This paper is the fourth installment in The Haunting of Long-Term Care: Understanding Healthcare Aides’ Experiences with Death and Dying During the COVID-19 Pandemic, a serialization of my doctoral research published in the Journal of Applied Hermeneutics. What follows is not only an academic inquiry, but the telling of a story – one shaped by suspicion, hiddenness and the ghosts that refuse to remain in the shadows of the house. Guided by a philosophical hermeneutic approach, I interviewed eight healthcare aides working in long-term care to understand how they made sense of death and dying during the COVID-19 pandemic. As an institution meant to care for older adults nearing the end of life, the long-term care home is, unavoidably, a place of death and dying. Yet death and dying are often kept in the shadows of long-term care, tucked into dark corners where the experiences of those who receive and deliver care remain largely unacknowledged, unexamined, and unquestioned. When the COVID-19 virus entered these homes, it did so like a kind of ghost – claiming the lives of older adults in ways that were unfamiliar, sudden, and deeply frightening. Healthcare aides were the first to encounter these ghosts, and the strange yet eerily familiar forms of death and dying they brought with them. As such, I came to understand my research as a kind of story, a frightening one, and healthcare aides’ experiences as a haunting of long-term care. In this fourth and final paper, the story descends without resolution. In the years since the pandemic, long-term care appears to have returned to the status quo, with few meaningful changes made to improve death and dying. I return to the structural integrity of the institution—the haunted house itself—and to how healthcare aides locate their experiences within enduring institutional failures that prevent quality care for dying residents. Remaining in the house, healthcare aides are understood as playing a game of hide-and-seek, where the structural problems laid bare during the pandemic have once again been hidden in dark corners. To explore this, I describe the ongoing limitations healthcare aides had “seen” during the pandemic, namely inadequate staffing and limited support. I then move to the “hide” section of the paper, which serves as the discussion, where I explore how these issues are being concealed again, the ghosts of the pandemic banished to the shadows, threatening to reappear. Finally, I offer a philosophical discussion of healthcare aides’ positionality through Heidegger’s understanding of the uncanny, particularly authentic versus inauthentic experience.

In this article, I argue that, on locked child and youth mental health units, friendships can form between patients and nurses. This may occur due to the confined nature of such settings, which gives rise to feelings of boredom. Boredom can be thought of as a stimulus or meaning deficit. Phenomenologically, it may be experienced as a dragging of time, restlessness, and a desire to do something else. Nurses often feel responsible for relieving the boredom of patients by engaging them in conversation or recreational activities. However, this ignores the fact that nurses experience boredom as well. One understanding of friendship, in this context, could be that friendship starts with a mutual understanding of the boredom of the other. Friendship is conventionally frowned upon by nursing regulators. However, in this paper, I argue that their views are based on a particular kind of friendship derived from the Western tradition—that which has normative characteristics and is incompatible with hierarchy. Using both aspects of Western and Confucian thought, I challenge this perspective, arguing that aspects of friendship do indeed show up in nurse-patient relationships and that they are not necessarily problematic. Using examples from my own practice, I aim to show that nurses and patients may involve each other symbiotically in shared meaning-making, especially in confined spaces such as the mental health ward. Nurses and patients mutually participate in a filling of “empty time,” demonstrating that even in confinement, there is the possibility of friendship.

Many people conceive of disabled Being as a disadvantageous and undesirable way of existing but these characteristics are neither inherent nor immutable. Martin Heidegger’s hermeneutic phenomenology framework, with emphases on his notions of care and meaning formulation and revelation, guided the current exploration of disabled Being. In addition, the author consulted critical and crip phenomenology along with data gleaned from the lives of disabled people. The results of the exploration illuminated how interactions between bodies and entities impact access. In turn, access, defined as the ability to use entities in their intended manner, affects revealed meanings. Atypical bodies and entities generally do not mesh well which hinders access and leads to revealing negatively oriented and devalued meanings. In contrast, using entities in the intended manner to complete personally relevant activities and projects contributes to positively oriented meanings. The article concludes by outlining two concomitant actions that foster more favorable views of disabled Being. First, creating inclusive practices of care and second, promoting thoughtful, collaborative discourse that seeks valued meanings of and roles for impairments in people’s lives.

This article is a review of Dr. Tom Grimwood’s recent book, Against Critical Thinking in Health, Social Care and Social Work: Reframing Philosophy for Professional Practice, published by Routledge (2024). In this book, Grimwood takes the reader through a series of encounters between philosophy and practice, attempting to disrupt the well-established assumptions of critical thinking so that we may better understand criticality for its utility among care practice professionals, and as a mode of understanding. Grimwood’s work is a necessary antidote to the well-established prescriptive and methodological application of how critical thinking has historically been "used" in the caring practice professions, or how it has been persuasive in the kind of understandings it produces. At a time when the contemporary social welfare landscape is becoming increasingly politicized and economized in ways that create societal divisiveness, as was exacerbated by the COVID-19 pandemic, current conceptualizations of criticality have left care professionals without a way to bridge misinformation and misunderstanding in their practice. Thus, Grimwood considered his project to be inherently hermeneutical, wanting to remedy the all too familiar divide between theory and practice of critical thinking for practice professionals and in new and reimagined ways for applied hermeneutics.

This third installment of the Emerging Horizons series explores Kelsey’s digital storytelling (DST) experience (please see the introductory editorial, Crafting Meaning, Cultivating Understanding, to access the documentary film on which the series is based). In addition to providing a compelling exploration of a relatively common occurrence of Adolescent and Young Adult (AYA) cancer survivors, delayed diagnosis, Kelsey’s involvement in the film illustrated the potential for DST to help participants explore, name, and represent their inner emotional experience. Her storyline illuminated how difficult it can be for AYAs to both understand their “true feelings” and share them with others in a way that moves beyond a surface level, “hashtag” description of emotion (e.g. #sad). I (Lang) conclude by discussing how the three primary modes of narrative engagement in the DST process (external, internal, and reflexive) could help AYAs cultivate a deeper understanding of their emotional cancer experiences, and in doing so, break cancer’s grasp on their life, by grasping it instead.

Purpose: In professional practice, body weight issues are typically considered from an individual-level standpoint. In contrast to this dominant perspective, we highlight that body weight has prominent social, economic, and political influences and connotations. An examination of the social complexity of weight provides opportunity to shift focus from individual to societal and structural influences on perceptions of weight. Methods: Seven renowned experts in weight-related issues with at least 10-years-experience in various fields from across Europe, Australia, the United States, and Canada participated in interviews about their professional experience with weight. Interviews were analyzed using hermeneutic methods via an iterative interpretive process. Results: The interviews revealed a battlefield, a war waged on weight. War emerged as an overall metaphor that included aspects of: war on obesity, bodies as battlefields, war camps, war fronts, entrenchment and negotiation and, finally, the phenomenon of “no man’s land.” Conclusions: In many ways, language itself limits us from capturing the complexities of weight. The war metaphor provides a way of understanding the intensity of the firestorm surrounding the construct of weight. New understandings from what we might refer to as veterans of the war on weight offer hope for transformation, not just win or lose, but a hermeneutic wager of possibility.

The following will provide a hermeneutical examination of two experiences of time: time as taking-away and time as giving. It will attempt to address the interrelated issues of death, time, and the time of silence in order to see whether time should be viewed as an inevitable force that destroys everything in front of it, or whether another concept of time should be considered, one which comes from the other as the gift of time. It will be argued that the gift of time is only fully audible in the time of silence and that gratitude is most well-attuned response to such a time and to the time that precedes and exceeds us.

Remembering the Babies

The COVID-19 pandemic has highlighted the significance of the politics of health as an ongoing interpretative event. The effectiveness of delivering prevention strategies is in negotiation with day-to-day arguments in the public sphere, not just by “experts” in peer-reviewed papers, but also in the everyday interpretations and discussions of available expertise on print and digital media platforms. In this paper I explore ae particular facet of these public debate over the politics of health: the deployment of the commonplace of stupidity. I argue that the growth of this commonplace within discussion is rooted in particular models of interpretation which limit self-understanding, by over-emphasising certain points of significance within the interpretative horizon over more banal (and “stupid”) aspects that are, nevertheless, influential on health interventions.

The following will provide a hermeneutical examination of two experiences of time: time as taking-away and time as giving. It will attempt to address the interrelated issues of death, time, and the time of silence in order to see whether time should be viewed as an inevitable force that destroys everything in front of it, or whether another concept of time should be considered, one which comes from the other as the gift of time. It will be argued that the gift of time is only fully audible in the time of silence and that gratitude is most well-attuned response to such a time and to the time that precedes and exceeds us.