Psychoanalytically informed research in an NHS continuing care unit for older people: Exploring and developing staff's work with complex loss and grief

Abstract

There are studies about the emotional and social aspects of loss and grief in continuing care environments such as care homes and hospital wards, but researchers have tended to focus on either the cultural aspect of the organisation or the emotional response of individuals [Holman, C., Meyer, J. & Cotter, A. (2004) 'The complexity of loss in continuing care institutions for older people: a review of the literature', Illness, Crisis and Loss, vol. 12, no. 1, pp. 38-51]. This splitting in the body of knowledge misses the opportunity to examine the link between the personal and the broader public domain [Williams, S. J. & Bendelow, G. (1996) 'Emotions, health and illness: the "missing link" in medical sociology?', in Health and the Sociology of Emotions, eds V. James & J. Gabe, Blackwell Publications Ltd, Oxford]. This paper concerns the methodology and initial findings from a psychoanalytically informed research study. It was aimed deliberately at exploring the juncture between the psychological and social domains that care staff have to negotiate in order to provide care related to loss and grief in an NHS continuing care ward. The method draws heavily on the Tavistock approach to learning about emotions [Rustin, M. (2003) 'Learning about emotions: the Tavistock approach', European Journal of Psychotherapy, Counselling and Health, vol. 6, no. 3, pp. 187-208] but also adopts participant observation methods rooted in the ethnographic tradition [Fielding, N. (2001) 'Ethnography', in Researching Social Life, 2nd edn, ed. N. Gilbert, Sage Publications, London]. The study identifies the emotional demand of caring for people experiencing loss and grief in a continuing care unit and the development of a reflective group that supported practice developments in meeting these tasks. The paper will argue that research that develops an understanding of social practices underpinned by psychoanalytic perspectives can inform development in areas where staff are expected to cope with high levels of anxiety and stress. © 2006 GAPS.