End of Life Care (EOLC) in Care Homes

点击翻译按钮获取中文摘要

Care homes play a crucial role in the end-of-life care (EOLC) of very old people (80+). About 30% of all deaths in England are of care home residents. The COVID pandemic further increased deaths in care homes, and care homes are predicted to become the most common place of death in England by 2040. Yet EOLC in care homes is under-researched. My PhD thesis explored EOLC in English care homes between 2019 and 2020. It was the first in-depth study on the topic in almost 20 years. During this Fellowship I will develop my PhD findings for academic and professional audiences to directly improve and foster the education and training of the care home workforce, which is a government priority. Most sociological research on death in care homes was conducted in the 1990s. My academic publications will update the field drawing on new medical, policy and practice interventions. For example, I will write an article exploring the construction of dying in care homes as 'natural'. The article engages with discourses on non-intervention, a topic my mentor Dr Borgstrom has researched. My second article uses the concept of a 'regulation-compliant death' - a new concept I developed - to examine what kinds of 'good' death staff seek to achieve. Lastly, my book chapter formulates a new theoretical approach, the biopolitical economy of care homes, that provides new insights into the devaluation of care work and the role of care homes within the provision of EOLC in England.The education and training of the social care workforce is a government priority. Research identifies EOLC in care homes as an area for improvement. Evidence reveals gaps in skills development at the frontline, managerial and leadership levels. The proposed plan of activities reflects this by engaging different audiences and stakeholders. I will run an Evidence Café with care home staff to share insights on best practice for EOLC. The Evidence Café is an established Open University workshop method for knowledge exchange involving 20-30 participants. The Open University provides training and facilitators to help researchers run the workshop. Care home workers, nurses and managers will be recruited through the networks of the Open Thanatology group and the university's educational links with care employers. Based on the Evidence Café, I will write an open-source article on the staff's role in caring for dying residents. The article will be part of the free courses provided by the Open University via OpenLearn to the general public (with millions of annual users); it will be distributed via networks to care home staff, residents and their families. EOLC is a crucial field and business opportunity for the care home sector. I will write an article for the leading professional-facing journal of the British care industry. Senior managers and executives of care homes read Care management Matters. My article will describe how they can support their staff to deliver better EOLC. I will also present at the largest conference of private care home providers in the UK since private providers make up 90% of the care home sector. Their owners, trustees, executives and champions of care excellence will learn about the challenges faced by staff in the care of residents' dying. The article and presentation will advocate to invest in workforce education and training on EOLC. Finally, drawing on insights from my PhD work which revealed the importance of intimate and sexual relationships at the EOLC in care homes, I will develop a new area of work for future funding. To do this, firstly I will organise a symposium on intimate and sexual relationships at the EOL. Invited practitioners and researchers will discuss staff education and training in this under-supported area. Secondly, I will conduct a literature review with my mentor Dr Jones on this emerging area in the sociology of ageing and dying. Lastly, I will develop an application for the ESRC New Investigator call on this topic.