Within the Circle of Care: Patient Experiences of Receiving Palliative Care

Abstract

This paper presents an overview of a qualitative study of six recently discharged hospice patients, who had experienced at least two episodes of inpatient palliative care and who were interviewed about their experience of care. The resulting data formed a representation-the Circle of Care-with a central theme being the recognition of patient identity. Other emerging themes were: humour, being watched, caring manner, being safe, chosen isolation, relinquishment and relaxation, keeping control, awareness of mortality, recognition of the palliative care philosophy, and the effect of the aesthetic and spiritual environment. Resume I Cet article presents une vue d'ensemble de l'etude qualitative portant sur six patients admis au moins 2 fois dans un service de soins palliatits, etant recernment retournes a domicile et ayant ete par la suite interviewes au sujet des soins qu'ils y avaient recu. Notre interpretation des resuttats est representee par ce que nous appelons " Ie Cercle des soins, » et ayant pour theme centralia reconnaissance de l'identite du patient. Les autres themes qui ont emerge sont: I'humour, les soins attentlonnss, Ie sentiment de seounte, Ie controle de la situation, la posstbilite de pouvoir s'isoler, I'acceptation de sa propre mortalite, la phisolophie des soins palliatifs, les effets benefiques d'un milieu de nature esthetlque et la necessite d'un environnement spirituel.

Death and dying from old people’s point of view. A literature review

“…Views of dying in people in the end-of-life phase or not (36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52) Like studies about death, in those about dying in older people, not in the end-of-life phase, some common themes were identified, although they took on different meanings for different people (Tables 3-4, [36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52]. These had to do with control, directly or indirectly spoken of (36)(37)(38)(39)(40)(41), who should take decisions when the time comes (38)(39)(40)(41)(42)(43)(44), awareness (37), being prepared …”

“…Reactions varied from anger, withdrawal and humor, to talking with staff about their situation (50). Preserved integrity (51), being in control (51,52,49), relationships with those close by (50,52), but also relieving them of being a burden (52), chosen isolation (51), being involved oneself in caring for others and feeling cared for (50) were all mentioned. Symptom management was also important, especially pain and nutritional problems (50,52), being safe (51) and the care atmosphere (51).…”

A model of treatment decision making when patients have advanced cancer: how do cancer treatment doctors and nurses contribute to the process?

“…In comparison with cancer treatment doctors, more limited research has been undertaken about the skills and specific roles nurses play in cancer care (Corner 2002a(Corner , 2003 especially in cancer treatment decision-making processes and particularly when patients have advanced cancer (McKinlay 2001). While doctors' involvement is notable in diagnosis and treatment of patients' physical problems, nurses are more likely to cast a broader view of the patients' well-being and response to treatment (Salantera et al 2003), be able to explain and interpret doctor's language and conversations and supply information about advanced cancer and treatment options (Castledine 2002).…”

Guidelines for a Palliative Approach in Residential Aged Care: Enhanced Version--May 2006

“…Conflict between the resident and family members may surface or may even be exacerbated during these times. The aged care team needs to help the resident's family accept the decision of the resident whenever appropriate, because in most instances the decision to accept a palliative approach should be the resident's [39] (Level QE). However, the views of the family are also relevant and need to be understood [40] (Level EO).…”