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University of Missouri

Snog & Grog

Preserving personal identity is key for people with long‐term or terminal illnesses.

Adults in care facilities appreciate social activities. Photo by Rob Hill.

Adults in care facilities appreciate social activities. Photo by Rob Hill.

Remember the last time you were admitted to the hospital? You were assigned a standard‐issue room. Your clothes were taken away and replaced with a standard‐issue hospital gown. In exchange for getting better, you surrendered your own identify and took on the role of “patient.”

In the U.S., we’re good at these short‐term transactions, says Allison Kabel, assistant professor in the School of Health Professions. But that trade‐off is ill‐suited for long‐term, degenerative or terminal illnesses, or injuries that don’t just heal and go away.

When there is no getting your life back, people are less willing to surrender,” Kabel says.

The hospice model — which offers in‐home or center‐based medical care, pain management, and emotional and spiritual support — is geared toward preserving patents’ identities as full, adult people, or, as Kabel puts it, “suspending social death until physical death.”

Kabel spent 18 months in England studying an adult daycare hospice center that clients affectionately called the “Snog and Grog” — English slang for kissing and booze (upon arrival, clients received a hug and a tipple — more English slang for their favorite adult beverages).

She came away impressed with how the staff evaluated and treated their clients — adjusting pain medication; giving massages, baths or physical therapy — without putting anyone in the role of patient.

They are so highly skilled, you don’t even [notice] what they’re doing,” Kabel says. “At times they were even assessing me because I threw my back out. They would be checking me out and asking me questions, and suddenly I realized what they were doing.”

Kabel says studies of hospice suggest that it lowers anxiety and stress in patients and lowers dependence on prescription pain medication. “If we could find ways of implementing palliative care expertise outside of the very last days [of life], patients would benefit.”