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Communication at the End of Life

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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 Three: Benchmarking the End of Life in Long-Term Care

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CHAPTER THREE

Benchmarking THE End OF Life IN Long-Term Care

JABER F. GUBRIUM

Oddly enough, the first sentence of Stephen King’s (1989) thriller The Dark Half is especially pertinent to the subject matter of this chapter. Not because the end of life is thrilling, but because what King says about life at the beginning of the book is to the point. Making a distinction, King writes: “People’s lives—their real lives, as opposed to their simple physical existences—begin at different times” (p. 3). If asked, King would probably agree that, likewise, the end of life concludes at different times. This would suggest that an individual can have many lives, each or all of which can begin and end at different times. This chapter addresses the communicative contours of the distinction in long-term care, part of a larger concern about the narrative organization of aging and dying (see Kenyon, Bohlmeijer, & Randall, 2011).

The distinction between life and living is commonplace in the corpus of empirical material drawn upon for this chapter. It was often mentioned, for example, in interviews with Helen, an 86-year-old nursing home resident who lamented, “I’ll go on living, but my life is over.”1 As Helen spoke about life, I came to know what many of us informally recognize, that the life is as experientially real—more real perhaps if we are to believe King—than concrete bearings, such as the bodies that undergird it. The life...

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