Light-hearted death talk in a palliative day care context.

This paper reports on an ethnographic investigation of a palliative day care unit. The aim of the study was to explore communication processes amongst patients with terminal disease, in an 'open awareness' context. The research involved participant observation over a period of 7 weeks. Detailed field notes were written and documentary information gathered on site. Analysis of the data showed that in the day care environment, patients readily talked about cancer, illness and death. Five themes were identified in the content of such 'death talk': talk about illness, symptoms and treatment, stories about illness and death, talk about patient deaths, talk regarding bereavement, and talk concerning personal mortality. In addition to content, it is maintained that the form of the patients' talk is pertinent to an understanding of the discursive context of palliative day care. It is proposed that the light-hearted and humorous nature of patient 'death talk' serves an important psychological function in allowing patients to distance themselves from their own deaths whilst simultaneously permitting an acknowledgement of their terminal condition. This suggests that the provision of an appropriate 'social' environment for patients with terminal disease may be as important to patients as one-to-one counselling by clinical nurse specialists.