ABSTRACT
Death, although written about by scientists and sages throughout time, is an abstract concept that may be defined clinically but remains an existential mystery. The process of dying is less abstract. R. Kastenbaum has cited sociologists B. G. Glaser and A. L. Strauss’s field study on “awareness concepts” as one of the most influential contributions to the understanding of the social context of dying. Glaser and Strauss obtained their data through direct observation of the communication patterns of dying patients in a variety of public and private hospitals and through interviews with nursing students. They observed four basic types of awareness contexts: closed awareness, suspected awareness, mutual pretense, and open awareness. It is important to recognize that dying trajectories are perceived rather than actual courses of dying. The way in which patients, families, and health care providers perceive dying trajectories may have a profound impact on the ways in which patients live their lives and on the care they receive.
