The aim of this paper was to examine the use of palliative care services by members of black/minority ethnic communities. Referral patterns of hospital consultants and general practitioners (GPs) to Birmingham St Mary's Hospice were examined. Semistructured interviews were carried out to explore doctors' perceptions of the benefits and limitations of hospice services for their black/minority ethnic patients and to identify potential barriers to referral. In total, 27 doctors were interviewed: 15 hospital consultants and 12 GP. The GPs were selected according to size of practice within areas of Birmingham with significant black/minority ethnic populations. Referrals received by the hospice for the period April 1996 to November 1997 were collected from the Hospice's computerized database. Results show that, compared to white Europeans, there was an underutilization of day care and inpatient hospice services by members of black/minority ethnic communities. Doctors did, however, refer their black/minority ethnic patients for hospice home-care services: 8.5% of referrals received by the hospice were for nonwhite patients. This referral rate increased to 19.3% in specific postcode areas known to have significant black/minority ethnic communities. Further research is needed to establish levels of awareness, explore attitudes towards palliative care services and assess the demand for specific services within various black/minority ethnic communities.
Summary
The present paper describes the findings of a pilot study funded by the NHS Executive Primary and Community Care Research Initiative Small Projects Scheme that investigated the knowledge and attributions of dementia held by care staff who work with older adults with learning disability. Meetings took place with 21 members of care staff identified as keyworkers to older adults with learning disability living in residential houses provided by Solihull Healthcare NHS Trust, Solihull, UK. The results suggest that staff have knowledge of ageing at a similar level to that of college students. Forgetfulness was the sign that they would most expect to see if they thought someone was suffering from dementia. When a change in behaviour was attributed to dementia, it was most likely to be viewed as ‘stable, uncontrollable’ with staff feeling pessimistic about being able to change the behaviour.
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