Livet nära döden : situationer, status och social solidaritet vid vård i livets slutskede

Sammanfattning: Palliative home care is largely intended for patients diagnosed as having terminal cancer. The purpose of the care is to alleviate the symptoms and improve the patient’s well-being as life comes to a close. A further objective is to help the patient to die with as much dignity and grace as possible.The aim of this dissertation is to show how palliative home care is shaped, reshaped and linked together through the interactions of the care-related actors, and also to examine how people registered within palliative home care are construed as individuals and patients in the tension between normative conceptions about what a patient is or ought to be and the belief in the individual as an autonomous subject. Empirical data has been collected by means of observations and interviews. During the fieldwork I accompanied the staff on their visits to patients’ homes and took part in different formal and informal staff-related activities.In spite of palliative home care being supposedly based on a holistic ideal, it is clear that it is the medical order that dominates the care. According to this, the medical knowledge of the actors within the caring situation also forms the basis of their hierarchical position.Palliative care’s historiography, descriptions of the good or natural death, formal and informal meetings and the ideology of the good home are all examples of factors involved in the creation and interconnection of palliative home care. Such care is also created in relation to “other care”, where a negative presentation of “other care” serves to highlight palliative home care as “good care”.Ideas of “the good” permeate palliative home care. However, in the staff’s eagerness to do good there is the risk that they will disregard the patient’s will and wishes and instead do what they think is best for the patient.