Rites of passage and the hospice culture

Abstract

Boundaries exist implicitly and explicitly in the area of life and death. The hospice movement seeks to manage death in an open and participatory way rather than denying or hiding it. By offering this alternative approach to the prevailing medical ideal of cure or prevention the hospice movement obscures these life-death boundaries. One theoretical framework, derived from anthropology, which offers an alternative way to consider the place of dying and bereaved people within the hospice culture is a 'rites of passage' model. Rites of passage structure the disorder of dying and bereavement by creating dynamic, flexible boundaries for these transitions. The dying or bereaved individual is in a temporary, liminal state, passing either from life to death or through a state of bereavement. A critique of the rites of passage framework will consider its relevance and usefulness in understanding the nature of the boundaries which determine how death, dying and bereavement are experienced by these individuals. To explore how a rites of passage framework illuminates aspects of hospice culture and its work with dying and bereaved people illustrative material is drawn from hospice literature prepared for patients and from interviews with hospice nursing staff.