Narratives surrounding end-of-life care in an institutional setting: a case study of an old age home on the southwest coast of Sri Lanka
Sae Nakamura (National Museum of Ethnology)
Paper short abstract:
Focusing on the narratives of staffs working at an institution in Sri Lanka, this paper explores how they strive to define their interaction with dying residents, in an ethical way. While analyzing its socio-cultural contexts, it also tries to rethink our ethical assumptions on end-of-life care.
Paper long abstract:
While majority of older Sri Lankans still live with their children, roughly 200 old age homes are providing social safety nets for those who lack familial support. In this presentation, through a case study of one institution on southwest coast of Sri Lanka, I explore how the staffs practice end of life care for the residents, and how they strive to define their relation with dying residents, in an ethical way. Ageing and, especially dying in institutions without support from one's family is a painful experience for both the residents and staffs. The staffs expressed 'kalakirima' or despair with life while caring for the dying residents, and further went on to say that their lives were "not worth living." Such response at first gave me a negative impression that they were looking down upon the suffering of residents without any moral imagination. However, a careful look at the staffs' narratives compels us to take a different perspective. Staffs were emotionally involved in the suffering of residents because they themselves were subject to similar kinds of suffering; suffering due to dying, and to the contingency of life. They practices as good care as they could because they would be treated in the same way if they were to enter such institutions in the future. While analyzing how socio-cultural values shape such narratives, I try to find common ground between the staffs' ethics and ours, and to rethink our familiar ethical assumptions surrounding the end of life care.
Politics of life and death and the practice of caring