Vilma Tripodoro

Palliative Care Staff Perspectives: The Challenges of End-of-Life Care on Their Professional Practices and Everyday Lives

This article has 3 goals: To describe the attitudes and experiences of staff on end-of-life care treatment of dying persons, to examine how the staff view their terminally ill patients, and to gather professionals’ opinions on how their experiences impact their daily lives. It is a qualitative research inquiry based on a constructivist-grounded theory design. The study subjects were professionals who were part of palliative care services in Buenos Aires city during 2012. A purposive sample of 30 personnel answered an open-ended questionnaire assessing attitudes and perceptions concerning end-of-life. The results showed the following: (a) “Good” deaths were considered those in which physical symptoms were dealt with, where the patient was surrounded or on good terms with family members, and where they were at peace with themselves, any unfinished business, or God. “Bad” deaths were believed to be those where the patient was physically uncomfortable, were within a conspiracy-silence atmosphere, and died alone. (b) The factors in common that staff members identified regarding deaths were the need for spiritual comfort, peace, and acceptance and the need for attaining a deep connection with others. (c) The unexpected issues identified among end-of-life trajectories were the varying attitudes that patients had regarding death. (d) The personal life of the staff was affected by being in charge of end-of-life care decision making.

Caregivers burden in palliative care patients: a problem to tackle.

Purpose of reviewTo revise the family caregivers burden concept and to understand the implications for the patient, family and healthcare system. We analyzed recent literature in three main areas: the role of family caregiver at the end of life, the family caregivers burden and the involvement of social care networks. Recent findingsThe family caregiver often accepts the caring as a natural action, presumably imposed by the society. A recent review described seven main roles of care which, according to family system and society, consist of different tasks and activities. To assume this role is not stress free. It is likely to develop a ‘burden’ by the assumed task. SummaryFamily members who are close to the patient may play the role of caregiver, well-being enhancer, diversity of tasks fulfiller, minimizer and managing suffering, palliative care facilitator and responsible for the continuity of care, apprentice and participant of health teams. The family caregiver often gives priority to the problems of his dependent family member, becoming almost ‘invisible’ to the health system. It should also be consider the relevance of this issue into future bereavement process. Considering all these aspects, the family caregiver is often considered by the healthcare teams as ‘overall tasks’ performers’.