Janicke Andersson

A discourse of silence : professional carers reasoning about death and dying in nursing homes

ABSTRACT Nursing homes are a setting in which death and dying is common. How death and dying is articulated and the actions that take place in a nursing home constitute a discourse that guides the staff in their work. The aim of this study was to explore the discourse of death and dying in nursing homes from the perspective and understanding of the staff. The study draws on Foucaults discourse analysis. Data are from five focus-group discussions held with 28 staff of four different nursing homes in Sweden. The findings show that the discourse had three characteristics: (a) dying was silent and silenced, (b) emotions were pushed into the background, and (c) attentiveness to death arose after the moment of the elderly persons death. The structure of the discourse was characterised by a movement between two positions, avoiding and confronting death, the main focus being on avoidance. The articulation and practices of silence highlight a need to regard dying as a process that requires attention. One way to ensure appropriate attention could be to instil the philosophy of palliative care in nursing homes, including training and support for the staff in their work. The study demonstrates that nursing-home staff need more knowledge and support to enable them to feel that they do a good job.

Governmentality as a Genealogical Toolbox in Historical Analysis.

The aim of this article is to show how governmentality may be used to analyze historical events and discourses, and how this historical analysis can be used as a perspective to problematize contemporary discourses. The example used in this article is from my research on life-extension handbooks published in Sweden 1700-1930, and by this I stress handbooks as a noninstitutional educative arena. I am advocating governmentality as a toolbox to analyze how various forms of power operate and how different levels of power integrate and conflict in this arena. In doing so, I recommend governmentality as a critical and empirical approach to analyze various forms of power relations and governance. I exemplify the flexibility of the toolbox by using genealogy and governmentality in combination with linguistic tools from Critical Discourse Analysis and Norman Fairclough. In this way, I want to stress the critical gaze and the importance of situation in time and space by arguing for greater respect for the variants of the concepts of genealogy and governmentality.