Barriers to providing palliative care for older people in acute hospitals.
BACKGROUND
the need for access to high-quality palliative care at the end of life is becoming of increasing public health concern. The majority of deaths in the UK occur in acute hospitals, and older people are particularly likely to die in this setting. However, little is known about the barriers to palliative care provision for older people within acute hospitals.


OBJECTIVE
to explore the perspectives of health professionals regarding barriers to optimal palliative care for older people in acute hospitals.


METHODS
fifty-eight health professionals participated in eight focus groups and four semi-structured interviews.


RESULTS
participants identified various barriers to palliative care provision for older people, including attitudinal differences to the care of older people, a focus on curative treatments within hospitals and a lack of resources. Participants also reported differing understandings of whose responsibility it was to provide palliative care for older people, and uncertainly over the roles of specialist and generalist palliative care providers in acute hospitals.


CONCLUSIONS
numerous barriers exist to the provision of high-quality palliative care for older people within acute hospital settings. Additional research is now required to further explore age-related issues contributing to poor access to palliative care.
University of Sheffield - School of Nursing & Midwifery, Sheffield, UK. c.gardiner@sheffield.ac.uk
Clare
C
Gardiner
Mark
M
Cobb
Merryn
M
Gott
Christine
C
Ingleton
D000328:Adult; D000367:Age Factors; D000368:Aged; D000375:Aging; D001291:Attitude of Health Personnel; D003299:Cooperative Behavior; D019033:Delivery of Health Care, Integrated / Q000191:economics; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006295:Health Resources / Q000191:economics; D006297:Health Services Accessibility / Q000191:economics; D054625:Healthcare Disparities; D017721:Hospital Costs; D006761:Hospitals; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008505:Medical Staff, Hospital / Q000523:psychology*; D008875:Middle Aged; D010166:Palliative Care / Q000191:economics; D010348:Patient Care Team; D011287:Prejudice; D036301:Qualitative Research; D011787:Quality of Health Care / Q000191:economics; D006113:United Kingdom