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Applying the phenomenology of grief:An autoethnographic study
No full textIn contrast to normative views on grief, phenomenological descriptions of grief aim to provide a comprehensive picture of the lived experience, providing space for both uniqueness and universality. However, it is unclear how application of phenomenological descriptions contributes to bereavement care. The aim of the current study was to evaluate the clinical applicability of phenomenological descriptions of grief through autoethnographic exploration. The lived experience of the first author’s grief following the death of his husband illustrates two strands of time that increasingly desynchronize: the alienated reality of everyday life and the lingering presence-in-absence of the deceased. Processing grief involved a fundamental reorganization of his identity through representation of and identification with the deceased. Clinical applications of phenomenological descriptions include diagnosing existential manifestations of Prolonged Grief Disorder, cultural aspects, and psychoeducation for the bereaved and for those close to them
The SEE ME-trainingstoolkit:From shortages to talents in elderly care
No full textZorg voor ouderen is meestal gericht op medische en fysieke aspecten, maar ouder worden brengt ook sociale, culturele en spirituele veranderingen met zich mee. Een breed perspectief op ouderenzorg is noodzakelijk, met aandacht voor de talenten en behoeften van ouderen. Het SEE ME-project ontwikkelde een trainingstoolkit die zorgverleners helpt om de persoon achter de oudere te ZIEN
Perspectives on the essential skills of healthcare decision making in children and adolescents with intellectual disability
No full textBackground: Involvement in healthcare decisions is associated with better health outcomes for patients. For children and adolescents with intellectual disability, parents and healthcare professionals need to balance listening to a child’s wishes with the responsibility of keeping them safe. However, there is a scarcity of literature evaluating how to effectively involve them in decision making. In this context, we review the concept of health literacy, focusing on the skills of healthcare decision making for children and adolescents with intellectual disability. Methods: We describe the concept of health literacy and models explaining shared decision making (individuals and healthcare professionals collaborate in decision making process) and supported decision making (when a trusted person supports the individual to collaborate with the healthcare professional in the decision-making process), and a rapid review of the literature evaluating their efficacy. We discuss healthcare decision making for children and adolescents with intellectual disability in the context of relevant recommendations from the recent Disability Royal Commission into Violence, Abuse, Neglect, and Exploitation of People with Disability in Australia. Results: Health literacy skills enable individuals to access, understand, appraise, remember and use health information and services. Shared decision making has been described for children with chronic conditions and supported decision making for adults with intellectual disability. Decision-making contributes to how individuals appraise and use healthcare. The rapid review found very limited evidence of outcomes where children and adolescents with intellectual disability have been supported to contribute to their healthcare decisions. Recommendations from the Disability Royal Commission highlight current needs for greater efforts to support and build the capacity of individuals with disability to be involved in the decisions that affect their life, including healthcare decision making. Conclusions: Existing rights frameworks and healthcare standards confirm the importance of providing all people with the opportunities to learn and practise health literacy skills including decision making. There is little literature examining interventions for healthcare decision making for children with intellectual disability. Childhood is a critical time for the development of skills and autonomy. Evidence for how children and adolescents with intellectual disability can learn and practice healthcare decision-making skills in preparation for adulthood is needed to reduce inequities in their autonomy
The frequency and types of resident relocations in Dutch nursing homes::a nationwide cohort study of electronic health record data
No full textPURPOSE: One third of Dutch nursing home residents relocated at least once during length of stay. Roughly 75 percent were individual relocations and the other 25 percent concerned group relocations. The average yearly number of individual relocations was about 3 times as high in the first 4 months after admission compared with later periods.METHODS: We performed an historical cohort study of pseudonymized registration data from a Dutch electronic health record. We selected data from nursing home residents aged 65 years and older who stayed on a ward for physical impairment or dementia and passed away between 2015 and 2019. Our study sample consisted of 26,060 long-stay nursing home residents from 67 nursing homes in the Netherlands. We examined the number of relocations, trends over time, individual versus group relocations and relocation destinations.RESULTS: We found that approximately one-third of long-stay nursing home residents relocated at least once with an average of 36 relocations per 100 residents per year. Roughly, 75 percent of relocations were individual relocations and 25 percent concerned group relocations. In the first 4 months after admission, the average number of individual relocations per 100 resident per year was about 3 times as often compared to later periods after admission. Most individual relocations were within the same type of care.CONCLUSION: A considerable proportion of Dutch long-stay nursing home residents experienced one or more relocations. Relocations for individual reasons occurred mostly in the first months after admission. Further investigation is warranted to explore which factors lead to relocations.</p
Needling the Public/Private Divide:How to Stitch a Common World to Care For
No full textTaking its starting point in the influential work of care ethicist Joan Tronto, this article critically examines the public/private divide within liberal political theory. This distinction not only conceals gendered power hierarchies in private life but also obscures mutual interdependencies from public view. Utilizing Palestinian embroidery as a companion to unlearn this division, the analysis explores three pivotal aspects of the craft. In the production process, the role of women, the voice of the embroiderers, and the treatment of materials and fabric emerge as vital concerns and active sites for change. Regarding curation, public exhibitions emerge as a means of preserving Palestinian cultural heritage but also contribute to the commodification of embroidered goods, challenging the deeply rooted geographical context of the craft. Concerning solidarity, the article elaborates the distinction between the private purchases of embroidered items and collective public action. A care ethics perspective underscores the interconnectedness of the private and public within a shared world. Embroidery becomes a metaphor for weaving a just and caring society, overcoming divisive boundaries
Responding to life itself: a proposed understanding of domain, goal and interventions for chaplaincy in a secular age
No full textIn this article, we present a model of chaplaincy in a secular age which includes, in one coherent system: domain, goal and an intervention pathway. The domain is presented as the process of “responding to life itself”. A corresponding goal of chaplaincy is considered in the context of “existential well-being”. This goal can be achieved through the proposed “The Ritual Bath Model” based on these new defined concepts
Dutch Therapists’ Professional Autonomy and Moral Agency After the Marketization and Bureaucratization of Mental Healthcare: Between Impracticalities and Impossibilities
No full textOver the last decades, western mental healthcare has increasingly been governed by market and bureaucratic principles. As a consequence, therapists are faced with conflicting demands and decreased autonomy. This study examines how they cope and whether their strategies suffice. Drawing on the direct experience of therapists through interviews, we demonstrate that psychologists have become quite skilled at balancing and navigating bureaucratic and market demands that were at odds with professionalism. However, when they were structurally faced with bureaucratic and market demands that were already irreconcilable with each other, these skills fell short. Trying to meet all requirements took up so much of their resources that sometimes, professional reasoning and agency disappeared altogether. In some cases, this led to detachment, burnout, and patient neglect. Our findings suggest that the public interest in having a well-functioning mental healthcare system requires more room for professional autonomy
Phenomenologies of aging: an introduction
No full textThis introduction to the special issue on the phenomenologies of aging explores the relative philosophical neglect of aging as a distinct topic. It critiques the naturalistic reduction of aging, which frames it primarily as decline, and examines the ethico-political implications of this perspective. In order to contextualize the possibilities of forming a new sustained philosophical debate on aging, we describe the earlier advances made in the field by notably Simone de Beauvoir’s work and the developments in critical gerontology, aging studies and the anthropology of aging and the life course. The introduction then programmatically states the need for a revitalized philosophical discourse on aging, suggesting that phenomenological inquiry can reveal the ontological complexities of intergenerational relationships and shared existence. Finally, we briefly introduce the contributions to this special issue by drawing forward the themes of corporeal temporality, generationality and the problem of sharing the world across generations
Who am I now? A scoping review on identity changes in post-stroke aphasia.
No full textPurposeProvide an overview of existing knowledge on the concept of identity and identity changes and formation of people with language disorders of aphasia. To date, there has been limited exploration of identity changes of people with aphasia as communication difficulties have been perceived as a barrier to participation by researchers.MethodA scoping review was performed utilizing Arksey and O’Malley’s methodological framework. The databases PubMed, PsycINFO, CINAHL, and Cochrane Library were searched, and both descriptive and thematic analysis were conducted.ResultsThe search yielded 492 records, of which 20 studies were included. The analysis revealed various theories and definitions of identity. There was limited uniformity in defining identity in the publications. A recurrent theme was, that identity is a social construct and storytelling is the vehicle through which it is navigated. Language and communication are essential in this process.ConclusionsThe model of Narrative Identity might be useful to clarify identity and its dynamic nature, since it integrates various theories of identity referred to in the publications. Different aspects of identity should be considered in future research to add to existing knowledge of identity changes and formation in people with aphasia and to tailor future interventions if necessary