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Tapestries: Interwoven voices of local and global identities Volume 8 Issue 1 Resisting Borders: Rethinking the Limits Article 9 of American Studies 2019 Dying the Good Death: Cultural Competence and Variance in Hospice Care Lydia Koh-Krienke Macalester College, [email protected] Keywords: Death, Hospice, Cultural competence, Culturally relevant, Pluralism, Universalism Follow this and additional works at: https://digitalcommons.macalester.edu/tapestries Recommended Citation Koh-Krienke, Lydia (2019) "Dying the Good Death: Cultural Competence and Variance in Hospice Care," Tapestries: Interwoven voices of local and global identities: Vol. 8 : Iss. 1 , Article 9. Available at: https://digitalcommons.macalester.edu/tapestries/vol8/iss1/9 This Article is brought to you for free and open access by the American Studies Department at DigitalCommons@Macalester College. It has been accepted for inclusion in Tapestries: Interwoven voices of local and global identities by an authorized editor of DigitalCommons@Macalester College. For more information, please contact [email protected]. Dying the Good Death: Cultural Competence and Variance in Hospice Care Lydia Koh-Krienke nun-chi. While I would still most likely be Introduction dying in my house, it may have a greater What do you want your death to significance to me as an act of “returning look like? home”. In both of these cases, I die a good I am at home, in a familiar bed with death, even though the setting and process may the nostalgic scent of simmering chicken broth differ. wafting up my nose. Four generations of my This paper will interrogate what it family surround me; the throng of means to “die well” by examining the grandchildren, too young to understand, play intersections between death and culture. with toy cars at my feet, and their laughter In America, we often do not engage with and shouts intermingle to create the cacophony the concept of death, and regard it as a that accompanies playtime. My mother and taboo subject. This mindset restricts us father, whom I am convinced will live forever, from having the necessary conversations stroke my forehead, their smiles lost in a sea about the culturally-specific ways in of a thousand wrinkles. I am old, but not so which we want to die. This may result in old that I cannot lift myself up in bed to a death that has little cultural meaning, survey the powerful dynasty of women, men, which we often equate with a life lived in and children I have created. I visualize my vain. Because of this, I claim that we must hard work in creating a more just and analyze culture and death through a equitable world in every single one of their pluralist, culturally relevant pedagogy in faces, and I feel good. I am ready to rest. order to fully understand what constitutes Amidst the chaos of grandchildren playing, a good death for a particular individual story swapping, and tear shedding, I quietly within a cultural group. I refute the slip away, laid to rest by the knowledge that universalist assertion that cultures are my family will continue to grow in number organized into a hierarchy, and and in strength as I watch over them. deconstruct this notion in favor of a If I was brought up in South Korea, pluralist, objective view of culture. I look where my mother’s family originates, I might specifically at a good death from Western visualize my ideal death differently. Rather and Eastern–specifically Korean-American than talking and laughing beside me, my –perspectives in an attempt to better family members might be performing imjong, understand the complexities surrounding and preparing me for my eternal life as an both. ancestor. I may have released the decisions In the second half of this paper, I about my life and death to my children, who argue that it is important to understand a know my preferences inherently through good death in a cultural context in order 1 to better serve the dying. I evaluate the diaspora from the homeland to the US tools that hospice care provides for a good beginning in 1903 onward, which death in both American and involves the physical crossing of nation Korean-American contexts, and deem our borders made difficult by xenophobic current hospice system to cater primarily legislation and racism. Another layer of to the Western notion of dying well. border crossing occurs out of the process Finally, I conclude that hospice has the of ​transculturation​, or the mixing of two potential to serve as the nexus between different cultures, which gives birth to a cultural variation and death, and propose a unique culture distinct from its two theoretical model that would aid hospice predecessors. Finally, I explore the border clinicians in providing culturally between life and death, and how competent care. This paper will adhere to individuals negotiate this boundary the overarching argument that a good through culturally-specific traditions and death looks different in various cultural values. This analysis of borders is contexts, and that it is a hospice provider’s multilayered and multifaceted; we cross job to understand this. scale as we move through different borders, from a national context to an Methods individual. In this way, we study the The topic of death is not cultural underpinnings of death through traditionally thought of in an American an American Studies lens, and explore Studies context by the academic psyche. how these border crossings relate to our American Studies scholars push the nations, our communities, and ourselves. concept of death off for anthropologists and thanatologists to tackle, in favor of A Note on the Use of “We” more exciting topics. I disagree with this; I Throughout this paper, I use the believe it is essential to frame the death pronoun “we” when commenting on both process by American Studies because it Western American and Korean-American happens to ​everyone regardless of race, constructions of culture. I mean not to socioeconomic status, sex, or gender. It is hinder the reader’s understanding, but the great unifying factor in a nation–and a instead do so in an attempt to deconstruct world–that is set up to divide. While we the myth of singularity, which American may conceptualize the socioculturally culture often assumes when referring to a “correct” way to die within the context of culture or group. I will discuss this our own culture, we still must recognize concept further in later sections, but I say that death systematically crosses and even this now to bring my own positionality sometimes dissolves borders. into the foreground of my argument. I It is in this way that this project belong to both American and Korean explores borders, both in a literal and cultural attitudes; blood from the East and figurative sense. First, I discuss the Korean from the West flows through my veins, 2 and I have grown up both revering my culture, even though its importance in Korean ancestors and fearing American modern society cannot be understated. ghosts. My perception of death is colored How is culture created? Is it formed both by Western American and Korean through crossing borders, putting up cultural norms. If my act of claiming both walls, or a mix of the two? Is the defining Western and Eastern cultural characteristic of culture language, constructions as my own confuses you, ethnicity, nationality, or a conglomeration good​! It is meant to. I welcome you to my of many factors? Are we a nation of ethnic world of cultural confusion with the hope enclaves, or a unified culture? that if you do belong to a single culture, Through asking these questions, I you can begin to understand the complex explore the different ways in which we processes of cultural blending and conflict. construct culture in American society. I I use “we” as a tool to add an additional give special attention to the formation of layer to my argument, a meta-narrative Korean-American culture and describe that reclaims my dual cultural identity how immigration has facilitated the from those who insist on categorizing me development of a culture that as belonging to one or the other. In simultaneously pulls from both of its writing this paper, I have created a space motherlands while creating unique values, to resist those comments that have traditions, and perceptions. By analyzing emphasized one part of my culture and the roots and migration patterns of reduced the other. I exist because of individuals belonging to a certain culture, cultural amalgamation, cultural conflict, we can better understand how its people and cultural blends: I am living, breathing interact with life and, the focus of this evidence of my argument. paper, death. In order to fully comprehend the Constructing Culture different mechanisms that Eastern and Defining Culture: Universalism and Western cultures use to negotiate death, Pluralism we must understand how cultures from Our increasingly globalized world different nations of origin interact with largely recognizes America as a nation the American psyche. First, I define composed of difference, and our history culture and discuss the two main views of reflects this. The intersections of universalism and pluralism that theorists colonization, immigration, importation, have adhered to from the 18th to 21st forced exile, and diaspora have created the centuries. I argue that universalism is American multicultural society in which inherently discriminatory, and therefore we now live. With this constant flow of describe the creation of a transnational ideas, languages, and Korean-American culture in a pluralist ethnicities, our colorful nation sometimes context. Finally, I expand on the concept struggles with the concept of defining of pluralism to claim that both American 3 and Korean-American cultures do not in the formation of new cultures and the exist as monolithic entities but as a transformation of existing ones.

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