Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
  1. Home
  2. Search

Refine search

Refine search

Access:
Content type:
Publication date:
Apply   From and To filters
Subject: Show more
Journals Show more
Publishers: Show more
Societies Show more
Series: Show more
Collections: Show more

Actions for selected content:

Select all | Deselect all
  • View selected items
  • Export citations
  • Download PDF (zip)
  • Save to Kindle
  • Save to Dropbox
  • Save to Google Drive

Save Search

You can save your searches here and later view and run them again in "My saved searches".

Please provide a title, maximum of 40 characters.
Cancel
×

2 results

  • 7 - Palliative and Hospice Care

  • Barbara A. Reich
  • Book:
    Intimations of Mortality
    Published online:
    10 March 2022
    Print publication:
    17 March 2022, pp 131-152

  • Summary

    Before the middle of the twentieth century, most people died rather abruptly of infection, or in the late stages of untreatable illnesses like cancer and heart disease, or in accidents or battle. It was comparatively rare to die slowly in old age. Now, in the age of modern medicine, protracted deaths from cancer, heart disease, dementia, and frailty are far more common, triggering an ever-increasing need for palliative and hospice care. The current health care system in the United States encourages high-intensity care and high utilization of technology at the end of life while reimbursing comparatively little for services such as coordination of care and advance care planning and counseling. The emphasis on technology and treatment makes sense when it is possible to cure or to prolong a life of acceptable (to the patient) quality. But, when death is approaching, our system sometimes fails the patients who need it most.

  • Professional caregivers' experiences with the Liverpool Care Pathway in dementia: An ethnographic study in a Dutch nursing home

  • Natashe Lemos Dekker, Marjolein Gysels, Jenny T. van der Steen
  • Journal:
    Palliative & Supportive Care / Volume 16 / Issue 4 / August 2018
    Published online by Cambridge University Press:
    11 July 2017, pp. 479-486
  • Objective:

    There are few studies on how professional caregivers apply the Liverpool Care Pathway (LCP) in nursing home care for people with dementia. Further, despite critiques in the United Kingdom, the LCP continues to be used in the Netherlands, while, to the best of our knowledge, no studies have been conducted since its implementation. The purpose of the present study was to analyze professional caregivers' experiences with the LCP in this context.

    Method:

    This article draws on an ethnographic study. Data collection was based on 4 months of ethnographic fieldwork in 2015 in 11 psychogeriatric units of a nursing home in a rural area of the Netherlands. Data collection included participant observation and 25 semistructured audiotaped interviews with specialist elderly care physicians, nursing staff, and a nurse practitioner.

    Results:

    We found that professional caregivers appreciate the LCP as a communication tool and as a reminder of care goals. However, the document was deemed too complicated and to cause duplication of work. It was also reported that the LCP did not cover the complexity of care needs that emerge in practice. Actual care needs were prioritized over the LCP, which calls its contribution into question.

    Significance of Results:

    Overall, the LCP does not match the context of dementia care in the nursing home. While it could be argued that the LCP does not intend to replace good care, its benefits as a reminder and a communication tool need continued consideration in relation to the amount of work it requires as a bureaucratic obligation.