Spirituality within the Comprehensive Geriatric Assessment Process

In this chapter, Ellingson argues that the comprehensive geriatric assessment ( CGA) , which is used in the development of treatment plans for elderly individuals in poor health, has failed to acknowledge the import of some aspects of the elderly patient\u27s life experiences. Ellingson uses case study analysis to demonstrate the significance of spiritual and religious beliefs and practices and suggests that the CGA model should be expanded to include explicit coverage of spirituality and religious issues

Embodied knowledge

Embodied knowledge situates intellectual and theoretical insights within the realm of the material world. Embodied knowledge is sensory; it highlights smell, touch, and taste as well as more commonly noted sights and sounds. Knowledge grounded in bodily experience encompasses uncertainty, ambiguity, and messiness in everyday life, eschewing sanitized detached measurement of discrete variables. Such an epistemology, or way of knowing, resists the Cartesian mind–body split that underlies Enlightenment philosophy and its persistent remnants, including the scientific method and the glorification of objectivity. Embodied knowledge is inherently and unapologetically subjective, celebrating—rather than glossing over —the complexities of knowledge production. Fieldwork, interviewing, writing, and other qualitative methods involve embodied practices performed by actors occupying specific standpoints or positions within cultures. The researcher\u27s body—where it is positioned, what it looks like, what social groups or classifications it is perceived as belonging to—matters deeply in knowledge formation

The Performance of Dialysis Care: Routinization and Adaptation on the Floor

Previous studies of communication in dialysis centers primarily focused on communication between nurses and patients. In this study, ethnographic methods were used to explore the dominant communication performances enacted by dialysis staff members, including registered nurses, patient care technicians, technical aides, a social worker, and a dietitian. Findings suggest a dialectic between extreme routinization of care and continual adaptation. The dominant routine involved repeating the same preparation, treatment, and discharge process 3 shifts per day, thrice weekly for each patient. At the same time, near-constant adjustments to scheduling, coordination of tasks, and problem solving were needed to maintain the performance of repetition. The balancing of this dialectic has significant implications for new staff training and socialization, understanding the role of technology and routine in dialysis and in health care systems more generally, and in further theorizing the role of unbounded communication interactions in health care

Academic Aunting: Reimaging Feminist (Wo)Mentoring, Teaching, and Relationships.

In this essay, we explore the potential of aunting relationships for rethinking feminist selves and relationships, especially in academic settings. Relationships between generations of academic feminists have often been described using mother-daughter metaphors. We suggest some limitations to framing teaching and learning across academic generations (e.g., teacher-student) and among colleagues (e.g., peer review of scholarship) using maternal imagery. We then argue that the figure of the aunt offers a powerful trope for negotiating relationships between the waves of academic feminism. Aunts provide a generative alternative to mothering and sisterhood as frameworks for feminist womentoring, teaching, and scholarly reviewing

Exploring young adults\u27 perspectives on communication with aunts

Women are typically studied as daughters, sisters, mothers, or grandmothers. However, many, if not most, women are also aunts. In this study, we offer a preliminary exploration of the meaning of aunts as familial figures. We collected 70 nieces\u27 and nephews\u27 written accounts of their aunts. Thematic analysis of these accounts revealed nine themes, which were divided into two categories. The first category represented the role of the aunt as a teacher, role model, confidante, savvy peer, and second mother. The second category represented the practices of aunting: gifts/treats, maintaining family connections, encouragement, and nonengagement. Our analysis illuminates important aspects of aunts in family schema and kin keeping

Disability

People with disabilities (PWD) are the fastest growing minority social group in the world. Moreover, this group is one in which many, if not all individuals, will eventually join due to accidents, injuries, illnesses, wear and tear on aging bodies, and genetic factors. Disabilities can be physical, cognitive, social, and/or emotional. The disability community overlaps with people of all races, ethnicities, age groups, genders, sexual orientations/ expressions, and socioeconomic statuses, although PWD are overrepresented among people who are economically disadvantaged and under-served in health care, environmental safety, nutrition, and other basic needs. While the proportion of people with disabilities increases with age, the majority of people with disabilities remains under the age of 65

Salvaging, Surrendering, and Saying Goodbye to My Leg

Nearly 20 years after my diagnosis with osteogenic sarcoma—a virulent, fist-sized tumor in my right femur just above the knee—my surgeon and I made the difficult decision to amputate my leg. After 12 reconstructive surgeries on my leg (and several on my chest and abdomen), 13 months of chemotherapy, three major staph and/or strep infections in my knee, and a promise that yet another surgical reconstruction of my leg would necessitate a lifetime on daily antibiotics and give me a knee that would almost certainly cease to function within a couple years, I was done. I had a good cry, talked with my spouse, Glenn, and then called and left a message with my surgeon’s nurse. “Please tell Dr. Leighton1 I’ll take the amputation,” I told her

The Poetics of Professionalism Among Dialysis Technicians

The vast majority of care for end-stage renal disease (ESRD) patients is provided by skilled (but not formally educated) paraprofessional technicians. Using Goffman\u27s (1959) framing of the performance of self in everyday discourse, this study examines discourse from dialysis technicians and technical aides to explore these paraprofessionals\u27 construction and performance of professional identity and professional communication within the context of an outpatient dialysis clinic. Themes of professionalism—individualized care, vigilance, teamwork, and emotion management—are illustrated via poetic transcription of interviews with technicians. I contend that such representation offers validity equal to that of traditional research accounts while embodying alternative representational strengths

The roles of companions in geriatric patient–interdisciplinary oncology team interactions

This study examined companions\u27 roles in interactions between patients and interdisciplinary geriatric oncology team members. Companions\u27 roles identified include memory aid, emotional support, transcriber, aid in decision making, companionship, elaboration, advocate for patient, and interpreter. Specific patterns of variability of roles across team member disciplines include relatively passive companions who performed more active roles with physician, relatively active companions who performed more passive roles with physician, and relatively passive companions who performed more active roles when particular topics were raised, regardless of team discipline. Two patterns of stability across interactions emerged: consistently active or passive

Communication within the comprehensive geriatric assessment

The comprehensive geriatric assessment (CGA) forms a cornerstone of geriatric care; the process is designed to assess the complex interaction of biological , psychological, and social challenges often faced by elder patients (e .g ., Extermann, 2003). Using a narrative case study of a patient undergoing a CGA by members of an interdisciplinary geriatric oncology team. I explore some of the communication challenges and opportunities for healthcare providers caring for geriatric patients. My goal in offering readers narratives of geriatric patient-healthcare provider communication-rather than only analysis of those interactions - is to complement typical analysis of research findings with an opportunity to do what Prank ( 1995) called thinking with a story, that is, to bear witness to someone\u27s experience and empathize with it. To contextualize the communication issues exemplified in the case study, I begin by defining the CGA, exploring its use by geriatric healthcare teams, providing a brief overview of common communication issues in the geriatric patient population, and introducing the project from which this case study is drawn