Religion and spirituality at the end of life. An ethnographic study of the institutional death

The overall aim of this study was to gain knowledge about the institutionalized death in contemporary Sweden and the experiences of death expressed both by care recipients and health professionals. The theoretical framework used in this study is based on the stress-appraisal-coping model developed by Richard Lazarus and Susan Folkman, Kenneth Pargaments theory of religious coping, and complemented by Lisa Sands concept of life links. Data collection was made through an ethnographic fieldwork at a hospice in Sweden where participant observations as well as formal and informal interviews were done. The interviews were analysed using a narrative method focusing on life stories and pathograpies, its narrative and its dramaturgical structure. The main finding of this study shows that ones impending death is characterized by a component of reappraisal of life and that meaning-based coping is helpful in this process. Time, and the lack of it, was seen as the main threat to life and the respondents found the thought of separation, especially from family, to be extremely painful. The results show prominent patterns in how the respondents presents themselves and their life stories, revealing that they find it vital to maintain a positive picture of themselves and of life. All of the respondents faced existential challenges evoked by the closeness of death and many respondents found spirituality to be helpful in coping with these feelings. This study also highlights a lack of education and knowledge about existential and spiritual challenges among healthcare professionals