The liminality of palliative care

Abstract

Introduction: This paper discusses the application of the anthropological concept of liminality to narratives of New Zealanders living in the community with life threatening conditions, both malignant and non-malignant. Method: This qualitative research aimed to explore the ways in which people diagnosed with life-threatening conditions managed their life world. Using a narrative approach, 13 participants, eight spousal caregivers, three adult children, three specialists, one general practitioner and one psychotherapist were interviewed. Analysis was thematic and interpretive within a phenomenological framework. Conclusion: Receiving a diagnosis with a poor prognosis heralded significant life changes for patients and their families and precipitated a transition from an identity as a productive member of society and community participant to that of patient living with an uncertain future. Conceptualising end of life care in terms of liminality offers a powerful framework for understanding the experiences and challenges faced by people with life threatening conditions and their families.

Liminality in Pediatric Palliative Care

“…that is [ultimately] a change in being'' 2(p97) The application of the anthropological notion of liminality has recently been made in adult palliative care. 3 Observant clinicians will agree with those who claim:…”

“…Similarly, attention to the patient's or family's narrative is also important. 3 Clinicians need to be aware of the particular place in a patient's story in which they encounter him or her. Is it a preliminal place or time-just entering into a clinical encounter, establishing a relationship, and prehospitalization?…”

“…Their needs will be different from those characteristic of the liminal phase-but they are no less important in addressing. 3,14,15…”

Moving on: Factors associated with caregivers’ bereavement adjustment using a random population-based face-to-face survey

“…4,18 Spousal caregivers may be the most vulnerable to cascading losses in bereavement, simultaneously losing their roles as caregiver and spouse, as well as longstanding routines and patterns of communicating. [51][52][53] There is also a higher likelihood that other lifestyle factors will be affected: household income, the ability to keep their home and the dynamics of supporting networks. Additionally, if disordered attachment underlies prolonged grief as many have proposed, it is in our closest and most emotionally dependent relationships with others that vulnerabilities in attachment come to the fore.…”

Ageing in extra-care housing: preparation, persistence and self-management at the boundary between the third and fourth age

“…Researchers have explored several ways in which people may experience liminality as they age. Here, focus has been placed on older people's experiences of the unsettled status and identity resulting from transitions into residential or nursing homes (Diamond, 1992; Frank, 2002) or into hospitals or hospices (Froggatt, 1997; Hirst, 2002; McKechnie et al ., 2011). Indeed, care environments may increase vulnerability and other features associated with the fourth age rather than functioning as a response to them (Grenier et al ., 2017).…”