Pathways in end-of-life care for older people: care managers' reasoning.
Seven care managers employed by a large municipality in Sweden were interviewed concerning their reasoning regarding end-of-life care for older people. Data were analyzed using a hermeneutic approach. The results showed that end-of-life care was considered to constitute a small part of the care managers' work and was something they did not focus on in general when assessing care needs. Two different pathways to death--the natural and the medical--were identified. In the natural pathway, death was invisible and the care was more routine-oriented. In the medical pathway, death was visualised and the care more individualised. Neither of the pathways paid attention to communication or existential needs. Thus, there is a need for a palliative pathway to death based on the philosophy of palliative care, which could provide guidance for care managers and promote opportunities for older people to achieve a dignified dying and death.
Osterlind
Jane
J
School of Health and Medical Sciences, Orebro University, Orebro, Sweden. jane.osterlind@esh.se
Hansebo
Görel
G
Lantz
Göran
G
Ternestedt
Britt-Marie
BM
D001291:Attitude of Health Personnel; D001293:Attitude to Death; D005260:Female; D005851:Geriatric Nursing / Q000458:organization & administration*; D017408:Guidelines as Topic; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D010166:Palliative Care / Q000458:organization & administration*; D013548:Sweden; D013727:Terminal Care / Q000458:organization & administration*