Abuse in Palliative Care Families: An initial exploration of the perceptions of palliative care nurses in Perth, Western Australia.
Faculty of Computing, Health and Science
School of Exercise, Biomedical and Health Science / Centre for Exercise and Sports Science Research
Despite the issue of abuse of the elderly being constructed as a major social problem facing Australian families, it is ignored within the palliative care literature and hence, not addressed at the coalface of palliative care service provision where the majority of patients are elderly. Constructing abuse as an issue for palliative care raises questions about the impact of an abusive relationship on the ability of the palliative care team to deliver high quality holistic care, a basic tenet of palliative care philosophy. This paper reports on a qualitative study undertaken in Perth, Western Australia examining the issue of abusive family relationships within families receiving palliative care from the perspective of nurses providing in-home services; the first such study conducted. The aims of the study were to (i) explore the perceptions of community-based palliative care nurses of abusive family relationships and the impact that these relationships have on quality of care for palliative care patients; and (ii) determine community-based palliative care nurses’ perceptions of their knowledge of, and confidence and skills in, identifying, dealing with and supporting families in which abuse occurs. Three broad themes emerged from this study reflecting the influences that shape the response, or non-response of palliative care nurses to issues of abuse: Personal Background, Life Experiences and Beliefs; Workplace/Managerial Influences; and Professional Beliefs. Results suggest that palliative care nurses are ill equipped to deal with issues of abuse. They lack formal educational skills and knowledge in the area, receive little organizational and professional support to intervene and, thus if they do respond to abusive situations, it is in terms of their personal background, life experiences and beliefs. The result is an ad hoc, inconsistent response from nurses to abusive situations.