Dying at home for people experiencing financial hardship and deprivation: how health and social care professionals recognise and reflect on patients’ circumstances

Quinn, S., Richards, N. and Gott, M. (2023) Dying at home for people experiencing financial hardship and deprivation: how health and social care professionals recognise and reflect on patients’ circumstances. Palliative Care and Social Practice, 17, p. 26323524231164162. (doi: 10.1177/26323524231164162) (PMID:37025502) (PMCID:PMC10071150)

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Abstract

Background: International palliative care policy often views home as the most desirable location for end-of-life care. However, people living in more deprived areas can worry about dying in poor material circumstances and report more benefits from hospital admission at the end of life. There is increasing recognition of inequities in the experience of palliative care, particularly for people living in more deprived areas. Promoting an equity agenda in palliative care means building healthcare professionals’ capacity to respond to the social determinants of health when working with patients near the end of their life. Objectives: The purpose of this article is to present data which reveal how some health and social care professionals view home dying for people experiencing financial hardship and deprivation. Design: This work was framed by social constructionist epistemology. Methods: Semi-structured qualitative interviews (n = 12) were conducted with health and social care professionals who support people at the end of life. Participants were recruited from one rural and one urban health board area in Scotland, UK. Data collection occurred between February and October 2021. Analysis: Thematic analysis was used to analyse the interview data. Discussion: Our findings suggest that healthcare staff relied on physical clues in the home environment to identify if people were experiencing financial hardship, found discussions around poverty challenging and lacked awareness of how inequities intersect at the end of life. Health professionals undertook ‘placing’ work to try and make the home environment a suitable space for dying, but some barriers were seen as insurmountable. There was recognition that increased partnership working and education could improve patient experiences. We argue further research is needed to capture the perspectives of individuals with direct lived experience of end-of-life care and financial hardship.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Quinn, Dr Sam and Richards, Dr Naomi
Authors: Quinn, S., Richards, N., and Gott, M.
College/School:College of Social Sciences > School of Social & Environmental Sustainability
Journal Name:Palliative Care and Social Practice
Publisher:SAGE Publications
ISSN:2632-3524
ISSN (Online):2632-3524
Published Online:31 March 2023
Copyright Holders:Copyright © 2023 The Authors
First Published:First published in Palliative Care and Social Practice 17: 26323524231164162
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
304429Dying at the Margins: uncovering the reasons for unequal access to home dying for the socio-economically deprivedNaomi RichardsEconomic and Social Research Council (ESRC)ES/S014373/1IS - Interdisciplinary Studies