Meaning and Practice of Palliative Care for Hospitalized Older Adults with Life Limiting Illnesses

Objective. To illustrate distinctions and intersections of palliative care (PC) and end-of-life (EOL) services through examples from case-centered data of older adults cared for during a four-year ethnographic study of an acute care hospital palliative care consultation service. Methods. Qualitative narrative and thematic analysis. Results. Description of four practice paradigms (EOL transitions, prognostic uncertainty, discharge planning, and patient/family values and preferences) and identification of the underlying structure and communication patterns of PC consultation services common to them. Conclusions. Consistent with reports by other researchers, study data support the need to move beyond equating PC with hospice or EOL care and the notion that EOL is a well-demarcated period of time before death. If professional health care providers assume that PC services are limited to assisting with and helping patients and families prepare for dying, they miss opportunities to provide care considered important to older individuals confronting life-limiting illnesses

The roles staff play in the social networks of elderly institutionalized people

This paper concerns different ways in which nursing home residents interpret their relationships with institution staff. The research on which it is based involved an anthropological social network analysis. Analysis revealed different patterns of resident-staff interaction that are described in relation to four types of personal networks. Their meaning is interpreted in terms of the tensions between residents' common needs for attachment and autonomy and their limited means to achieve satisfaction.institutionalized elderly long-term care United States