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

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 incr...

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Main Authors: Sam Quinn, Naomi Richards, Merryn Gott
Format: Article
Language:English
Published: SAGE Publishing 2023-03-01
Series:Palliative Care and Social Practice
Online Access:https://doi.org/10.1177/26323524231164162
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author Sam Quinn
Naomi Richards
Merryn Gott
author_facet Sam Quinn
Naomi Richards
Merryn Gott
author_sort Sam Quinn
collection DOAJ
description 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.
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spelling doaj.art-e6614b77ecb047e58bf54d1caab52d9a2023-03-31T12:33:19ZengSAGE PublishingPalliative Care and Social Practice2632-35242023-03-011710.1177/26323524231164162Dying at home for people experiencing financial hardship and deprivation: How health and social care professionals recognise and reflect on patients’ circumstancesSam QuinnNaomi RichardsMerryn GottBackground: 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.https://doi.org/10.1177/26323524231164162
spellingShingle Sam Quinn
Naomi Richards
Merryn Gott
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
title Dying at home for people experiencing financial hardship and deprivation: How health and social care professionals recognise and reflect on patients’ circumstances
title_full Dying at home for people experiencing financial hardship and deprivation: How health and social care professionals recognise and reflect on patients’ circumstances
title_fullStr Dying at home for people experiencing financial hardship and deprivation: How health and social care professionals recognise and reflect on patients’ circumstances
title_full_unstemmed Dying at home for people experiencing financial hardship and deprivation: How health and social care professionals recognise and reflect on patients’ circumstances
title_short Dying at home for people experiencing financial hardship and deprivation: How health and social care professionals recognise and reflect on patients’ circumstances
title_sort dying at home for people experiencing financial hardship and deprivation how health and social care professionals recognise and reflect on patients circumstances
url https://doi.org/10.1177/26323524231164162
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AT merryngott dyingathomeforpeopleexperiencingfinancialhardshipanddeprivationhowhealthandsocialcareprofessionalsrecogniseandreflectonpatientscircumstances