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End-of-life care for older people in community hospitals
  1. Chris Kerr, Senior Research Fellow,
  2. Sheila Payne,
  3. Sheila Hawker,
  4. David Seamark,
  5. Nikki Jarrett,
  6. Helen Roberts and
  7. Helen Smith
  1. Chris Kerr, Senior Research Fellow, Social Work Studies, University of Southampton, Southampton; Sheila Payne, Help the Hospices Chair in Hospice Studies, International Observatory on End of Life Care, Institute for Health Research, Lancaster University, Lancaster; Sheila Hawker, Senior Research Fellow, Social Work Studies, University of Southampton, Southampton; David Seamark, General Practitioner, The Honiton Group Practice, Honiton, Devon; Nikki Jarrett, Lecturer, School of Nursing and Midwifery, University of Southampton, Southampton; Helen Roberts, Senior Lecturer in Geriatric Medicine, Elderly Care Research Unit, University of Southampton, Southampton General Hospital, Southampton; Helen Smith, Professor of Primary Care, Division of Primary Care and Public Health, Brighton and Sussex Medical School, Mayfield House, University of Brighton, Brighton. Email for correspondence: s.a.payne{at}lancaster.ac.uk

Abstract

Background: The need for end-of-life care is likely to increase. Older people and those in rural areas do not have equal access to specialist palliative care services. End-of-life care is being offered to an increasing population of older people in community hospitals. Aims: To explore the views of senior clinical managers about end-of-life care in relation to the environment and staffing of community hospitals. Methods: Thirty semistructured interviews were carried out with senior clinical managers in community hospitals in the South East and South West of England. Results: Community hospitals can offer flexible accommodation for end-of-life care. Stable staff teams provide local knowledge and continuity of care. The relationship between local GPs and community hospital staff was key and nurses took the lead in the care of dying patients. Conclusions: Managers believe that community hospitals are appropriate places for older patients requiring end-of-life care. Issues arise around out-of-hours’ care and staff training. Conflicts of interest: none

  • Community hospital
  • End-of-life care
  • Older people
  • Palliative care

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