Provision of palliative and end-of-life care in New Zealand residential aged care facilities: general practitioners’ perspectives
Deborah Balmer
A C , Rosemary Frey A , Merryn Gott A , Jackie Robinson A and Michal Boyd A B
+ Author Affiliations
- Author Affiliations
A School of Nursing, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.
B Freemasons’ Department of Geriatric Medicine, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.
C Corresponding author. Email: d.balmer@auckland.ac.nz
Australian Journal of Primary Health 26(2) 124-131 https://doi.org/10.1071/PY19081
Submitted: 17 April 2019 Accepted: 15 November 2019 Published: 14 February 2020
Abstract
This exploratory study examined general practitioners’ (GPs) perspectives on delivering end-of-life care in the New Zealand residential aged care context. A general inductive approach to the data collected from semi-structured interviews with 17 GPs from 15 different New Zealand general practices was taken. Findings examine: (1) GPs’ life experience; (2) the GP relationship with the facilities and provision of end-of-life care; (3) the GP interaction with families of dying residents; and (4) GP relationship with hospice. The nature of the GP relationship with the facility influenced GP involvement in end-of-life care in aged care facilities, with GPs not always able to direct a facility’s end-of-life care decisions for specific residents. GP participation in end-of-life care was constrained by GP time availability and the costs to the facilities for that time. GPs reported seldom using hospice services for residents, but did use the reputation (cachet) associated with hospice practices to provide an authoritative buffer for their end-of-life clinical decisions when talking with families and residents. GP training in end-of-life care, especially for those with dementia, was reported as ad hoc and done through informal mentoring between GPs.
Additional keywords: general practice, professional roles and responsibilities, qualitative research, relationships.
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