End of Life Care (EOLC) in Care Homes

养老院在高龄老人(80岁以上)的临终关怀(EOLC)中发挥着至关重要的作用。英国约30%的死亡病例是养老院居民。COVID大流行进一步增加了疗养院的死亡人数，预计到2040年，疗养院将成为英国最常见的死亡地点。然而，疗养院的EOLC研究不足。我的博士论文研究了2019至2020年间英国养老院的EOLC。这是近20年来首次对这一主题进行深入研究。在这次奖学金期间，我将为学术和专业受众发展我的博士发现，以直接改善和促进护理院工作人员的教育和培训，这是政府的优先事项。大多数关于养老院死亡的社会学研究都是在20世纪90年代进行的。我的学术出版物将更新这一领域，借鉴新的医疗、政策和实践干预措施。例如，我将写一篇文章，探索在疗养院死亡的结构是“自然的”。这篇文章涉及关于不干预的论述，这是我的导师博格斯特罗姆博士研究的一个话题。我的第二篇文章使用了“合规死亡”的概念--这是我提出的一个新概念--来考察死亡工作人员寻求实现什么样的“好”死亡。最后，我的书中的章节阐述了一种新的理论方法，即养老院的生物政治经济学，它为英格兰护理工作的贬值和养老院在提供EOLC中的作用提供了新的见解。社会护理劳动力的教育和培训是政府的优先事项。研究发现，疗养院的EOLC是一个需要改进的领域。有证据表明，在一线、管理和领导层的技能发展方面存在差距。拟议的活动计划通过让不同的受众和利益攸关方参与来反映这一点。我将与护理之家的工作人员一起经营一家证据咖啡馆，分享对EOLC最佳实践的见解。证据咖啡馆是开放大学建立的一种知识交流方法，有20-30名参与者参加。开放大学提供培训和辅导员，帮助研究人员运营研讨会。护理之家的工作人员、护士和经理将通过开放死亡学组织的网络和大学与护理雇主的教育联系来招聘。基于证据咖啡馆，我将写一篇开源文章，讲述员工在照顾垂死的居民方面所扮演的角色。这篇文章将是开放大学通过开放学习向公众(每年有数百万用户)提供的免费课程的一部分；它将通过网络分发给护理之家的工作人员、居民和他们的家人。EOLC对疗养院部门来说是一个至关重要的领域和商机。我将为英国护理行业领先的面向专业的期刊写一篇文章。养老院的高级经理和高管阅读护理管理事项。我的文章将描述他们如何支持他们的员工提供更好的EOLC。我还将出席英国最大的私人疗养院提供者会议，因为私人提供者占疗养院部门的90%。他们的所有者、受托人、高管和卓越护理的拥护者将了解到护理居民临终的工作人员面临的挑战。文章和演示文稿将倡导在EOLC上投资于劳动力教育和培训。最后，从我的博士工作中得到的洞察力揭示了疗养院EOLC中亲密关系和性关系的重要性，我将为未来的资金开发一个新的工作领域。要做到这一点，首先我将在EOL组织一个关于亲密和性关系的研讨会。受邀从业者和研究人员将讨论这一支持不足领域的工作人员教育和培训。其次，我将与我的导师琼斯博士就老龄化和死亡社会学这一新兴领域进行文献回顾。最后，我将为ESRC关于这个主题的新调查者电话会议开发一个应用程序。

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.