Exploring the Contemporary Stage and Scripts for the Enactment of Dying Roles: A Narrative Review of the Literature

Abstract

This narrative review explores the literature regarding the drama of dying from several academic perspectives. Three key themes were identified including "The impact of blurred boundaries on roles and transitions," "The orchestration of death and dying through time," and "Contemporary dying and new machinery of control." This review reveals the manner in which tightly scripted dying roles serve the needs of the living to a greater extent than those of the dying, by ensuring the depiction of both dying and death as phenomena which have been brought under the control of the living, thereby countering death anxiety. An incongruence between the actual experience of dying and contemporary dying scripts is also highlighted. The authors argue that this incongruence is hidden from the broader societal audience through the maintenance of a dying role that demands serenity and acceptance, thus downplaying or even hiding the actual end-of-life experiences of the dying themselves.

Reappraising ‘the good death’ for populations in the age of ageing

“…It is hard to construct a model of how to die well from chronic degenerative incapacity, frailty and mental incapacity alongside a prolonged and uncertain illness trajectory. Lowrie, et al 14 works as a mechanism of social control. It constrains, rather than enables, choice and disadvantages those who cannot or do not wish to conform.…”

Uncertain trajectories in old age and implications for families and for palliative and end of life care policy and practice

“…I have drawn on an account of my father's last weeks of life as an illustrative case study of an increasingly common scenario of dying and death in old age (particularly in resource rich countries such as England), which follows on from a prolonged period of increasing frailty and co-morbidities (Lowrie, Ray, Plummer, & Yau, 2018). My account resonates with the increasingly common scenario whereby, for elderly people, there is often no clear defining point of recognising dying or of where the end-of-life phase begins; this is a pressing issue within the policy context of end-of-life care in England.…”

“…Further, these factors obscure the complex and unpredictable realities of dying (Gott, 2014), in particular for what Lowrie et al (2018) refer to as a 'dying underclass'-those with multiple morbidity and unclear illness trajectories who are frequently not recognised as dying. This population of older people often remain invisible within the current paradigms of palliative and end-of-life care (Pollock & Seymour, 2018).…”