End‐of‐life priorities of older adults with terminal illness and caregivers: A qualitative consultation

Health Expectations

Margo Barr¹  Magnolia Cardona²  Kathryn McFarland³  Alex Psirides⁴  Angela Dawson⁵  Ebony T. Lewis⁶  Reema Harrison⁶  Laura Hanly⁷  Ken Hillman⁷  Alexandra Zammit⁸ 

[1] Centre for Primary Health Care and Equity Faculty of Medicine University of New South Wales Sydney New South Wales Australia;Centre for Research in Evidence‐Based Practice Faculty of Health Sciences and Medicine Bond University Gold Coast Queensland Australia;Cunningham Centre for Palliative Care Sacred Heart Health Service St Vincent's Health Network Sydney New South Wales Australia;Department of Intensive Care Medicine Wellington Regional Hospital Wellington New Zealand;Faculty of Health The Australian Centre for Public and Population Health Research University of Technology Sydney Sydney New South Wales Australia;Faculty of Medicine School of Public Health and Community Medicine University of New South Wales Sydney New South Wales Australia;SWS Clinical School The Simpson Centre for Health Services Research University of New South Wales Sydney New South Wales Australia;Thomas Holt Aged Care Sydney New South Wales Australia;

关键词: care priorities;    end‐of‐life;    family caregivers;    older adults;    qualitative study;   

DOI  :  10.1111/hex.12860

来源: DOAJ

【 摘 要 】

Abstract Background As older adults approach the end‐of‐life (EOL), many are faced with complex decisions including whether to use medical advances to prolong life. Limited information exists on the priorities of older adults at the EOL. Objective This study aimed to explore patient and family experiences and identify factors deemed important to quality EOL care. Method A descriptive qualitative study involving three focus group discussions (n = 18) and six in‐depth interviews with older adults suffering from either a terminal condition and/or caregivers were conducted in NSW, Australia. Data were analysed thematically. Results Seven major themes were identified as follows: quality as a priority, sense of control, life on hold, need for health system support, being at home, talking about death and competent and caring health professionals. An underpinning priority throughout the seven themes was knowing and adhering to patient's wishes. Conclusion Our study highlights that to better adhere to EOL patient's wishes a reorganization of care needs is required. The readiness of the health system to cater for this expectation is questionable as real choices may not be available in acute hospital settings. With an ageing population, a reorganization of care which influences the way we manage terminal patients is required.

【 授权许可】

Unknown