations, which enables to establish a link between the economic and political demands of the farmers. This analysis leads the author to conclude, that in contrast with the peasants' movements in India, which helped to break up the feudal agrarian set-up, the recent farmers' movements, with a few exceptions, have little revolutionary content. Their leadership has been appropriated by the rich landowners, who have transformed the movements into a lobby for advancing their own interests, within the existing power structure, to the neglect of the poorer peasantry.

scholarly journals Conversations About Death and Dying, End-of-Life Care Plans and Preferences Between Aging Parents and Adult Children

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 417-417
Author(s):  
Hyo Jung Lee ◽  
Jacobbina Jin Wen Ng
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
Adult Children ◽  
End Of Life Care ◽  
Death And Dying ◽  
Family Members ◽  
Life Care ◽  
Joint Decision ◽  
Aging Parents ◽  
Care Plans

Abstract This study aims to investigate whether attitude and perception on late-life death and dying, end-of-life care plans and preferences could be better understood from current values shared between aging parents and their adult children in the multi-cultural city-bound country, Singapore. We are in the process of interviewing 20 aging parent-adult child dyads. Up to date, six semi-structured interviews were completed and transcribed. We performed Content analysis to analyze the transcripts. Preliminary findings showed that both aging parents and adult children rarely discussed this issue, although parents had their own plans or preferences. The major barriers against open conversations about death and dying of aging parents include: the perception of not-yet time to talk about this issue (without knowing when the right time is) and tendency to have conversations about death in tandem with finances, but not death itself. Although specific end-of-life care plans or arrangements were not thought out thoroughly, aging parents expressed a high level of trust and reliance on close family members’ decisions regarding their end-of-life care. They tended to agree on joint decision-making process within family, even though adult children had no or unmatched ideas about their aging parents’ end-of-life wishes. This did not necessarily align with previous findings in Western countries, underscoring individuals’ control over their own death and dying process. Open conversation within family, family-involved advance care planning, or joint decision-making processes may be warranted to promote quality of life and death in older Singaporeans and well-being of their family members of all ages.

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