In recent years, choice and autonomy have been prioritized as key quality indicators in palliative care services. This article examines current palliative care discourses with respect to patient choice. While recognizing the importance of personal autonomy, using evidence from Ireland, this article explores how a discourse on choice can contribute to inequalities in palliative care because it fails to take account of pre-existing structural inequalities, human relationality, and bodily decline. This article proposes a relational approach to care that takes account not only of the relational lives in those in need of care but also of their careers.
This article explores perceptions of time reported by service users, family carers, care workers, nurses, social workers and agency managers across home support services for older adults in Ireland. The findings are organised around: time spent waiting for care; time spent ‘processing’
care across primary and secondary care boundaries; time and person-centred care; and time, technology and communication. Time emerges as a problematic aspect of all processes and structures around formal home care, suggesting that addressing issues around time is central to resolving systemic
challenges. Greater flexibility in time allocation and effective communication among stakeholders could improve experiences of care.
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