Living and Dying at Murray Manor, Book Review Example

Abstract

This critique is focused on the subject of elderly in long-term care. With the ethnographic research conducted of Living and Dying at Murray Manor by Jaber F.Gubrium, his purpose was to write on first-hand experience about working alongside nursing home care staff, and reporting on the experiences of its residents. More importantly, he writes on the long-term care and the process of dying. He seeks out the factors that influence the experience of dying, the social process of dying, the attitudes of the residents and staff towards death, by whom and how the news is spread with in the facility, and what transpires after the occurrence of the death. This critique will not only focus on the author’s main purpose, but also look at how his book has furthered the commentary of the elderly and long-term care.

Introduction tothe Book

Living and Dying at Murray Manor by Jaber F. Gubrium provides an ethnographic narrative that analyzes the state of nursing homes in the United States. The author provides one of the best comprehensive perspective on long-term care and the dying process. His introspective look analyzes the main factors in which influence the experience of dying in the nursing homes, the social process of dying, the attitudes of the residents and staffs have towards death, and by whom and how the news of those that have died spreads within the nursing home. More importantly, the author provides the experience of what happens after the occurrence of death in the facility. During his research of working alongside staff members in the nursing home, he was able to get raw emotional experiences of how comfortable residents are with confronting and discussing the death, compared to the staff members. Even though, long-term care and nursing homes are constantly confronted with death in the facility, the ethnographic narrative details how the elderly residents consider it a natural part of growing older, and take a pragmatic approach to dying. His narrative is important to the discussion of the state of care in long-term facilities, and the treatment of the elderly as they age.

Critique of Living and Dying at Murray Manor

Began in 1973, Gubrium, provides a nursing care world in which is structured tightly that consists of the objectives of division of labor, power allocation, and dividing the residents from the staff. In using the nursing home that consist of a 360 bed church organization, he observed how the staff and the clientele interacted. At the time that he conducted his observational study, the nursing facility was only a third occupied. Gubrium begins his study by looking at the way in which the staff is structured, their world, their focus on death and dying, passing time, bed and body work, and their socialization of the patients. In summarizing the experiences of the organization, he provides explicit examples, provides source of invaluable information for experience of living and working in the nursing organization. Taking more of a sociologist role in examining the Catholic nursing home, his observation that advances the knowledge of individuals of dying and living at an elderly age. One of the more significant factors of the exercised power by the nursing home staff, specifically by the management, is the power in which reality is defined. Gubrium focuses on the reality of the nursing home, in which the staff’s work is critique in what is a failure, and what is a success. Gubrium shows the caregiving complex world in which gives views on the daily meaning of the world in which is seen through his observational study. He fundamentally shows how the nursing home residents have created an organized social entity, through the participants’ compromise of needs, goals, and roles, invoking duties and rights. In other words, fault can never be put on the system if there is problems with the way the nursing care facilities are operated, but with the residents. Hiring and firing is a mechanism that is used in adjusting the human operations in which the power that could be used to alter the system, is thus used. The basic problems that the author chooses to identify is that the nursing home staff believes in evoking the power of the human operations for the sake of efficiency in the home and the system. While Gubrium points out could still be used as process in which regiments the lives of residents, and depersonalizes their experiences in the nursing facilities.

The Nursing Home Setting

The lives of the residents and patients are limited to the point that anything frequently planned tackles incredible imperativeness. The division of work at the facility is entirely characterized, as is the structure of power. The staff comprises of all workers in the different divisions of the nursing home, in addition to the medical director and the home’s administrator. Their perspective of the nursing facility depicts it, preferably, as a well-running framework. As they have stated, ‘A great home can be accomplished when everybody contributes and does his thing.’ When things are accepted to be running under short of what ideal conditions, individuals are at flaw. The extraordinary danger to the framework is the excessively individualized patient or inhabitant, with the goal that the staff is mindful so as to lessen the individual characteristics of any individual who could form into a troublemaker. The day-by-day living of residents and patients is partitioned into three sections. “The central part, morning, is viewed as the busiest as in lounging around includes a mixture of ‘easily overlooked details you ought to do.'” This incorporates, “washing little things of garments. As we read in this respect. The second piece of the day, evening, is viewed as the longest. Evenings are said to simply drag by. Each is carried out gradually and deliberately. Then, around eleven o-clock, residents start contemplating lunch. When they are not in help or occupied with ceremonials, for example, gatherings, trips, and saying the rosary or at the less than desirable end of overnight routine work, they generally lounge around. Such an individual can without much of a stretch turn into a troublemaker, so the methodology of depersonalization and socialization is grinding away continually.

The everyday life of the residents is constrained. Daily living concentrates on the real occasions of the day -the three dinners, and symbols of prize or discipline are utilized, once more, to keep the residents and patients under control. Symbols are utilized to standardize and control, as Gubrium composes as for cigarettes: “Take Kitty Hayes, a third-floor persistent who is known to ‘smoke like a devil.’ Several times each day, she approaches the attendants’ station and approaches whoever is there for two cigarettes. Some of the time she is overlooked without further ado, on the grounds that everybody knows she’ll ask again at any rate, so you can’t in any way, shape or form overlook it. At the point when Kitty is not given cigarettes instantly, she gets to be noticeably shaken. Her trepidation makes her shake on the grounds that she needs a nicotine fix (Gubrium 154). Actually when she is overlooked, they tease her and inevitably attest their power by withholding the cigarettes until she is demonstrated her helplessness. Other examples of how patients are treated goes with the simple task of making a phone call. While this is easy for the staff, it can prove difficult for patients that are handicapped, or wheelchair, in which the task can quickly become complicated. In viewing this experience through their nearsightedness, the organization focuses on the patient’s uncooperativeness and irritability. The social worker and the top administrative staff tend to look at the patient’s behavior not as a social problem, but as individual psychological functioning. This can complicate the development of more realistic client procedures and policies.

Murray Manor socialization process is a powerful drive, which attempts to control the residents and patients and to characterize and utmost the exercises of all people who live and work at the home. The route in which the nursing home is organized constitutes a great part of the day-by-day living that resident and patients do at the Manor. The result is a home brimming with individuals who comprehend what their occupations are.  Realize what the cutoff points and obligations of those employments are, recognize what the day-by-day routine is, and they all started to anticipate what the framework gives, as opposed to whatever they may have trusted for or anticipated that before they came will the home. Among the staff, there are two divisions that separate between “workers in offices not called orders” (support, housekeeping, and so forth). As well as those in the controls; social services, nursing, occupational therapy, and so on. (Gubrium 161).

As Gubrium composes, parts of the top staff are the Manor’s authorities. Plainly, the staff to control the residents and patients and to keep in mind the end goal to keep the life of the Manor organized and routinized control symbols. “If you take persons who are, at the moment, members of one place, and listen to what they say and watch what they do, you will note that, for the part, they routinely go about the taken-for-granted affairs of the place” (Gubrium 39). Those with the most power to characterize reality, issues and arrangements in the home are the ones who do the slightest work with the real customers. At the point when managing the residents does not include managing staff parts, patients ordinarily say that they ‘lounge around.’ This is not just a question of simply doing nothing. Those blamed genuinely feel they are trying their hardest work property. The patients and residents are never permitted to overlook that they are not free, that the benefits they appreciate are in the hands of the staff (Gubrium 81). It is unexpected that the perfect administer to every inhabitant or patient is evidently “individualized” to arrangement most viable with the particular needs and issues of every occupant or patient. What this “individualized” consideration boils down to, nonetheless, is a method for control. It ought to likewise be noted that the majority of the staff accept that such methods are for the benefit of the framework and that without them the framework could not survive.

As a general public, then, Murray Manor is a nursing home, which is entirely characterized and worked, through and through. The division of work takes after nearly and takes its signs from the structure of power. Top staff’s work identified with patient consideration includes making consideration approach that is probably focused around precise learning of demographic and their ordinary lives in the home. Albeit top staff has almost no continuous, immediate involvement with customer base, aside from in passing (Gubrium 81).

The power streams starting from the top, and this expands the force of the issues of the patients themselves. On the grounds that the individuals who work most nearly with the patients and resident at the home are those most expelled from the locus of power. Nursing staff on the floor comprises of the charge nurture on each one story, which is typically an enlisted attendant; supporting authorized useful medical attendants and fluctuating number of medical attendants’ assistants. The following layer of staff can be classified as operational, in that they bargain specifically with the client base. The staff working with supplies, housekeeping, and so on. It can be characterized together as a support, cleaning up and paying the bills. These departments consist of occupational therapy, pastoral care, recreation, central supply, dietary, housekeeping, maintenance, nursing, social services, and accounting. The top staff can be arranged as regulatory, financial, and so on, the extent that capacity goes. Top staff makes shifted claims about its work.

The way of top staff’s vicinity on the floors takes out floor staff’s sympathy toward the behavioral substance of the objective of an aggregate consideration. The staff decides the needs of the inhabitant or patient to utilize those needs as a method for control instead of consideration. The strict necessities and obligations of the specialists at the home are reflected in every class: All yet the nursing division have from one to ten parts. The nursing office utilizes around 65 individuals appropriated similarly in excess of three movements. The primary team is viewed as in charge of “running the home,” while the recent group “runs” the demographic. While the top staff busies itself with the facility’s system, in short, life in differed places on the floors goes on. The exercises of the floor nursing staff fall into three classifications. Initially, the charge medical attendant oversees other nursing staff on her unit; representatives work assignments and patient loads, and performs an assortment of floor-related managerial undertakings. Second, LPNs and RNs oversee persistent medicines and disseminate prescriptions. Third, helpers have a tendency to informal lodging deal with demographic, for example, helping them with different activities, bathing, dressing, turning in the bed, eating, and voiding.

The staff, as Gubrium calls attention to, does not see the courses of action of regimentation, depersonalization, socialization, and de-individualization as terrible methods. They will contend, as agents of the framework, which such methodologies are vital if the framework is to work proficiently. In light of their faultfinders, they would say that you ‘simply can’t work a decent home that route.’ To them, running a home means working ‘as indicated by code’ or approval from the fire inspector or ‘by the standards of the diversion.’ They may have had elevated requirements about the great that they do as guardians, however in the routinized universe of the nursing home, those desires inexorably decrease. These extents from cases relating to future getting ready for the Manor to those relating to the definition of individualized, aggregate patient consideration plans. The top staff has the most power. However, they think more about merging and ensuring that power than with utilizing it to enhance the part of the individuals they should be nurturing. The staff decides the “mind” that is expected to “round off” the singular’s unpleasant edges, those territories of the identity, which may lead eventually to resistance or inconvenience making. The staff were not as open around residents when death occurred in the nursing home.

What Gubrium found, was when residents were thought to be asleep or not alert they were more open. Staff usually were found to withdraw from residents, and discuss the death so that residents were not able to hear them. Staff would try to contain the news of the death by removing the body of the deceased at mealtime, feigning patient treatment, pulling the curtains, and closing the doors. The staff was in charge of disposing of the body. This means, washing, and preparing the body by removing the personal belongings of the resident. The staff believed that it was not good to discuss death in from of the patients, because of free that it would make their work harder if they were scared. (Gubrium 207). However, when discussing with the residents, Gubrium found that the residents freely discussed the death of a fellow resident. The news traveled stealthily and quickly among the nursing home. Many of the residents served as informants, and took advantage of the being able to keep watch of the ambulance arriving at the nursing homes. When they have a confirmed death, the residents knew what was happening. Due to the close proximity in which the residents lived, they were very aware when one passed away. They were not frightened, but they saw it as a natural occurrence to them aging, and in the facility. The staff did not have a general sadness when a death occurred, because they were generally the ones that cared for the residents, and saw their death a part of aging. The way in which the residents  reacted was acceptance, but also a sadness since they were close to them.

Whatever foundation expectations that patients and residents have are adjusted off and lessened by the socialization methodology of the home. Routine is regulated, so that both the patients and residents, and staff structure the time. The staff and residents are, one might say, “detainees” (as Kitty complaints) in that their lives are controlled and molded by the different activities of power from the staff. The division of work is stringent, the lives of the patients, patients, and staff are routinized, and the connections of residents and staff are nearly checked. The days are regularized, “routinized,” with the goal that almost no happens which is not expected and/or formally booked. To permit singular residents and patients to live they however see fit, go where they need to go and would what they like to do, would spell fate for the home and the framework.

Conclusion

The author does not just present a documented account of what a terrible place nursing homes can be for the elderly. Instead, it provides an analysis that is in-depth of the institution seen as the nursing home. The author uses compassion and insight in his critique of the nursing home; he tries to examine how the patients try to live as human beings, in a world dominated by a financial institution. The problem that the author does not try to address is how his appearance in the observational study, may have influence the qualitative research conducted by interviewing the staff and patients.  His critique shows not only the interaction with staff, but shows how many of the nursing staff do desire improvement and dedication to the total care that includes the religious, social, emotional, and physical needs of the client.

The staff at the home is for the most part diminished, systematically, to the role of guard dogs of the patients and residents. The essential issues of the home frequently focused in the framework itself are never tended to, and this disappointment is expected to some extent to the way that the individuals who have the power in the home. The top staff is the ones who characterize the center of the operations of the laborers. Top staff’s absence of information of client base life and its psychologistic deduction homogenize the objective of individualized consideration. On the off chance that desires were the standard for operations in the home, the framework would be reformed. Therefore, the day-by-day forms at work in Murray Manor from morning until night work and disintegrate those desires. The objectives characterized by the powerful staff are glorified objectives. For some patients and residents, such errands are prone to fill a decent piece of the morning. The individuals must be changed from being so individualistic it is not possible being, conceivably, parts of the association. The facility must consider the needs of the patients/clientele, while also trying to open better ways of communication with the aspects of long-term care. Therefore, remember to treat the patients as human beings that are individuals.

References

GUBRIUM, J. F. Living and Dying at Murray Manor.Charlottsville, Va.: University Press of Virginia, 1975. Reprint, 1997.