Death and Dying: An Intergroup Communication Approach

Author(s):  
Chien-Yu Chen

Death is inevitable: We witness the death of others and eventually face our own. However, people in general view death as taboo and tend to avoid discussing their own or others’ mortality. A cultural shift has been taking place in the developed world so that dying has become an increasingly medicalized process, where death is viewed as something to be stopped or delayed instead of accepted as part of a natural life cycle. As family members are less responsible for the dying process, communication about death and dying becomes a sensitive topic and is often ignored or avoided. Lack of this meaningful communication can lead to stereotypes about the dying person, conflict among family members, and fear of death. Talking about death and dying, if done correctly, can have a positive impact on health-care delivery and the bereavement process. Incorporating knowledge of intergroup communication with a lifespan approach can deepen communication effectiveness about death and dying. People’s group identities can play important roles in the conversation about death and dying. As children and adolescents, people can encounter the death of older family members (e.g., grandparents) and the communication here can be intergenerational. Due to age differences, younger adults may feel uncomfortable to react to older adults’ painful disclosure of death and the bereavement process. During adulthood, people deal with the death uncertainty for themselves and their loved ones. The communication in this period can be intergenerational and inter-occupational, especially when there are third parties involved (e.g., medical providers or legal authorities). Death and dying communication tend to happen mostly, albeit not always, during the later lifespan, as time of death approaches, among older adults, family members, and medical providers. These conversations include advanced care planning (i.e., arrangements and plans about the dying process and after death), medical decision making, palliative care, and final talks. Increasing the awareness of death and dying can help to normalize the dying process.

2020 ◽  
Author(s):  
Jie Xiong ◽  
Meiyun Zuo

BACKGROUND The mobile platform of medical and senior care (MPMSC) is the platform that provides users with one-stop medical and senior care services through mobile devices. The MPMSC presents users—namely, older adults and their family members—with multiple benefits. However, we lack sufficient understanding of the factors motivating users to adopt such new platform. OBJECTIVE The aim of this study is to understand the factors that drive older adults and their family members to adopt MPMSC. METHODS Focusing on the unique characteristics of MPMSC, this study develops a research model based on perceived value theory to understand the benefit and sacrifice factors influencing user adoption of the MPMSC. This study uses Partial Least Squares techniques to analyze data collected from a sample of 215 potential users to verify its hypotheses. RESULTS The results demonstrate that perceived value is a predictor in explaining users’ intention to adopt MPMSC (β=0.701, P<0.001). In terms of benefit factors, perceived service usefulness (β=0.325, P<0.001) has a positive impact on perceived value, and perceived service complementarity has a positive impact on perceived value too (β=0.179, P=0.006). In terms of sacrifice factors, perceived service fee has a negative impact on perceived value (β=-0.415, P<0.001), while legal concerns have a negative impact on intention to adopt MPMSC (β=-0.112, P=0.02). The research model explained 54.7% of the variance in intention to adopt MPMSC and 58.2% of the variance in perceived value. CONCLUSIONS Based on the perceived value theory, we proposed and tested the MPMSC adoption model. The findings can enhance our understanding of the factors influencing the adoption of MPMSC, and help practitioners successfully implement MPMSC by attracting more users.


2014 ◽  
Vol 10 (3) ◽  
pp. 263-271
Author(s):  
Pairote Wilainuch

This article explores communicative practices surrounding how nurses, patients and family members engage when talking about death and dying, based on study conducted in a province in northern Thailand. Data were collected from three environments: a district hospital (nine cases), district public health centres (four cases), and in patients’ homes (27 cases). Fourteen nurses, 40 patients and 24 family members gave written consent for participation. Direct observation and in-depth interviews were used for supplementary data collection, and 40 counselling sessions were recorded on video. The raw data were analysed using Conversation Analysis. The study found that Thai counselling is asymmetrical. Nurses initiated the topic of death by referring to the death of a third person – a dead patient – with the use of clues and via list-construction. As most Thai people are oriented to Buddhism, religious support is selected for discussing this sensitive topic, and nurses also use Buddhism and list-construction to help their clients confront uncertain futures. However, Buddhism is not brought into discussion on its own, but combined with other techniques such as the use of euphemisms or concern and care for others.


Author(s):  
Jessica Flanigan

Though rights of self-medication needn’t change medical decision-making for most patients, rights of self-medication have the potential to transform other aspects of healthcare as it is currently practiced. For example, if public officials respected patient’s authority to make medical decisions without authorization from a regulator or a physician, then they should also respect patient’s authority to choose to use unauthorized medical devices and medical providers. And many of the same reasons in favor of rights of self-medication and against prohibitive regulations are also reasons to support patient’s rights to access information about pharmaceuticals, including pharmaceutical advertisements. Rights of self-medication may also call for revisions to existing standards of product liability and prompt officials to rethink justifications for the public provision of healthcare.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 417-417
Author(s):  
Hyo Jung Lee ◽  
Jacobbina Jin Wen Ng

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.


Author(s):  
Aram Cho ◽  
Chiyoung Cha

People adopt health promotion behaviors to promote their health as they interact within the environment. The purpose of this study was to examine factors influencing health promotion behaviors among older adults caring for family members with dementia. For this cross-sectional study, data from 135 older adults who were the main caregivers were collected at an outpatient clinic at a university hospital in the capital city of South Korea between September and October in 2020. Sociodemographic characteristics, caregiver-related characteristics, dementia knowledge, fear of dementia, and health promotion behaviors were measured. Univariate analysis revealed that the level of health promotion behaviors differed by age, sex, educational level, monthly income, relationship with the family member with dementia, and cohabitation with family members with dementia. In the multivariate analysis, a hierarchical multiple regression model explained 33.9% of the variance. Sex, duration of caregiving, use of long-term care service, and fear of dementia predicted health promotion behavior. A strategic tailored care plan for target population is needed to improve the health promotion behavior of older adults caring for family members with dementia.


2020 ◽  
pp. 104973152098235
Author(s):  
Kuei-Min Chen ◽  
Hui-Fen Hsu ◽  
Li-Yen Yang ◽  
Chiang-Ching Chang ◽  
Yu-Ming Chen ◽  
...  

Purpose: This study aimed to test the effectiveness of High-Need Community-Dwelling Older Adults Care Delivery Model (HCOACDM) in Taiwan. Methods: A cluster randomized controlled trial with repeated measures design was conducted in eight community care centers, involving 145 high-need older adults who were assigned to the intervention group or comparison group. The HCOACDM was provided over 6 months. Functional ability, quality of life, depressive symptoms, and health care and social service utilizations were measured at baseline, at 3 months, and 6 months into the intervention. The participants’ satisfaction was measured at the end of 6-month intervention. Results: Positive effects were shown on all variables in the intervention group at both the 3-month and 6-month intervals (all p < .05). The intervention group had a higher satisfaction with care delivery than the comparison group ( p < .05). Discussion: The promising findings supported a long-term implementation of the HCOACDM as applicable and beneficial.


2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Satoe Okabayashi ◽  
Takashi Kawamura ◽  
Hisashi Noma ◽  
Kenji Wakai ◽  
Masahiko Ando ◽  
...  

Abstract Background Predicting adverse health events and implementing preventative measures are a necessary challenge. It is important for healthcare planners and policymakers to allocate the limited resource to high-risk persons. Prediction is also important for older individuals, their family members, and clinicians to prepare mentally and financially. The aim of this study is to develop a prediction model for within 11-year dependent status requiring long-term nursing care or death in older adults for each sex. Methods We carried out age-specified cohort study of community dwellers in Nisshin City, Japan. The older adults aged 64 years who underwent medical check-up between 1996 and 2005 were included in the study. The primary outcome was the incidence of the psychophysically dependent status or death or by the end of the year of age 75 years. Univariable logistic regression analyses were performed to assess the associations between candidate predictors and the outcome. Using the variables with p-values less than 0.1, multivariable logistic regression analyses were then performed with backward stepwise elimination to determine the final predictors for the model. Results Of the 1525 female participants at baseline, 105 had an incidence of the study outcome. The final prediction model consisted of 15 variables, and the c-statistics for predicting the outcome was 0.763 (95% confidence interval [CI] 0.714–0.813). Of the 1548 male participants at baseline, 211 had incidence of the study outcome. The final prediction model consisted of 16 variables, and the c-statistics for predicting the outcome was 0.735 (95% CI 0.699–0.771). Conclusions We developed a prediction model for older adults to forecast 11-year incidence of dependent status requiring nursing care or death in each sex. The predictability was fair, but we could not evaluate the external validity of this model. It could be of some help for healthcare planners, policy makers, clinicians, older individuals, and their family members to weigh the priority of support.


Author(s):  
Hongsoo Kim ◽  
Seyune Lee ◽  
Young-Il Jung ◽  
Yun-Chul Hong

Only a few studies have examined the impacts of environmental exposure on frailty. This study investigated the association between phthalates and frailty among community-dwelling older adults. The Korean Elderly Environmental Panel II (KEEP II) study is a repeated panel data study of 800 community-dwelling older adults in South Korea. Frailty was measured with five items defined by Fried and colleagues. Environmental pollutants in the form of two types of metabolites for Di-ethylhexyl phthalate (DEHPs)—Mono (2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) and Mono (2-ethyl-5-oxohexyl) phthalate (MEOHP)—were obtained from urine specimens. Analyses were performed using repeated linear mixed models. The concentration levels of both MEOHP and MEHHP in urine were significantly higher in the pre-frail or frail group than its counterparts. While adjusting for covariates, MEOHP level was positively associated with the likelihood of being pre-frail or frail in both males and females; the concentration level of MEHHP also had a positive impact on the likelihood of being pre-frail or frail in females. The DEHP metabolite concentrations were significantly lower among adults with daily fruit consumption in both males and females. DEHPs, measured by metabolite concentrations, may increase the risk of frailty among older men and women; further studies are necessary. The preventive effects of nutrition on DEHP risk should also be further investigated.


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