[Palliative care practices at home: instead of social exclusion of older people in later life?].

The understanding of palliative care practices at home (PCH) is limited by the lack of available scientific knowledge. This is explained by the fact that its practices are relatively recent and they question our relationship with death and dying individuals. This study aims to contribute to the advancement of knowledge about PCH with the elderly. More specifically, with a perspective of social exclusion, it aims to understand how practices either do or do not produce social exclusion with seniors receiving palliative care. Nineteen participants from two local community services centers were interviewed and six multidisciplinary meetings were attended for observation. This study suggests that positive representations concerning the elderly in palliative care and recognition of their autonomy can avoid social exclusion, including its symbolic and identificatory dimensions. However, standardization of practices seems to contribute to institutional exclusion and foster nonrecognition.

[1]  P. Piselli,et al.  Communicating cancer diagnosis and prognosis: when the target is the elderly patient-a GIOGer study. , 2009, European journal of cancer.

[2]  K. Steinhauser,et al.  End-of-life care in nursing home settings: Do race or age matter? , 2008, Palliative and Supportive Care.

[3]  E. Osuna,et al.  Elderly patients also have rights , 2007, Journal of Medical Ethics.

[4]  P. Butow,et al.  Truth-telling in discussing prognosis in advanced life-limiting illnesses: a systematic review , 2007, Palliative medicine.

[5]  H. Abu‐Saad,et al.  What is a good death? Terminally ill patients dealing with normative expectations around death and dying. , 2006, Patient education and counseling.

[6]  K. Kehl.  Moving Toward Peace: An Analysis of the Concept of a Good Death , 2006, The American journal of hospice & palliative care.

[7]  I. Gutheil,et al.  Psychosocial Services at the End of Life , 2006 .

[8]  Mireille Blais,et al.  L’analyse inductive générale : description d’une démarche visant à donner un sens à des données brutes , 2006, Recherches qualitatives.

[9]  David C. Perry,et al.  Beliefs, Death Anxiety, Denial, and Treatment Preferences in End-of-Life Care , 2005, Journal of social work in end-of-life & palliative care.

[10]  Marie-Fleur Bernard.  Prendre soin de nos aînés en fin de vie: à la recherche du sens , 2004 .

[11]  P. Hintermeyer.  Les critères du bien mourir , 2004 .

[12]  Michel Castra.  Les soins palliatifs et l'euthanasie volontaire : l'affirmation de nouveaux modèles du “bien mourir” , 2004 .

[13]  J. Déchaux.  Mourir à l'aube du xxie siècle , 2002 .

[14]  B. Fazekas,et al.  The coverage of cancer patients by designated palliative services: a population-based study, South Australia, 1999 , 2002, Palliative medicine.

[15]  H. Doucet.  Personnes âgées et soins de santé , 2002 .

[16]  O. Michel,et al.  Existe-t-il une spécificité des soins palliatifs chez le sujet âgé? , 2002 .

[17]  C. Bertheloot,et al.  Patient jeune ou âgé : des soins palliatifs différents ? , 1999, Gérontologie et société.

[18]  O. Jean,et al.  Age et restriction d'accès aux soins : Les toutes dernières années de la vie , 1999 .

[19]  G. Howarth.  ‘Just live for today’. Living, caring, ageing and dying , 1998, Ageing and Society.

[20]  C. Todd,et al.  Place of death and access to home care services: are certain patient groups at a disadvantage? , 1998, Social science & medicine.

[21]  D C McCrory,et al.  Getting Meaningful Informed Consent from Older Adults: A Structured Literature Review of Empirical Research , 1998, Journal of the American Geriatrics Society.

[22]  Pierre Paillé.  L’analyse par théorisation ancrée , 1994 .