My research looks at End of Life Care (EOLC) for and with old adults living and dying in care homes. Given the ageing of populations and the epidemiological transition to non-communicable diseases, more and more people are expected to die in their late 80s when the incidence of dementia, chronic disabling illnesses and institutionalisation is higher. Hence, this PhD answers whether care homes provide - or have the potential to provide - a kind of EOLC that is attuned to the hallmarks of dying in the 21st century England, that is in late old age (80+), with severe disability, frailty, and dementia. It does so by applying a mixed methods design that integrates multivariate analysis of the English Longitudinal Study of Ageing (ELSA) with ethnographic observation and interviewing of staff in up to six care homes in the South West of England. This project thus addresses the lack of up-to-date evidence base to inform EOLC practice in institutional long-term care. Further, it investigates the potential and hurdles of EOLC provision in the care home sector.
My research looks at older adults living and dying in care homes. The UK is at the forefront of addressing dying in late old age. British end of life care (EOLC) relies on the strong legacy of Dame Cicely Saunders and the Modern Hospice Movement. Further, England was the first country to issue a comprehensive EOLC policy at the national level. Nonetheless, EOLC for older adults in care homes does not come without issues. My project addresses the following research questions:
1) Is EOLC in care homes responsive to dying in late old age?
2) Who are the old adults most likely to end their lives in a care home as opposed to other care settings?
3) How is EOLC undertaken in a care home setting?