When Relations Matter Most: Death and Dying Personifications and Experiences from the Perspectives of Recreation Therapists

Abstract

ABSTRACT Over the past 200 years, death has been heavily medicalized within Global North healthcare settings, no longer positioned as naturally occurring but as a failure of medicine. In modern society, death is hidden between the four walls of our hospitals and care facilities, resulting in healthcare workers developing a closer, more persistent relationship to death than the general public. This phenomenon was emphasized by the COVID-19 pandemic, causing healthcare workers’ overexposure to death. The silencing of death creates barriers to care and emphasizes the need for comprehensive death education and better support for healthcare professionals when experiencing death in their workplaces.

Guided by phenomenology and expanding personification theory, this study aims to capture the unique experiences and perspectives of death from a healthcare professional group often overlooked in the literature, recreation therapists, by exploring the following questions: 1) How is death understood and experienced by recreation therapists? 2) How is death personified by practicing recreation therapists? What do these personifications tell us about understandings and experiences of death? 3) How might personifications of death and the experiences of death shared by recreation therapists inform us on what recreation therapists need to support their experiences of death and dying? How might death education benefit recreation therapists?

This study recruited nine recreation therapists across Canada to participate in a two-step data collection process. Step one used arts-based research methods to capture participants’ personifications of death utilizing collaging and painting. Step two involved four small group virtual research conversations. The research conversations provided opportunities to share and explore the artistic personifications of death outlined in step one and delve deeply into the experiences of death for recreation therapists. A phenomenological analysis process was used to analyze and interpret both the personifications of death and the transcripts of the research conversations.

This project demonstrates the entanglement of beauty and darkness in the experience of death and dying from the perspectives of recreation therapists. The findings highlight the impact of relational approaches in end-of-life care and reveal the need for more support to combat burnout and expand the role of recreation therapists in caring for the dying. This project highlighted the participants’ navigation of the emotional and relational challenges of death in healthcare, with artistic personifications reflecting the tension between solace and finality. There is a shared hope for greater support in environments that lack adequate resources, emphasizing the need for systemic change in end-of-life care.

This research integrates recreation therapy into the conversation on death and dying, highlighting the essential role of recreation therapists at the end-of-life. Methodologically, it contributes by combining phenomenology and personification to explore the essence of experience through visual art. The findings offer practical implications for recreation therapists, healthcare organizations, and educators in supporting staff and incorporating recreation therapy centered death education.