Presented by: Merryn Gott
In many resource rich countries, death now most commonly occurs in advanced age. However, limited consideration has been given to how the unique palliative care needs of this age group could be better addressed by adopting a public health approach. In this presentation we report on a study conducted with the family and whānau (extended family) carers of participants in the LiLACS NZ longitudinal study of ageing dying aged >80 years in Aotearoa/New Zealand. Interviews were conducted with 58 people (19 Māori and 39 non-Māori) who had cared for 52 family/whānau members at end of life. Kaupapa Māori and social constructionist frameworks informed the research design and analysis. Recognised analytic techniques were adopted to promote data rigour. Overall, we found that family and whānau noted a reduction in the older person’s social networks prior to death due to the death/ill health of peers and moving, for example into an aged care facility. Barriers to community engagement were reported including access, poor health (notably dementia) and the reported preference of the older person to receive care primarily from family/whānau. Whilst there was some limited evidence that the older person could draw on existing social networks where these were already strong, there was very little evidence of new networks being established. Family and whānau had low expectations of what communities could provide at end of life to support people dying in advanced age, but did identify a potential role for community members in terms of reducing social isolation and loneliness.