The Social Ecology of Dying: Observations of Wards for the Terminally III

The authors describe the conditions that existed on three wards for chronic and terminally ill medical patients. Most of the patients were old, few were ambulatory, and many showed cognitive deterioration. There was little interaction among them, or with staff. Staffing the ward was difficult; turnover was high and morale low. The physical facilities failed to meet the agency's standards for nursing homes to which patients might be discharged. An even greater problem was the lack of privacy and dignity afforded the patients in routine nursing procedures. The authors suggest types of activities that can help patients retain their sexual identity and sense of selfhood.