Experience of the moment of death at home

Abstract

The aim was to enquire qualitatively into the phenomenon of the moment of death at home as experienced by the lay carer. Using a purposeful sampling strategy, rural and urban families were identified in the mid-west of Ireland. Semi-structured interviews were conducted with the main carer 2 to 21 days (average 10 days) after the death. The proximity of the interviews to the death was a unique aspect of the study. Twenty-two families were recruited with 10 completing the interviews which were analysed using a framework approach of grounded theory. The first of three major themes describes the experience of the moment of death with particular reference to breathing and mystery. The second theme of relationship encompasses the characteristics of the carer, gender, humour, and the patient's personality. Finally, the role of the professional as guide is explored. This is the experience of the moment of death as recounted by 10 families. Our findings bring the deathbed scene to our clinical and conceptual attention. The painful, mysterious, and intimate reality of dying needs to be given its place in the curriculum of medical training. It already has its place in the community we serve.

The “Moment of Death”

“…More recently, Donnelly et al (2005) have drawn attention to the continuing importance of dying moments for family carers in relation to a study of the home deaths of patients who had been referred to a Palliative Care Service in the mid-west of Ireland. The findings from this study reflect a palliative care setting and cultural context in which traditional and religious beliefs and practices still play significant roles.…”

Informal caring networks for people at end of life: building social capital in Australian communities

“…A number of other authors emphasise the importance of a refocus from individual to community capacity building and community development for EoLC, in particular Donnelly et al (2006), Kellehear (2005) and Thomas et al (2010). Current Australian policy asks palliative care services to move towards implementing the National Strategic Plan that foregrounds a health promoting approach to palliative care (Palliative Care Australia, 2010), and takes up the concepts of community capacity-building and community development.…”

“…Over the past ten years, a wide range of research has described the individual experiences and needs of carers and caring at home at the end of life (Donnelly, Michael & Donnelly, 2006;O'Brien & Jack, 2010;Thomas et al, 2010;Weibull, Olsen & Neergaard, 2008). There is now a large body of evidence documenting the burden on family members providing EoLC at home.…”

“…Currow et al (2011) found that 75% of people who have cared for someone who is dying would indeed do it again; this finding was stable across all age groups. Positive aspects of caring at EoL include an increase in personal satisfaction and commitment (Donnelly et al, 2006), and caring as an expression of love and increased intimacy (Aranda & Hayman-White, 2001;Horsfall, Leonard, Noonan & Rosenberg, 2013;PCA, 2004). In a comprehensive, two-part review of both quantitative and qualitative research literature into home-based family caregiving (1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008), loneliness, social isolation and dysfunction were identified as prevalent burdens amongst carers, whilst the essential role of the family caregiver was strongly acknowledged.…”

Diversidade de anfíbios anuros e lagartos de serapilheira em uma paisagem fragmentada de Ribeirão Grande, São Paulo

“…Estudos considerando os efeitos sinergéticos -efeitos da integração de elementos que dão como resultado algo maior que a simples soma desses elementos -entre perda e configuração de habitat na manutenção das espécies em regiões de florestas tropicais ainda são escassos para os neotrópicos FREIRE, 2001;DEVELEY;BELL;DONNELLY,2006), e não há consenso em relação à influencia desses fatores sobre a comunidade de lagartos (SMITH et al, 1996;BURBRINK;PHILLIPS;HESKE, 1998;MAISONNEUVE;RIOUX, 2001;DRISCOLL, 2004;BELL;DONNELLY, 2006…”