Monday, April 22, 2013

singara889: Dying at home: the normalization and silencing of ...

Dr. Lisa Seto Nielsen, an Assistant Professor of the School of Nursing at York University, spoke at the Women?s Mental Health and Well-Being Speaker Series held at York University. Using the lessons she learnt from her research in palliative care, home care, death, dying, and immigrant health she found that in Chinese immigrant families caring for a family member with terminal cancer, how women took up the caregiving role was potentially different from men, but it was highly contextual. Most importantly, the pragmatics of dying at home took priority over adherence to essentialized cultural ?beliefs? such that the social and material conditions of participants and the enormity of dealing with death and dying provided more insights into patient?s experiences of palliative home care. Her presentation was informed by her doctoral dissertation which explored the palliative home care experiences of Chinese immigrants with advanced cancer in the Greater Toronto area. Even though her dissertation did not focus solely on gender, gendered aspect regarding dying at home did emerge.

Using postcolonial theory, a critical perspective of culture was adopted that viewed culture as dynamic and fluid, rather than a set of static beliefs. Of particular interest was the work of Bhaba (1994/2004) and the ?Third space? as a space for cultural transformation and cultural hybridity. A postcolonial perspective provided an critical analysis that highlighted how different roles and the positioning of the other created vulnerabilities for both men and women caregivers.

? ? getting up, washing, dressing and cooking, a little cooking. (I: Does your family help you?) Oh, when they come home from work in the evening, they help a little because they have to work and don?t have a lot of time?. even if there?s pain, I still have to get up.? (CR4, translated). ?Those were the words of one of the study participants who was describing the impact of being a terminal cancer patient, wife, and caregiver. Using lessons learned from her research, Dr. Seto Nielsen elaborated on how caregiving roles are still mostly carried out by women but this was due in part because immigrant family members could not take time off work because of lack of job security. Dr. Seto Nielsen also described how this issue is complex and should not be looked at solely from a gender perspective but also to include social and material conditions immigrant women are living in.

She spoke of how some men still categorized doing groceries as women?s work and that one male caregiver in her study spoke comfortably about doing meal preparation and household chores, but not personal care. As such, a key aspect of whether Chinese immigrant women would move from home to hospice is whether they were able to provide their own personal care. The female care recipients indicated that they would consider being admitted to a hospice or palliative unit when they could no longer bathe or toilet themselves. Thus male care recipients were able to stay at home to die because they could reject personal care from outside providers as they could depend on their wives to provide that care. In doing so, the male care recipients could avoid the vulnerability of exposing their bodies to strangers, but inadvertently became dependent on their wives for their care. She concluded her lecture by answering questions from the audience and offering some helpful discussion on social and spatial complexity of palliative home care.

Source: http://health.blog.yorku.ca/2013/04/19/dying-at-home-the-normalization-and-silencing-of-womens-caregiving-roles-in-palliative-care/

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Source: http://singara889.blogspot.com/2013/04/dying-at-home-normalization-and.html

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