Is There Anyone in There?”: Caregivers and Professionals’ Mutual Positioning to Take Care of Vegetative State Patients

The vegetative state is a condition in which a person is wakeful without being aware. To understand a patient who can be considered neither alive nor dead, caregivers and professionals re-define traditional identities, roles, and practices. By drawing on wider research, in the current chapter, we aimed to show how caregivers and practitioners positioned the patient and themselves within the institutional context of five nursing homes in Lombardy. We conducted 65 semi-structured interviews with 35 caregivers (sons, partners, parents) and 30 professionals (health, mental health professionals, and social workers). Our discourse analysis identified three different interpretative repertoires to position the patient: an organic, an interactional, and a possibilistic one. Their encounter both leads to disagreement and convergence. In particular, by taking each other’s perspective, professionals and caregivers might converge toward the common ground of balanced hope, where the possibility for patients’ awareness is neither fostered nor denied. In this space of possibilities, caregivers find a justification for their monitoring and patient stimulation activity and take on the role of spokesperson for the patient. This common ground allows them to communicate, justify their reciprocal action and acknowledge their roles and expertise in taking care of the patient.