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Article
Publication date: 9 September 2013

Randall Smith

The purpose of this paper is to trace the history of official policy on the regulation of care homes in respect of end of life care and to contrast this with the results of…

Abstract

Purpose

The purpose of this paper is to trace the history of official policy on the regulation of care homes in respect of end of life care and to contrast this with the results of research on this important theme, not least in terms of what is required to support care home staff in relation to dying residents and their relatives. A central concern is to argue for the open recognition that care homes now cater primarily for frail people towards the end of their lives. Good end of life care and a good death could become a positive “selling point”. The author concludes that the system of regulation has broadly failed to address a good death or good end of life care in a residential home. Death talk should no longer need to be avoided in care homes. The research suggests that appropriate support for care home staff in relation to dying residents needs careful identification and investment. A cultural shift is required.

Design/methodology/approach

Following a review of policy documents on regulation and standards of care in residential homes and a subsequent review of the research literature on death and dying in care homes, the paper illuminates the contrast between the ambitious aims in policy documents with very varied practice in everyday care of frail residents.

Findings

The recent systems of regulation have broadly failed to address a good death or good end of life care in residential homes. Open acknowledgement of death and dying should not be avoided in care homes. Appropriate support for care home staff in relation to dying residents needs careful identification and investment.

Originality/value

The focus of this paper is to contrast official policy with everyday practice. Whilst policy documents suggest recognition of the importance of dignity and respect from dying residents, the research literature indicates great variation in the practice of everyday care.

Details

Quality in Ageing and Older Adults, vol. 14 no. 3
Type: Research Article
ISSN: 1471-7794

Keywords

Article
Publication date: 9 September 2014

Tina Maschi, Suzanne Marmo and Junghee Han

The growing numbers of terminally ill and dying in prison has high economic and moral costs as global correctional systems and the society at large. However, to date little is…

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Abstract

Purpose

The growing numbers of terminally ill and dying in prison has high economic and moral costs as global correctional systems and the society at large. However, to date little is known about the extent to which palliative and end-of-life care is infused within global prison health care systems. The purpose of this paper is to fill a gap in the literature by reviewing and critically appraising the methods and major findings of the international peer-reviewed literature on palliative and end-of-life care in prison, identify the common elements of promising palliative and end-of-life services in prison, and what factors facilitate or create barrier to implementation.

Design/methodology/approach

A content analysis was conducted of the existing peer-reviewed literature on palliative and end-of-life care in prison. English-language articles were located through a comprehensive search of peer-reviewed journals, such as Academic Search Premier Literature databases using differing combinations of key word search terms, “prison,” “palliative care,” and “end-of-life care.” A total of 49 studies published between 1991 and 2013 met criteria for sample inclusion. Deductive and inductive analysis techniques were used to generate frequency counts and common themes related to the methods and major findings.

Findings

The majority (n=39) of studies were published between 2001-2013 in the USA (n=40) and the UK (n=7). Most were about US prison hospice programs (n=16) or barriers to providing palliative and end of life care in prisons (n=10). The results of the inductive analysis identified common elements of promising practices, which included the use of peer volunteers, multi-disciplinary teams, staff training, and partnerships with community hospices. Obstacles identified for infusing palliative and end-of-life care in prison included ethical dilemmas based on custody vs care, mistrust between staff and prisoners, safety concerns, concern over prisoners’ potential misuse of pain medication, and institutional, staff, and public apathy toward terminally ill prisoners and their human rights to health in the form of compassionate and palliative care, including the use of compassionate release laws.

Research limitations/implications

Implications for future research that foster human rights and public awareness of the economic and moral costs of housing the sick and dying in prisons. More research is needed to document human rights violations as well as best practices and evidence-based practices in palliative and end-of-life care in prisons. Future studies should incorporate data from the terminally ill in prison, peer supports, and family members. Future studies also should employ more rigorous research designs to evaluate human rights violations, staff and public attitudes, laws and policies, and best practices. Quantitative studies that use experimental designs, longitudinal data, and multiple informants are needed. Qualitative data would allow for thick descriptions of key stakeholders experiences, especially of the facilitators and barriers for implementing policy reform efforts and palliative care in prisons.

Practical implications

This review provides a foundation on which to build on about what is known thus far about the human right to health, especially parole policy reform and infusing palliative and end-of-life care for the terminally ill and dying in prisons. This information can be used to develop or improve a new generation research, practice, policy, and advocacy efforts for that target terminally ill and dying in prison and their families and communities.

Social implications

There are significant social implications to this review. From a human rights perspective, the right to freedom from torture and cruel and unusual punishment is a fundamental human right along with prisoners’ rights for an appropriate level of health care. These rights should be guaranteed regardless of the nature of their crime or whether they are in a prison placement. The information provided in this review can be used to educate and possible transform individual's and society's views toward the terminally ill and dying who are involved in the criminal justice system.

Originality/value

This paper extends the extant literature by using both quantitative and qualitative analysis methods to organize, summarize, and critically analyze the international literature on palliative care and end of life care in prison. This review is designed to increase awareness among the international community of the pain and suffering of the terminally ill in prison and the facilitators and barriers to providing them compassionate care while in custody.

Details

International Journal of Prisoner Health, vol. 10 no. 3
Type: Research Article
ISSN: 1744-9200

Keywords

Article
Publication date: 3 June 2020

Marc van den Berg, Hans Voordijk and Arjen Adriaanse

The purpose of this study is to explore how demolition contractors coordinate project activities for buildings at their end-of-life. The organizations are thereby conceptualized…

Abstract

Purpose

The purpose of this study is to explore how demolition contractors coordinate project activities for buildings at their end-of-life. The organizations are thereby conceptualized as information processing systems facing uncertainty.

Design/methodology/approach

A multiple-case study methodology was selected to gain in-depth insights from three projects with different end-of-life strategies: a faculty building (material recycling), a nursing home (component reuse) and a psychiatric hospital (element reuse). Using a theory elaboration approach, the authors sought to explain how and why demolition contractors process information for end-of-life coordination.

Findings

End-of-life strategies differ in the degree of building, workflow and environmental uncertainty posed to the demolition contractor. Whether or not a strategy is effective depends on the (mis)match between the specific levels of uncertainty and the adopted coordination mechanisms.

Research limitations/implications

The explanatory account on end-of-life coordination refines information processing theory for the context of (selective) demolition projects.

Practical implications

The detailed case descriptions and information processing perspective enable practitioners to select, implement and reflect on coordination mechanisms for demolition/deconstruction projects at hand.

Originality/value

Reflecting its dual conceptual-empirical and inductive-deductive focus, this study contributes with new opportunities to explain building end-of-life coordination with a refined theory.

Details

Construction Innovation , vol. 20 no. 4
Type: Research Article
ISSN: 1471-4175

Keywords

Article
Publication date: 1 August 2007

Alice Shiner and Jennifer Stothard

National evidence shows that around 60% of patients would prefer to receive end of life care and die at home, but in 2005 in North Derbyshire only 20% of patients were supported…

Abstract

National evidence shows that around 60% of patients would prefer to receive end of life care and die at home, but in 2005 in North Derbyshire only 20% of patients were supported to do so. This article discusses the tools used to improve end of life care services in the community and explores the enablers and barriers.

Details

Journal of Integrated Care, vol. 15 no. 4
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 1 September 2002

Tushna Vandrevala, Sarah Hampson and Theopisti Chrysanthaki

The greater availability of life‐sustaining technology, such as cardiopulmonary resuscitation, and the medical, legal and moral pressures to use them, often enable the…

Abstract

The greater availability of life‐sustaining technology, such as cardiopulmonary resuscitation, and the medical, legal and moral pressures to use them, often enable the prolongation of lives of older people. The dying process can be extended regardless of quality of life. Further, there is much public debate on the increasing emphasis on individual rights and personal autonomy in the dying process. This qualitative study examined older people's perspectives on end‐of‐life decision‐making and advance care planning. A sample of 12 older people living in the community was recruited and studied in‐depth. A semi‐structured interview explored patients' conceptualisations of decision‐making in the later stages of life and the significant others they would like involved in the process. The data were analysed using ‘content analysis’. The resulting broad categories, themes and sub‐themes formed the foundation of an emerging model of older people talking about end‐of‐life care. Finally, results were discussed with regard to practice and policy development.

Details

Quality in Ageing and Older Adults, vol. 3 no. 3
Type: Research Article
ISSN: 1471-7794

Keywords

Book part
Publication date: 12 October 2011

Eva Kahana, Boaz Kahana, Loren Lovegreen, Jeffrey Kahana, Jane Brown and Diana Kulle

This chapter discusses challenges faced by older adult health-care consumers in obtaining access to responsive care from physicians relevant to a broad spectrum of health issues…

Abstract

This chapter discusses challenges faced by older adult health-care consumers in obtaining access to responsive care from physicians relevant to a broad spectrum of health issues ranging from prevention to chronic illness and end-of-life care. Based on our prior research with community-dwelling elders (E. Kahana & B. Kahana, 2003, 2010), we propose a conceptual model of consumer self-advocacy for better access to effective health care in late life. We argue that older adults who are well informed and confident health-care partners and who involve their physicians in active dialogue will experience better care, and will be more satisfied with their health care. We present findings from our studies of cancer prevention and from our research focused on end-of-life care relevant to patient self-advocacy. We also discuss the role of educational interventions and of patient empowerment in facilitating greater access to responsive health communication and health care, particularly among elders who are disadvantaged and who have low health literacy.

Details

Access to Care and Factors that Impact Access, Patients as Partners in Care and Changing Roles of Health Providers
Type: Book
ISBN: 978-0-85724-716-2

Keywords

Article
Publication date: 15 February 2023

Esther Oluwadamilola Olufemi Rotimi, Lester W. Johnson, Hassan Kalantari Daronkola, Cheree Topple and John Hopkins

The purpose of this study is to apply and extend the predictors within the theory of planned behaviour (TPB) to understand consumers' behaviour toward recycling end-of-life

Abstract

Purpose

The purpose of this study is to apply and extend the predictors within the theory of planned behaviour (TPB) to understand consumers' behaviour toward recycling end-of-life garments among Australian consumers. The predictors explored within this study include attitude, perceived behavioural control, subjective norms, self-identity, general recycling behaviour eco-literacy, self-efficacy, intentions to recycle and behaviour to recycle end-of-life garments.

Design/methodology/approach

Data were collected from a sample of consumers across all eight recognised states/territories in Australia through survey questionnaires. A total of 481 usable responses were analysed using structural equation modelling.

Findings

Results show positive relationships between the factors explored with all hypotheses supported. The findings of this study have theoretical and managerial implications. They (1) provide an insight into the significant factors that influence consumers' recycling behaviour amongst Australian fashion consumers; (2) bridge the gap in the explanatory nature of TPB by extending this theory; (3) call to develop marketing campaigns to educate consumers on the impact of fashion waste; (4) suggest the need for provision of household textile collection bins at a national level and (5) highlight the need for policy reform on garment recycling enabled by the Australian government.

Originality/value

This study is part of the limited studies that focus on the recycling of consumer fashion waste within the Australian context. Little research has also applied the TPB to end-of-life fashion products with a focus on recycling. In addition, no study to the authors' knowledge has, in combination, explored self-efficacy, self-identity, general recycling behaviour and eco-literacy as predictors of intentions to recycle end-of-life garments.

Details

Journal of Fashion Marketing and Management: An International Journal, vol. 27 no. 2
Type: Research Article
ISSN: 1361-2026

Keywords

Article
Publication date: 2 May 2017

Karen Gillett, Liz Reed and Liz Bryan

The purpose of this paper is to describe the delivery of facilitated action learning sets as an integral component of a multidisciplinary end-of-life care course.

Abstract

Purpose

The purpose of this paper is to describe the delivery of facilitated action learning sets as an integral component of a multidisciplinary end-of-life care course.

Design/methodology/approach

The educational intervention described in this paper is delivered by specialist palliative care practitioners to those working with dying patients and their families in non-specialist settings. The programme consists of two components: the first taught/experience-based component takes place in a hospice. The second integral component involves action learning sets which are facilitated by specialist palliative care staff over a six-month period. This paper reports the challenges, learning and benefits of using action learning sets to improve end-of-life care.

Findings

Action learning sets provide support which enables staff to implement changes to end-of-life care. Participants in the successful action learning sets were motivated to change practice and identified themselves as change agents. Management support was vital to allow participants the authority to implement changes to practice.

Practical implications

Facilitators need to gain participant and management commitment to the action learning process before the programme begins if they are to be successful in achieving changes to end-of-life care.

Originality/value

Hospices and other health care organisations work in partnership to deliver this programme, and this paper demonstrates how action learning sets can increase mutual understanding and communication between specialist and non-specialist end-of-life care settings.

Details

Leadership in Health Services, vol. 30 no. 2
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 1 December 2008

Catherine Evans and Claire Goodman

The second in a new series about mental health in old age, this article reviews policies and research evidence on services for people with dementia at the end of their lives, and…

Abstract

The second in a new series about mental health in old age, this article reviews policies and research evidence on services for people with dementia at the end of their lives, and looks at future commissioning priorities

Details

Journal of Integrated Care, vol. 16 no. 6
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 21 September 2012

Erik Sundin, Kristofer Elo and Hui Mien Lee

The purpose of this paper is to explore how manufacturers can develop automatic end‐of‐life processes facilitated by product design methods, e.g. design for disassembly, recycling…

Abstract

Purpose

The purpose of this paper is to explore how manufacturers can develop automatic end‐of‐life processes facilitated by product design methods, e.g. design for disassembly, recycling and remanufacturing. Also to illustrate this kind of product and end‐of‐life process development while maintaining economic and environmental values. Here, the cases of toner cartridges and liquid crystal displays are the focus.

Design/methodology/approach

The research methodology for this paper began with a literature study within the fields of design for automatic recycling and remanufacturing. It also includes the research performed at two different industrial companies using automation in their end‐of‐life processes. These companies were visited and interviewed several times, in order to understand their processes and what current problems they have in automation and product design.

Findings

Design implications on the end‐of‐life have been explored, and in particular, three general product trends are in conflict with automatic disassembly: products are getting more complex and more heterogeneous; products are getting sleeker; and products are using more proprietary joints. In addition, the three industrial cases describe different problems in industry and how they can be tackled. Although many manufacturers have adapted the design principles of DFM and DFE, there is still much to improve when it comes to designing for the product's end‐of‐life processes. These kinds of adaptations should increase in importance over time as more and more products and components are remanufactured and/or material recycled. These kinds of adaptations will also encourage an increase of products passing through more resource efficient end‐of‐life options.

Practical implications

Manufacturers reading what design problems other companies are experiencing and what solutions can be found would facilitate their own businesses and willingness to start their own and/or improve their existing manufacturing business. This could then be in shape developing products for end‐of‐life processes which also would encourage them to start their own end‐of‐life process facilities.

Social implications

From a societal perspective, an increase in remanufactured products being placed on the market can increase the awareness and confidence of the consumers in non‐new products made from non‐virgin materials. This will increase the market for second‐life products and bring about economics of scale, which in turn will alleviate the problem of depletion of resources.

Originality/value

Most previous research in this area treats the different end‐of‐life processes separately; material recycling and product remanufacturing are but two examples. However, in this paper the focus is more on the overall view of end‐of‐life processes, along with examples of more specific and detailed end‐of‐life processes, such as disassembly and cleaning.

Details

Assembly Automation, vol. 32 no. 4
Type: Research Article
ISSN: 0144-5154

Keywords

1 – 10 of over 3000