ABSTRACT

Angelique's taking up of decisions near the end of life are part of her movement toward self-actualization and well-being, and are constitutively moral experiences. Angelique appeals to her caregiver to rub ointment on her perineum to relieve the soreness and burning she is experiencing. This is an example of Angelique's coping with her suffering condition through decision making about her care-a manifestation of her agency. Angelique's relationships with her health care professionals and direct care staff are part of her situatedness in the care facility community and environment, and are part of the social context of decision making. Independent of the objective intensity and quality of the pain, assessment and treatment of any pain are not routine. Abandonment of the elder in a state of pain heightens the person's pain and leads to suffering. Angelique's inexorable drive moves her toward her intended and determinate goals and a fulfilling agency to help satisfy her intentions and meanings.