How initial policy responses to COVID-19 contributed to shaping dying at home preferences and care provision: key informant perspectives from Canada
Abstract Objectives In response to COVID-19’s first wave, provincial governments rapidly implemented several public health directives, including isolation measures and care facility visitor restrictions, which profoundly affected healthcare delivery at the end of life and dying experiences and perce...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-11-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-023-10340-x |
| _version_ | 1797415636265074688 |
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| author | Maria Cherba Laura Funk Erin Scott Bora Salman Andrea Rounce Corey Mackenzie Kelli Stajduhar Carren Dujela Marian Krawczyk S. Robin Cohen |
| author_facet | Maria Cherba Laura Funk Erin Scott Bora Salman Andrea Rounce Corey Mackenzie Kelli Stajduhar Carren Dujela Marian Krawczyk S. Robin Cohen |
| author_sort | Maria Cherba |
| collection | DOAJ |
| description | Abstract Objectives In response to COVID-19’s first wave, provincial governments rapidly implemented several public health directives, including isolation measures and care facility visitor restrictions, which profoundly affected healthcare delivery at the end of life and dying experiences and perceptions. The objective of this study was to identify implications of early policy changes for dying at home. Methods Analysis of interviews with 29 key informants with expertise in the policy and practice context of dying at home and care for those dying at home was conducted as part of a larger mixed-methods study on dying at home in Canada. Results Initial pandemic policy responses, especially visitor restrictions and limitations to home care services, shaped dying at home in relation to three themes: (1) increasing preferences and demand for, yet constrained system ability to support dying at home; (2) reinforcing and illuminating systemic reliance on and need for family/friend caregivers and community organizations, while constraining their abilities to help people die at home; and (3) illuminating challenges in developing and implementing policy changes during a pandemic, including equity-related implications. Conclusion This study contributes to broader understanding of the multifaceted impacts of COVID-19 policy responses in various areas within Canadian healthcare systems. Implications for healthcare delivery and policy development include (1) recognizing the role of family/friend caregivers and community organizations in end-of-life care, (2) recognizing health inequities at the end of life, and (3) considering possible changes in future end-of-life preferences and public attitudes about dying at home and responsibility for end-of-life care. |
| first_indexed | 2024-03-09T05:52:27Z |
| format | Article |
| id | doaj.art-a7eec9bb178641c8afb9e19c79339e16 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-03-09T05:52:27Z |
| publishDate | 2023-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-a7eec9bb178641c8afb9e19c79339e162023-12-03T12:16:45ZengBMCBMC Health Services Research1472-69632023-11-0123111010.1186/s12913-023-10340-xHow initial policy responses to COVID-19 contributed to shaping dying at home preferences and care provision: key informant perspectives from CanadaMaria Cherba0Laura Funk1Erin Scott2Bora Salman3Andrea Rounce4Corey Mackenzie5Kelli Stajduhar6Carren Dujela7Marian Krawczyk8S. Robin Cohen9University of OttawaUniversity of ManitobaUniversity of ManitobaUniversity of ManitobaUniversity of ManitobaUniversity of ManitobaUniversity of VictoriaUniversity of VictoriaUniversity of GlasgowMcGill UniversityAbstract Objectives In response to COVID-19’s first wave, provincial governments rapidly implemented several public health directives, including isolation measures and care facility visitor restrictions, which profoundly affected healthcare delivery at the end of life and dying experiences and perceptions. The objective of this study was to identify implications of early policy changes for dying at home. Methods Analysis of interviews with 29 key informants with expertise in the policy and practice context of dying at home and care for those dying at home was conducted as part of a larger mixed-methods study on dying at home in Canada. Results Initial pandemic policy responses, especially visitor restrictions and limitations to home care services, shaped dying at home in relation to three themes: (1) increasing preferences and demand for, yet constrained system ability to support dying at home; (2) reinforcing and illuminating systemic reliance on and need for family/friend caregivers and community organizations, while constraining their abilities to help people die at home; and (3) illuminating challenges in developing and implementing policy changes during a pandemic, including equity-related implications. Conclusion This study contributes to broader understanding of the multifaceted impacts of COVID-19 policy responses in various areas within Canadian healthcare systems. Implications for healthcare delivery and policy development include (1) recognizing the role of family/friend caregivers and community organizations in end-of-life care, (2) recognizing health inequities at the end of life, and (3) considering possible changes in future end-of-life preferences and public attitudes about dying at home and responsibility for end-of-life care.https://doi.org/10.1186/s12913-023-10340-xCanadaCOVID-19End of life carePalliative carePublic policyThematic analysis |
| spellingShingle | Maria Cherba Laura Funk Erin Scott Bora Salman Andrea Rounce Corey Mackenzie Kelli Stajduhar Carren Dujela Marian Krawczyk S. Robin Cohen How initial policy responses to COVID-19 contributed to shaping dying at home preferences and care provision: key informant perspectives from Canada BMC Health Services Research Canada COVID-19 End of life care Palliative care Public policy Thematic analysis |
| title | How initial policy responses to COVID-19 contributed to shaping dying at home preferences and care provision: key informant perspectives from Canada |
| title_full | How initial policy responses to COVID-19 contributed to shaping dying at home preferences and care provision: key informant perspectives from Canada |
| title_fullStr | How initial policy responses to COVID-19 contributed to shaping dying at home preferences and care provision: key informant perspectives from Canada |
| title_full_unstemmed | How initial policy responses to COVID-19 contributed to shaping dying at home preferences and care provision: key informant perspectives from Canada |
| title_short | How initial policy responses to COVID-19 contributed to shaping dying at home preferences and care provision: key informant perspectives from Canada |
| title_sort | how initial policy responses to covid 19 contributed to shaping dying at home preferences and care provision key informant perspectives from canada |
| topic | Canada COVID-19 End of life care Palliative care Public policy Thematic analysis |
| url | https://doi.org/10.1186/s12913-023-10340-x |
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