Search

The present article is based on an ethnographic research project exploring the constitution and reproduction of exchange relationships between residents and caregivers in Swiss nursing homes and elaborating on their significance within end-of-life trajectories. The results show that despite scarce personnel, time and cost resources in old-age long-term care, exchange relationships in the sense of non-liquidating transactions are of major significance both in daily interactions and in the context of acute dying in the nursing home. Residents as well as caregivers invest in relationships that build on an informal ‘giving and giving back’. Invested goods or services are manifold and often immaterial, both on the caregivers’ and on the residents’ side. The main informal investments are: 1) permitting affection and emotional involvement 2) sharing personal information, and 3) offering extra-time. The paper demonstrates how actors exchange these goods to establish an informal dimension in their care relationships and how this dimension may influence end-of-life practices in the nursing home. Focusing on informal parts in exchange relationships allows considering care relationships from a theoretical perspective that has gained little attention so far, both in anthropological exchange theory and in disciplines concerned with care relationships.

This special issue on migrant dying and death showcases the work of a number of authors exploring a newly emerging field of study within European research and policy contexts. Indeed before the 200...

This paper presents ethnographic data on a migrant-specific nursing home ward in Switzerland. It shows that the structurally pre-defined segregation of residents sharing a common characteristic affects care practices along three dimensions: performances of sameness/otherness, informalisation of relationships and language/understanding. Yet, ‘death work’ showed little difference to non-segregated wards. However, relatives’ practices in dying trajectories were less congruent with nursing home ‘doing death’, and collisions may evolve. The need for negotiations associated with running a segregated ward seems to elicit enhanced institutional reflexivity with potential to increase the ability of institutions to provide diversity-sensitive services to all residents. KEYWORDS: Nursing home, end-of-life care, doing death, migration, diversity, ethnography

A recurring theme of the public discourse on immigration in Europe today is that migrants are primarily young people, of working age. Against this short-sighted view, the main contribution of this book is to propose that processes of ageing and dying constitute a critical juncture in the settlement of migrant-origin communities, precipitating novel intercultural negotiations in societies characterized by post-migration diversity. Bringing together seven studies reflecting different institutional and (trans)national contexts, the chapters fall under two main themes. A key issue when facing death is the organization of adequate care for the dying, which may be a challenging task in pluralized settings involving both migrant patients and migrant carers. Facing the end of life furthermore involves the practice of rituals in order to make sense of the transition from life to death. Whether through care or ritual, the studies presented here show that the need to reconcile different cultural, religious and administrative norms relating to death is infused with ontological insecurities which may result in new or renewed interrogations of identities and belongings. This book was originally published as a special issue of the Journal of Intercultural Studies.

This paper focuses on the normative notion of ‘good death’, its practical relevance as a frame of reference for ‘death work’ procedures in institutional elder care in Switzerland and the ways in which it may be challenged within migrant ‘dying trajectories’. In contemporary palliative care, the concept of ‘good death’ focuses on the ideal of an autonomous dying person, cared for under a specialised biomedical authority. Transferred to the nursing home context, characterised by long-term basic care for the very old under conditions of scarce resources, the notion of ‘good death’ is broken down into ready-to-use, pragmatic elements of daily routines. At the same time, nursing homes are increasingly confronted with socially and culturally diversified populations. Based on ethnographic findings, we give insight into current practices of institutional ‘death work’ and tensions arising between contradicting notions of a ‘good death’, by referring to decision-making, life-prolonging measures, notions on food/feeding and the administration of sedative painkillers.