“The great escape”: how an incident of elopement gave rise to trauma informed palliative care for a patient experiencing multiple disadvantage
Abstract Background This case report from Scotland, UK illustrates how unresolved traumatic experiences across the life course can affect a patient’s engagement with palliative care and offers insights into the flexibility and adaptations necessary for taking a trauma informed approach to care for a...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | BMC Palliative Care |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12904-024-01374-x |
| _version_ | 1797272815141912576 |
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| author | Sam Quinn Libby Ferguson Derek Read Naomi Richards |
| author_facet | Sam Quinn Libby Ferguson Derek Read Naomi Richards |
| author_sort | Sam Quinn |
| collection | DOAJ |
| description | Abstract Background This case report from Scotland, UK illustrates how unresolved traumatic experiences across the life course can affect a patient’s engagement with palliative care and offers insights into the flexibility and adaptations necessary for taking a trauma informed approach to care for an individual experiencing multiple disadvantage. Trauma informed care is a cornerstone in the pursuit of equitable palliative care, particularly for those facing multiple disadvantage, as it acknowledges the impact of past traumas on current healthcare experiences, and fosters an environment of understanding, acceptance, and tailored support to alleviate suffering in the final stages of life. Case presentation “M” was a veteran with a history of homelessness, living with end stage anal cancer and symptoms consistent with post-traumatic stress disorder, although he never received a formal diagnosis. M exhibited complex behaviours perceived to be related to his history of trauma, including his decision to elope from the hospice, reluctance to accept personal care from nurses, and unpredictability. These behaviours posed a significant challenge to his palliative care team, both in the hospice and at home. An individualised and flexible approach to care delivery was eventually adopted, which included a ‘safety-netting’ approach and care delivery outside of the hospice. M was ultimately supported to remain at home until a week before he died. Conclusion M’s case underscores the necessity of adopting a trauma informed approach to palliative care, particularly for patients with a history of trauma and multiple disadvantage. The case highlights the importance of understanding and respecting a patient’s past traumas, promoting safety and autonomy, and ensuring flexibility in care delivery. |
| first_indexed | 2024-03-07T14:35:04Z |
| format | Article |
| id | doaj.art-484905f3068c478d823391b0cc2f5da6 |
| institution | Directory Open Access Journal |
| issn | 1472-684X |
| language | English |
| last_indexed | 2024-03-07T14:35:04Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Palliative Care |
| spelling | doaj.art-484905f3068c478d823391b0cc2f5da62024-03-05T20:42:40ZengBMCBMC Palliative Care1472-684X2024-02-012311710.1186/s12904-024-01374-x“The great escape”: how an incident of elopement gave rise to trauma informed palliative care for a patient experiencing multiple disadvantageSam Quinn0Libby Ferguson1Derek ReadNaomi Richards2End of Life Studies Group, University of GlasgowMarie Curie ScotlandEnd of Life Studies Group, University of GlasgowAbstract Background This case report from Scotland, UK illustrates how unresolved traumatic experiences across the life course can affect a patient’s engagement with palliative care and offers insights into the flexibility and adaptations necessary for taking a trauma informed approach to care for an individual experiencing multiple disadvantage. Trauma informed care is a cornerstone in the pursuit of equitable palliative care, particularly for those facing multiple disadvantage, as it acknowledges the impact of past traumas on current healthcare experiences, and fosters an environment of understanding, acceptance, and tailored support to alleviate suffering in the final stages of life. Case presentation “M” was a veteran with a history of homelessness, living with end stage anal cancer and symptoms consistent with post-traumatic stress disorder, although he never received a formal diagnosis. M exhibited complex behaviours perceived to be related to his history of trauma, including his decision to elope from the hospice, reluctance to accept personal care from nurses, and unpredictability. These behaviours posed a significant challenge to his palliative care team, both in the hospice and at home. An individualised and flexible approach to care delivery was eventually adopted, which included a ‘safety-netting’ approach and care delivery outside of the hospice. M was ultimately supported to remain at home until a week before he died. Conclusion M’s case underscores the necessity of adopting a trauma informed approach to palliative care, particularly for patients with a history of trauma and multiple disadvantage. The case highlights the importance of understanding and respecting a patient’s past traumas, promoting safety and autonomy, and ensuring flexibility in care delivery.https://doi.org/10.1186/s12904-024-01374-xPalliative careTrauma informed carePost-traumatic stress disorderPovertyHomelessnessVeteran |
| spellingShingle | Sam Quinn Libby Ferguson Derek Read Naomi Richards “The great escape”: how an incident of elopement gave rise to trauma informed palliative care for a patient experiencing multiple disadvantage BMC Palliative Care Palliative care Trauma informed care Post-traumatic stress disorder Poverty Homelessness Veteran |
| title | “The great escape”: how an incident of elopement gave rise to trauma informed palliative care for a patient experiencing multiple disadvantage |
| title_full | “The great escape”: how an incident of elopement gave rise to trauma informed palliative care for a patient experiencing multiple disadvantage |
| title_fullStr | “The great escape”: how an incident of elopement gave rise to trauma informed palliative care for a patient experiencing multiple disadvantage |
| title_full_unstemmed | “The great escape”: how an incident of elopement gave rise to trauma informed palliative care for a patient experiencing multiple disadvantage |
| title_short | “The great escape”: how an incident of elopement gave rise to trauma informed palliative care for a patient experiencing multiple disadvantage |
| title_sort | the great escape how an incident of elopement gave rise to trauma informed palliative care for a patient experiencing multiple disadvantage |
| topic | Palliative care Trauma informed care Post-traumatic stress disorder Poverty Homelessness Veteran |
| url | https://doi.org/10.1186/s12904-024-01374-x |
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