Les pratiques de soins palliatifs à domicile: lieu d’exclusion sociale des personnes âgées en fin de vie?

Author(s):  
Marijo Hébert ◽  
Kareen Nour ◽  
Patrick Durivage ◽  
Isabelle Wallach ◽  
Véronique Billette ◽  
...  

ABSTRACTThe understanding of palliative care practices at home (PCH) is limited by the lack of available scientific knowledge. This is explained by the fact that its practices are relatively recent and they question our relationship with death and dying individuals. This study aims to contribute to the advancement of knowledge about PCH with the elderly. More specifically, with a perspective of social exclusion, it aims to understand how practices either do or do not produce social exclusion with seniors receiving palliative care. Nineteen participants from two local community services centers were interviewed and six multidisciplinary meetings were attended for observation. This study suggests that positive representations concerning the elderly in palliative care and recognition of their autonomy can avoid social exclusion, including its symbolic and identificatory dimensions. However, standardization of practices seems to contribute to institutional exclusion and foster nonrecognition.

2018 ◽  
Vol 21 (2) ◽  
pp. 243-253 ◽  
Author(s):  
Luciana Aparecida Soares de Andrade ◽  
Sulamita de Paula Santos ◽  
Roselene Campos Corpolato ◽  
Mariluci Hautsch Willig ◽  
Maria de Fátima Mantovani ◽  
...  

Abstract Objective: To identify the care practices of nurses for the elderly in emergency departments. Method: An integrative review was carried out in the CAPES database, selecting publications in English, Portuguese and Spanish published between January 2011 and October 2016. The descriptors used were: "Emergency nursing"; "Geriatric nursing"; "Health services for the elderly"; "Elderly person"; "Nursing care". Results: Sixteen articles were analyzed in English, the majority of which had a qualitative approach (56.2%). Australia had the largest number of publications (31.2%). After reading the studies in full, the common themes were organized and classified into three categories: Challenges/difficulties in the care of the elderly in the emergency department, Positive experiences of elderly care in the emergency department and The emergency department as a space of death and dying. Conclusion: The care practices of nurses are focused on identifying the main problems regarding elderly care, adaptation and the planning of their work routine. Another strategy is the implementation of instruments of evaluation specific to elderly patients and the involvement of the family in all stages of care.


Author(s):  
Tamara Sussman ◽  
Sharon Kaasalainen ◽  
Susan Mintzberg ◽  
Shane Sinclair ◽  
Laurel Young ◽  
...  

RÉSUMÉCette étude qualitative canadienne rapporte les résultats de 19 groupes de discussion comprenant 117 participants, incluant des bénéficiaires, des familles et des membres du personnel. Elle avait pour objectifs : 1) d’explorer les soins palliatifs offerts en soins de longue durée (SLD) en vue de faire face aux tensions associées à la prestation de soins aux personnes qui sont encore bien vivantes et celles en fin de vie dans une même communauté de soins et 2) d’identifier des améliorations qui pourraient être apportées aux pratiques en soins palliatifs afin de mieux répondre aux besoins de tous les bénéficiaires en vie ou mourants dans les établissements de SLD, ainsi que celles des familles et du personnel qui leur apportent du soutien. Notre étude a montré que les perspectives liées au confort en fin de vie du personnel en SLD, celles des bénéficiaires et de leurs familles étaient appliquaient à ceux qui se trouvaient en fin de vie ou aux familles qui les soutenaient. Cette compréhension du confort limitait l’intégration des principes de soins palliatifs lors des derniers jours de vie des bénéficiaires. Les résultats de notre étude ont aussi suggéré que le fait de recueillir les perceptions des bénéficiaires liées au confort en fin de vie, de partager l’information à propos de la mort d’un bénéficiaire d’une manière plus personnelle, et de s’assurer que les bénéficiaires, leurs familles et le personnel aient des occasions de participer dans les soins de confort pour les bénéficiaires mourants pouvaient accroître le confort en fin de vie et soutenir une plus grande intégration des principes de soins palliatifs en SLD.


2019 ◽  
Author(s):  
Hungyi Chen ◽  
Yuan-Chia Chu ◽  
Feipei Lai

BACKGROUND Time banking is a good mechanism to provide elderly care in community services with members having mutual benefits, besides social welfare and out-of-pocket fee payment mechanisms. With further integration with off-line works, mobile time banking may provide a better way, compared to traditional web access. On the other hand, blockchain technology has been long encountering difficulty in integrating with real-world economies or activities. Development of a mobile time banking system on blockchain (MTBB) may provide a realistic solution for community elderly care. Besides, the tracking mechanism from blockchain technology itself may also help track the elderly care service transaction records in order to measure better Sustainable Development Goals (SDGs) set by United Nations (UN). OBJECTIVE The aim of this study was to develop the MTBB, which enables tracking service transaction records in community elderly care through mutual helps. METHODS The MTBB was developed to empower organizations, either Corporate Social Responsibility (CSR) organizations, or Non-Profit Organizations (NPOs), to issue time tokens of their proprietary token types to the members who participate in the volunteer activities organized by the organizations respectively. In the service activities, members sign in and sign out before and after the services by using a smartphone app, and then get the time tokens afterwards. Members with time tokens can then exchange time tokens for elderly care services using the same smartphone app. MultiChain is used as the blockchain technology stack, as one of its features to support multiple token types is critical. RESULTS Database applications with smartphone apps integrated with MultiChain were developed. The whole set of the database schema was integrated with two smartphone apps, one for members, and the other for organizations, in addition to the two backend operations modules, one for organizations, and the other for managing all organizations and members. The MultiChain wallet was also integrated into the member app, as well as the organization backend modules for keeping track of the service transactions and time tokens. Metadata with the service transaction information is stored in the MultiChain blocks so that the transaction records are immutable and can thus be analyzed in the future. CONCLUSIONS The twelve characteristics of Cahn’s time banking are the guidelines of developing this MTBB with integration of MultiChain blockchain technology for tracking service transaction records. The study also combines the 1-to-1 member service exchange with organizations holding volunteer activities and issuing proprietary time tokens. With the blockchain transaction tracking mechanism, all of the elderly care service records through or within organizations can be tracked and analyzed to align with UN’s five SDGs.


2019 ◽  
Vol 29 (4) ◽  
Author(s):  
Elham Hesari ◽  
Zahra Sabzi ◽  
Shohreh Kolagari

Chronic pain is among problems of old people and causes changes in their life pattern and processes. Teaching palliative care can help old people suffering from chronic pain to live an active life. The aim of this research was to determine effects of educating of palliative care on life pattern of elderly women with chronic pain. The present study was a Quasi-experimental design with pre-test and post test was conducted on 30 elderly women suffering from chronic pain in 2018 in Iran. The Questionnaire for evaluating the Pattern of Life with Pain in the elderly was filled before the intervention, group educating of palliative care was carried out using an educational package, and the questionnaire was completed again immediately and one and three months after. The data was analyzed using mean, standard deviations, Fisher’s F test, and Greenhouse-Geisser and Bonferroni post-hoc test by employing SPSS- 16. Mean changes before teaching palliative care significantly differed from those of immediately and one and three months after the educational program (p = 0.0), (p = 0.004). There were significant differences between the stages of immediately and one month after the educational program and that of three months after it (p = 0.001), (p = 0.002). Concerning the personal life patterns, there were statistically significant differences between the stage immediately after the educational program and those before the intervention and three months after it (p = 0.005), (p = 0.000). Regarding the social life pattern, only the stage of one month after the educational program significantly differed from that of three months (p = 0.005). Mean growth in life pattern of the old women suffering from chronic pain in the stages after the intervention indicated the importance of and the necessity for palliative care during old age. Moreover, the success of this education three months after the educational program as compared to immediately and one month after it indicates that allocation of sufficient time plays a very important role in transferring information and in teaching methods of palliative care to old people.


2009 ◽  
Vol 21 (2) ◽  
pp. 131-139 ◽  
Author(s):  
B.J.A. Laird ◽  
M.T. Fallon

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Antonia M. Willemsen ◽  
Piret Paal ◽  
Silja Zhang ◽  
Stephen Mason ◽  
Frank Elsner

Abstract Background China holds one fifth of the world’s population and faces a rapidly aging society. In its ambition to reach a health care standard comparable to developed countries by 2030, the implementation of palliative care gains special importance. Until now, palliative care education in China is limited and disparate. This study aims to explore and determine factors that have impeded the development and implementation of palliative care education in China. Methods We conducted semi-structured interviews with n=28 medical teachers from seven Chinese universities. Interviews were transcribed, and thematic analysis applied. Results Three themes with two subthemes were constructed from data analysis. Theme 1 covers the still ambivalent perception of palliative care and palliative care education among participants. The second theme is about cultural attitudes around death and communication. The third theme reflects participants’ pragmatic general understanding of teaching. All themes incorporate obstacles to further implementation of palliative care and palliative care education in China. Conclusions According to the study participants, palliative care implementation through palliative care education in China is hindered by cultural views of medical teachers, their perception of palliative care and palliative care education, and their understanding of teaching. The study demonstrates that current attitudes may work as an obstacle to the implementation of palliative care within the health care system. Approaches to changing medical teachers’ views on palliative care and palliative care education and their cultural attitudes towards death and dying are crucial to further promote the implementation of palliative care in China.


Author(s):  
Isabel Brown

ABSTRACTA retrospective study was conducted in a large multilevel geriatric centre to analyse the deaths reported in the year 1981. This centre provides accommodation for 750 elderly and/or chronically ill persons in three agencies—an apartment complex, a home for the aged, and a long-term care hospital The study revealed that the hospital is the place of death for a high proportion of the elderly residents of the centre. In particular, residents of the home for the aged are unlikely to remain in the “home” to die. It was found that patterns of death and dying for individuals admitted to the hospital from the general community differ in several ways from the patterns of those who are already living in the centre in terms of age and probable cause of death.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Anita Mallon ◽  
Felicity Hasson ◽  
Karen Casson ◽  
Paul Slater ◽  
Sonja McIlfatrick

Abstract Background Moving palliative care from a solely clinical focus to a more population based and community orientated approach is the hallmark of a much advocated public health approach to palliative care. Young adults are a vital cohort of the public, yet their understanding of palliative care has not been investigated. This study aimed to explore young adults’ understanding of palliative care and identify factors that influence their engagement. Methods A purposive sample of young adults (n = 24) aged 18–29 years were recruited from one UK University. Semi-structured interviews were undertaken face to face or via telephone or Skype between November 2017 and February 2018. Thematic analysis using a framework approach and underpinned by a socioecological perspective was used to analyse the interviews. Results Three thematic categories were identified relating to intrapersonal and interpersonal influences, cultural and social influences and organisational and public policy influences. Palliative care was understood as supportive comfort care, delivered in the absence of cure, associated with the end of life and specifically focused on death and dying. Negative attitudes related to the context of care, which represented a static and hopeless situation. Whilst some reported positive attitudes, potential engagement was seen to be governed by a lack of knowledge and protective cultural norms. In terms of demonstrating readiness to engage with palliative care, participants requested clear information and suggested a normalising of palliative care through the education system. Conclusion Young adults in this study were ready to find out more about palliative care and identified social media as a platform upon which to engage this population. However, their perception of a society that views palliative care as a subject for those directly affected, creates a barrier to engagement. This study identified the ingredients of a public health message and mediums for disseminating the message. However, findings also suggest that a cultural shift is required to recognise the potential of engaging young adults in health issues that cross the life span, empowering them not only as individuals but as vital members of community and society.


2014 ◽  
Vol 16 (3) ◽  
pp. 180-192 ◽  
Author(s):  
Kritika Samsi ◽  
Jill Manthorpe ◽  
Karishma Chandaria

Purpose – Financial abuse of people with dementia is of rising concern to family carers, the voluntary sector and professionals. Little is known about preventative and early response practice among community services staff. The purpose of this paper is to investigate voluntary sector staff's views of the risks of managing money when a person has a dementia and explore ways that individuals may be protected from the risks of financial abuse. Design/methodology/approach – An online survey of staff of local Alzheimer's Society groups across England was conducted in 2011 and was completed by 86 respondents. Open-ended responses supplemented survey questions. Statistical analysis and content analysis identified emergent findings. Findings – Most respondents said their people with dementia experienced problems with money management, with almost half the respondents reporting encountering cases of financial abuse over the past year. Most were alert to warning signs and vulnerabilities and offered suggestions relevant to practice and policy about prevention and risk minimization. Research limitations/implications – Adult safeguarding practitioners are likely to encounter money management uncertainties and concerns about exploitation of people with dementia. They may be contacted by community-based support staff from the voluntary sector about individual queries but could ensure that such practitioners are engaged in local training and networking activities to promote their skills and confidence. Practical implications – As with other forms of elder abuse, professionals need to be aware of risks of financial abuse and be able to suggest effective yet acceptable preventive measures and ways to reduce risks of harm and loss. Further publicity about adult safeguarding services may be needed among local community support services. Originality/value – There have been few studies investigating the views of people working with people with dementia in the community about adult safeguarding.


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