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Living and dying: responsibility for end-of-life care in care homes without on-site nursing provision - a prospective study

Handley, M, Goodman, C, Froggatt, K, Mathie, E, Gage, H, Manthorpe, J, Barclay, S, Crang, C and Iliffe, S (2014) Living and dying: responsibility for end-of-life care in care homes without on-site nursing provision - a prospective study HEALTH & SOCIAL CARE IN THE COMMUNITY, 22 (1). pp. 22-29.

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Abstract

The aim of the study was to describe the expectations and experiences of end-of-life care of older people resident in care homes, and how care home staff and the healthcare practitioners who visited the care home interpreted their role. A mixed-method design was used. The everyday experience of 121 residents from six care homes in the East of England were tracked; 63 residents, 30 care home staff with assorted roles and 19 National Health Service staff from different disciplines were interviewed. The review of care home notes demonstrated that residents had a wide range of healthcare problems. Length of time in the care homes, functional ability or episodes of ill-health were not necessarily meaningful indicators to staff that a resident was about to die. General Practitioner and district nursing services provided a frequent but episodic service to individual residents. There were two recurring themes that affected how staff engaged with the process of advance care planning with residents; ‘talking about dying’ and ‘integrating living and dying’. All participants stated that they were committed to providing end-of-life care and supporting residents to die in the care home, if wanted. However, the process was complicated by an ongoing lack of clarity about roles and responsibilities in providing end-of-life care, doubts from care home and primary healthcare staff about their capacity to work together when residents’ trajectories to death were unclear. The findings suggest that to support this population, there is a need for a pattern of working between health and care staff that can encourage review and discussion between multiple participants over sustained periods of time.

Item Type: Article
Subjects : Economics
Divisions : Faculty of Arts and Social Sciences > School of Economics
Authors :
AuthorsEmailORCID
Handley, MUNSPECIFIEDUNSPECIFIED
Goodman, CUNSPECIFIEDUNSPECIFIED
Froggatt, KUNSPECIFIEDUNSPECIFIED
Mathie, EUNSPECIFIEDUNSPECIFIED
Gage, HUNSPECIFIEDUNSPECIFIED
Manthorpe, JUNSPECIFIEDUNSPECIFIED
Barclay, SUNSPECIFIEDUNSPECIFIED
Crang, CUNSPECIFIEDUNSPECIFIED
Iliffe, SUNSPECIFIEDUNSPECIFIED
Date : 1 January 2014
Identification Number : 10.1111/hsc.12055
Copyright Disclaimer : This is the peer reviewed version of the following article: Handley, M., Goodman, C., Froggatt, K., Mathie, E., Gage, H., Manthorpe, J., Barclay, S., Crang, C. and Iliffe, S. (2014), Living and dying: responsibility for end-of-life care in care homes without on-site nursing provision - a prospective study. Health Soc Care Community, 22: 22–29. doi:10.1111/hsc.12055, which has been published in final form at http://onlinelibrary.wiley.com/doi/10.1111/hsc.12055/abstract. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Uncontrolled Keywords : Science & Technology, Social Sciences, Life Sciences & Biomedicine, Public, Environmental & Occupational Health, Social Work, PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH, SSCI, SOCIAL WORK, advance care planning, care home staff, district nurses, dying, end-of-life care, General Practitioners, residential care homes, INTEGRATED WORKING, RESIDENTS, DEMENTIA, SERVICES
Related URLs :
Depositing User : Symplectic Elements
Date Deposited : 12 Aug 2016 13:25
Last Modified : 12 Aug 2016 13:25
URI: http://epubs.surrey.ac.uk/id/eprint/811690

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