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Communication at the End of Life


Edited By Jon F. Nussbaum, Howard Giles and Amber Worthington

Communication is at the heart of any complete understanding of the end of life. While it is true that individuals physically die as a single entity, the process of ending an individual life is located within a complex system of relationships and roles connected and constructed through communicative processes. In this volume, top scholars from numerous disciplines showcase the latest empirical investigations and theoretical advances that focus on communication at the end of life. This multi-contextual approach serves to integrate current findings, expand our theoretical understanding of the end of life, prioritize the significance of competent communication for scholars and practitioners, and provide a solid foundation upon which to build pragmatic interventions to assist individuals at the end of life as well as those who care for and grieve for those who are dying. This book is suitable for undergraduate and graduate courses in Death and Dying, Communication and Aging, Health Communication, Life Span Development, Life Span Communication, Long term care, Palliative care and Social Work.
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Chapter Ten: Hospice Care and Communication



Hospice Care AND Communication


The predominant medical paradigm is the biomedical model whereby health is seen as the absence of disease. Although historically the reductionist biomedical model was effective in combating infectious diseases and pathogens, modern medicine has had to shift its focus to assisting patients who suffer with chronic conditions (Havelka, Lučanin, & Lučanin, 2009). The goal of the biomedical approach to any health issue remains the same, however—to extend life and delay death. Health professionals in modern hospitals are highly trained to cure illness and disease using tools of medicine and technology. However, except for the very few palliative care specialists, clinicians may succeed in extending the length of life to the detriment of quality of life. The predominant biomedical approach has failed in many ways to relieve patients’ suffering with chronic illness—suffering that is experienced on physical, social, emotional, and spiritual levels (e.g., Kaut, 2002). The aim of this chapter is to consider how communication in hospice settings has been used to reinforce the traditional biomedical model or extend beyond it in the delivery of effective hospice care to patients.


In 1977, Georg Engel introduced the “biopsychosocial model of medicine” (or BPS model; Engel, 1977), which criticized the reductionist biomedical model for ← 157 | 158 → its separation of mind and body, privileging the view of the body as machine (for a recent overview,...

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