Ethnicity, Older People and Palliative Care

This report brings together established and developing work on older people, ethnicity and palliative care from PRIAE (Policy Research Institute on Ageing and Ethnicity) and the National Council for Palliative Care (NCPC). It draws attention to the palliative care needs and experiences of elders from groups most commonly referred to in the UK as being 'minority ethnic'. The recognition of how multiple and simultaneous disadvantages can affect palliative care needs and experiences is an issue of broad relevance to palliative care - and one that is not restricted to the discussion of old age and ethnicity. In this sense, the report also aims to encourage more complex approaches to inequality in palliative care for all service users

Troubling meanings of family and competing moral imperatives in the family lives of young people with a parent who is at the end of life

This article draws on a narrative study of young people with a parent who is at the end of life to examine how family lives are troubled by life-limiting parental illness. Young people struggled to reconcile the physical and emotional absence of family members with meanings of ‘family’; the extent to which young people could rely on family to ‘be there’ in these troubling circumstances was of practical, emotional and moral significance. Our discussion is situated in the context of an English end of life care policy predicated on the ideal of a good death as one that takes place at home accompanied by family members. We explore how the shift away from family as a site for nurturing children towards family as a space to care for the dying is experienced by young people, and consider how these competing moral imperatives are negotiated through relational practices of care

End of Life Care: Achieving Quality in Hostels and for Homeless People, A Route to Success

This publication aims to provide a practical guide to support hostel staff in ensuring that people nearing the end of their life receive high quality end of life care

Barriers to the development of palliative care in Western Europe

The Eurobarometer Survey of the <i>EAPC Task Force on the Development of Palliative Care in Europe</i> is part of a programme of work to produce comprehensive information on the provision of palliative care across Europe. Aim: To identify barriers to the development of palliative care in Western Europe. Method: A qualitative survey was undertaken amongst boards of national associations, eliciting opinions on opportunities for, and barriers to, palliative care development. By July 2006, 44/52 (85%) European countries had responded to the survey; we report here on the results from 22/25 (88%) countries in Western Europe. Analysis: Data from the Eurobarometer survey were analysed thematically by geographical region and by the degree of development of palliative care in each country. Results: From the data contained within the Eurobarometer, we identified six significant barriers to the development of palliative care in Western Europe: (i) Lack of palliative care education and training programmes (ii) Lack of awareness and recognition of palliative care (iii) Limited availability of/knowledge about opioid analgesics (iv) Limited funding (v) Lack of coordination amongst services (vi) Uneven palliative care coverage. Conclusion: Findings from the EAPC Eurobarometer survey suggest that barriers to the development of palliative care in Western Europe may differ substantially from each other in both their scope and context and that some may be considered to be of greater significance than others. A number of common barriers to the development of the discipline do exist and much work still remains to be done in the identified areas. This paper provides a road map of which barriers need to be addressed

Living well, dying well - the importance of housing

David Clark and Sandy Whitelaw outline their vision for a new type of ‘care campus’ that would provide an environment in which older people, ranging from those able to live with complete independence to those with palliative care needs, would become part of the community of the Crichton Campus in dumfries

End of life care: an educational pathway for community nurses.

This article reports on an innovative educational pathway for district and community nurses aimed at enhancing confidence and competence in dealing with end of life care (EoLC). Nurses were aligned with a mentor from a specialist palliative care team and, after completing a training needs analysis, created their own development plan. Participants undertook a range of formal and informal education, and a rise in confidence was identified, specifically in communication skills and symptom management. Such practice-based education may offer a powerful and convenient approach to EoLC education for community staff. Read More: http://rcnpublishing.com/doi/abs/10.7748/phc2014.02.24.1.18.e80

A critical literature review exploring the challenges of delivering effective palliative care to older people with dementia in the acute hospital setting

Aim. This paper considers the challenges of delivering effective palliative care to older people with dementia and the possible strategies to overcome barriers to endof-life care in these patients. Background. In UK alone, approximately 100 000 people with dementia die each year and as the number of older people increases, dementia is set to become even more prevalent. Dementia is a progressive terminal illness for which there is currently no cure. Patients dying with dementia have significant health-care needs and in recent years it has been recognised that palliative care should be made available to everyone regardless of diagnosis, as this improves comfort and quality of life. Despite this, patients dying with dementia are often still not given access to palliative care services. Method. A review of English language literature published after 1996 to the present day relating to older people with dementia during the terminal phase of their illness. Results. Twenty-nine articles met inclusion criteria for the review. Most originated from North America and UK and were mostly quantitative in nature. Four key themes were identified: difficulties associated with diagnosing the terminal phase of the illness (prognostication); issues relating to communication; medical interventions; and the appropriateness of palliative care intervention. Conclusions.This review reinforces the importance of providing appropriate palliative care to individuals suffering from end-stage dementia and identifies some of the barriers to extending such specialist palliative care provision. Relevance to practice. There is an urgent need to improve palliative care provision for older people with end-stage dementia and, in addition, more research is required on the needs of patients entering the terminal phase of dementia to assist the allocation of appropriate resources and training to ensure quality and equality in the provision of end-of-life care

Hospice and Palliative Care - Access for All

Published to coincide with World Hospice and Palliative Care Day 2006, this report showcases the success stories of how hospice and palliative care has been provided in the most difficult settings. It also explores how services can be made more accessible and reflects the diversity of our society and the different beliefs and attitudes to care that people have. It focuses on a number of barriers to good care provision including geography, complex needs, culture and perception, and social exclusion

Palliative care declarations: mapping a new form of intervention

No abstract available