Speaking of Life: Horizons of Meaning for Nursing Home Residents

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Transaction Publishers - Medical - 197 pages
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In one of his earlier books, "Living and Dying at Murray Manor, "the author availed himself of ethnographic techniques to explore the experience of life in a nursing home. This volume extends that exploration to an assessment of the quality of long-term care provided to residents of nursing homes, and of the resulting quality of lives.

Taking a bottom-up rather than a top-down view, Gubrium presents these qualities in the voices of "the residents themselves, in collaboration with the interviewer. Because many residents have been "long stayers" in nursing facilities, they are confronted with matters of home, family, life history, dependence, isolation, self-worth, even destiny in ways that would be irrelevant in shorter hospital stays. Such matters present significant narrative contexts for conveying the subjective meaning of the quality assurance that has become a leading goal of health care delivery.

Two key concepts are employed to organize and interpret the narratives: narrative linkages and horizons of meaning. Narrative linkages refer to the experiences, inside or outside the nursing home, that are drawn upon to communicate subjective meaning. A horizon is the pattern of narrative linkages a resident conveys in speaking of life. The approach and narrative material provide conceptual, methodological, and personal lessons. The issues raised by Gubrium's book are informed by a view of residents as biographically active and by the expectation of narrative diversity. He relates thereby a personal encounter with storytellers who offer the listener the broad range of orientations and special circumstances that continue to make meaning even at the very end of life.

 

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Contents

Faces without Stories?
1
RETRIEVED KNOWLEDGE
3
A NARRATIVE TURN
6
BIOGRAPHICALLY ACTIVE RESPONDENTS
8
HORIZONS AND THEIR NARRATIVE LINKAGES
9
THE STUDY AND THE RESIDENTS
10
THE INTERVIEWS
13
ORIENTATIONS
17
Travelers
103
JAKE BELLOWS
104
PETER RINEHART
110
Sisters
119
LULA BURTON
120
LILY ROBINSON
124
Spouses
133
JANE AND TOM MALINGER
134

Worried to Death
19
RITA VANDENBERG
20
REBECCA BOURDEAU
25
ROLAND SNYDER
30
Making a New Home
37
MARTHA GILBERT
38
JANE NESBIT
43
RUBY COPLIN
48
Its Come to This
53
ALICE STERN
58
Lovin the Lord
69
JULIA McCALL
70
MARY CARTER
76
The Vigilant
87
BEA LINDSTROM
88
BETTY RANDOLPH
94
SPECIAL CIRCUMSTANCES
101
SUE AND DON HUGHES
140
Disabled
151
GRACE WHEELER
152
OPAL PETERS
156
CELIA TURNER
161
Knowledgeable
165
THE FIRST INTERVIEW
166
THE SECOND INTERVIEW
172
Lessons
177
CONCEPTUAL LESSONS
178
METHODOLOGICAL LESSONS
180
PERSONAL LESSONS
187
Appendix
189
References
191
Index
195
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