Recognizing a dying person: Death as a social process

Frail older persons seem to be at high risk of not receiving appropriate end-of-life care. The main reasons for this inadequate situation are anticipated to be, the slow dying processes and difficulties to medically predict nearness of death of frail older persons. Death is not, however, just a physiological phenomenon diagnosed by clinicians. It is also a social process, especially when someone slowly approaches death in long-term care. Therefore, the status of a dying person is negotiated in multiple everyday interactions and communication between older persons, their relatives, and nursing professionals. Successful negotiations may result in adequate recognition of a dying person, whereas lack of negotiations may even result in frail older person’s social death before the physiological one. In this research, death as a social process will be studied by conducting an ethnographical study to give voice to people living, visiting, and working in two long-term care facilities, one in Finland and another in Ireland. Data collection in two countries enables the acknowledgment and comparison of the institutional, societal and cultural differences in attitudes towards old age and dying. Participant observation, individual interviews, and focus group interviews will be conducted on-site to understand how the dying process is socially constructed. The research concentrates on how death as a social process can be empirically studied, comprehensively theorized, and utilized to enable a more dignified life to the growing number of frail older people in our society. The research will contribute to the international death studies, and for its part, add to the agenda of end-of-life care research and old age policies. This research will inform society on the current conditions of dying in long-term care facilities and advance older persons’ dignity and well-being at the end of their life. Research will help national and international palliative care communities to have a clearer voice in advocating appropriate end-of-life care as a human right. In addition, new knowledge on social death will help societies to establish new policies and practices to avoid social discrimination of individuals and marginal groups.