The Haunting of Long-Term Care, Part Three. COVID “Wanted to Snatch Life Out”: How Healthcare Aides Feared an Unfamiliar Ghost and Understood Residents’ Fear of Death and Dying in the Context of Palliative Care

This paper is the third 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 third paper, the story reaches a kind of reckoning, as healthcare aides become fully subsumed within the haunting of long-term care and fear takes hold. Where death had long been a familiar presence in long-term care, quietly roaming hallways or lingering in the shadows, healthcare aides were now faced with a kind of poltergeist, which, while unseen, raged loudly in its disturbance of the house and any previous understanding of death. I begin with this ghost: a strange and unknowable Other that claimed residents’ lives in unfamiliar, yet familiar, ways, and consider how this shaped healthcare aides’ position within the house. I then explore fear, and how its presence in experiences of death and dying influenced healthcare aides’ understandings of palliative care. From here, I consider how healthcare aides’ fear may be better understood as a kind of anxiety, with their experiences speaking to the uncanny. Finally, I explore healthcare aides’ accounts of residents’ fear and palliative care through a lens of suspicion, suggesting that the institution, or haunted house itself, may have mediated their testimony.