Gendered Processes in Hospice Palliative Home Care for Seniors With Cancer and Their Family Caregivers

Sutherland, Nisha; Ward‐Griffin, Catherine; McWilliam, Carol L.; Stajduhar, Kelli

doi:10.1177/1049732315609571

Cited by 13 publications

(24 citation statements)

References 65 publications

(116 reference statements)

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“…In this article, the structural impact on gendered expectations and exemptions of family caregivers of clients with terminal cancer in HPHC is reported. Reported elsewhere are the normalizing and equalizing ideological processes shaping gendered patterns for clients, family caregivers and providers in HPHC (Sutherland, Ward-Griffin, McWilliam, & Stajduhar, 2016). The social mechanisms underlying gender inequities in HPHC are described elsewhere (Sutherland, 2014).…”

Section: Literature Reviewmentioning

confidence: 99%

“…Reported elsewhere are the normalizing and equalizing ideological processes shaping gendered patterns for clients, family caregivers and providers in HPHC (Sutherland, Ward-Griffin, McWilliam, & Stajduhar, 2016). The social mechanisms underlying gender inequities in HPHC are described elsewhere (Sutherland, 2014). Dorothy Smith's (2005) critical feminist perspective was used to foreground gender.…”

Section: Literature Reviewmentioning

confidence: 99%

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Structural impact on gendered expectations and exemptions for family caregivers in hospice palliative home care

et al. 2016

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Evidence of gender differences in the amount and type of care provided by family caregivers in hospice palliative home care suggests potential inequities in health and health care experiences. As part of a larger critical ethnographic study examining gender relations among clients with cancer, their family caregivers and primary nurses, this article describes gendered expectations and exemptions for family caregivers within the sociopolitical context of end-of-life at home. Data were collected from in-depth interviews (n = 25), observations of agency home care visits (n = 9) and analyses of policy and home care agency documents (n = 12). Employing a critical feminist lens, a gender-based analysis revealed that structural discourses emphasizing an artificial divide between public and private spheres constructed end-of-life at home as private and apolitical. Associated with care of home and family, women were most impacted by these public/private discourses underpinning neoliberal values of cost-efficiency. Findings suggest that a critical perspective is needed to assist policy makers and healthcare providers to view how caregiver experiences are shaped by structures that control the availability of resources. Thus, instead of focusing on caregivers' deficits, interventions should be directed at the social, political and economic conditions that shape gendered experiences.

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Section: Literature Reviewmentioning

confidence: 99%

Section: Literature Reviewmentioning

confidence: 99%

Structural impact on gendered expectations and exemptions for family caregivers in hospice palliative home care

et al. 2016

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“…Therefore, systematic research is required to recommend gender-sensitive palliative care to equal quality of end-of-life care [31]. A first step in reaching this goal is to identify the range of gender-related issues in the context of palliative care.…”

Section: Introductionmentioning

confidence: 99%

Exploring the gender dimension of problems and needs of patients receiving specialist palliative care in a German palliative care unit - the perspectives of patients and healthcare professionals

et al. 2019

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Background Gender disparities of specific symptoms and problems have frequently been observed in palliative care patients, but research rarely focused on the range of problems and needs affected by gender. Methods We conducted semi-structured interviews with patients and healthcare professionals (HCPs) of a hospital-based palliative care unit to examine gender effects on patients’ problems and needs based on systematically gathered qualitative data. Content analysis was used to identify emerging themes with data coded using MAXQDA. Results Ten patients (5 female, 5 male) and 17 HCPs (12 female, 5 male) were interviewed. Seven categories of gender-specific problems and needs emerged: “physical symptoms, care and body image”, “psychological symptoms and emotional response”, “interaction with the palliative care team”, “use of professional supportive measures”, “activation of informal social networks”, “decision-making”, and “preservation of autonomy and identity”. Both patients and HCPs felt that female patients adopt more expressive coping strategies, have stronger need for communication with and support of HCPs, and activate an extended social network for support and decision-making. Further, both groups thought that male patients mainly rely on social support from partners, have higher expectations to be cared for at home, and have higher need for preservation of autonomy. Conclusion Gender relevantly impacts patients’ problems and needs during palliative care. Therefore, gender-sensitive palliative care that acknowledges the patient’s individual situation and respective ramifications are required.

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“…Informed by evidence that end-of-life caregiving is a heavily gendered process [29,43,75], TM subsequently conducted a feminist quality appraisal of the evidence to determine how issues of power, gender and inequity (including those pertaining to intersecting identities of race, class and age) were handled in the aims, study design, data collection and analysis, discussion and recommendations for change section of each included study [76]. The studies were scored and the quality attributed through the same process outlined for Gough's tool.…”

Section: Discussionmentioning

confidence: 99%

“…Another explanation for their unaided caring may be that their partner is not being offered services because they are lower priority given their age and non-malignant conditions [17]. More research is needed in this area, including the views of service providers [75] as well as from a gendered perspective given wider evidence that indicates men tend to receive more formal and informal support whilst caring than women [30,108].…”

Section: Discussion and Implications For Research Policy And Practicementioning

confidence: 99%

Experiences of oldest-old caregivers whose partner is approaching end-of-life: A mixed-method systematic review and narrative synthesis

et al. 2020

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Background and objectives Population ageing has rapidly increased the number of people requiring end-of-life care across the globe. Governments have responded by promoting end-of-life in the community. Partly as a consequence, older spouses are frequently providing for their partner's end-of-life care at home, despite potentially facing their own health issues. While there is an emerging literature on young-old caregivers, less is known about spouse carers over 75 who are likely to face specific challenges associated with their advanced age and relationship status. The aim of this review, therefore, is to identify and synthesise the literature concerning the experiences of caregiver's aged 75 and over whose partner is approaching end-of-life. We conducted a mixedmethod systematic review and narrative synthesis of the empirical literature published between 1985 and May 2019, identified from six databases: Medline, PsychINFO, Cumulative Index to Nursing and Allied Health Literature, Embase, Sociological Abstracts and Social Service Abstracts. Hand searching and reference checking were also conducted. Gough's Weight of Evidence and Morgan's Feminist Quality Appraisal tool used to determine the quality of papers. From the initial 7819 titles, 10 qualitative studies and 9 quantitative studies were included. We identified three themes: 1) "Embodied impact of care" whereby caring was found to negatively impact carers physical and psychological health, with adverse effects continuing into bereavement; 2) "Caregiving spouse's conceptualisation of their role" in which caregiver's navigated their self and marriage identities in relation to their partner's condition and expectations about gender and place; 3) "Learning to care" which involved learning new skills and ways of coping to remain able to provide care. We identified a recent upsurge in published papers about very old spousal caregivers, which now comprise a small, medium-quality evidence base. This review outlines a range of potential lines of inquiry for future research including further clarification of the impact of caregiving on the likelihood of mortality, the incidence of men and women providing end-of-life care amongst this age group, and the role of anticipatory grief in shaping their perceptions of their relationship and their own longevity.

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Gendered Processes in Hospice Palliative Home Care for Seniors With Cancer and Their Family Caregivers

Cited by 13 publications

References 65 publications

Structural impact on gendered expectations and exemptions for family caregivers in hospice palliative home care

Structural impact on gendered expectations and exemptions for family caregivers in hospice palliative home care

Exploring the gender dimension of problems and needs of patients receiving specialist palliative care in a German palliative care unit - the perspectives of patients and healthcare professionals

Experiences of oldest-old caregivers whose partner is approaching end-of-life: A mixed-method systematic review and narrative synthesis

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