Delirium as letting go: An ethnographic analysis of hospice care and family moral experience:

Background:Delirium is extremely common in dying patients and appears to be a major threat to the family’s moral experience of a good death in end-of-life care.Aim:To illustrate one of the ways in which hospice caregivers conceptualize end-of-life delirium and the significance of this conceptualization for the relationships that they form with patients’ families in the hospice setting.Design:Ethnography.Setting/participants:Ethnographic fieldwork was conducted at a nine-bed, freestanding residential hospice, located in a suburban community of Eastern Canada. Data collection methods included 15 months of participant observation, 28 semi-structured audio-recorded interviews with hospice caregivers, and document analysis.Results:Hospice caregivers draw on a culturally established framework of normal dying to help families come to terms with clinical end-of-life phenomena, including delirium. By offering explanations about delirium as a natural feature of the dying process, hospice caregivers strive to protec...