How initial policy responses to COVID-19 contributed to shaping dying at home preferences and care provision: key informant perspectives from Canada

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dc.contributor.authorCherba, Maria
dc.contributor.authorFunk, Laura
dc.contributor.authorScott, Erin
dc.contributor.authorSalman, Bora
dc.contributor.authorRounce, Andrea
dc.contributor.authorMackenzie, Corey S
dc.contributor.authorStajduhar, Kelli
dc.contributor.authorDUJELA, CARREN
dc.contributor.authorKrawczyk, Marian
dc.contributor.authorCohen, S. Robin
dc.date.accessioned2024-01-03T21:51:02Z
dc.date.available2024-01-03T21:51:02Z
dc.date.issued2023-11-30
dc.date.updated2023-12-01T04:27:09Z
dc.description.abstractObjectives In response to COVID-19’s first wave, provincial governments rapidly implemented several public health directives, including isolation measures and care facility visitor restrictions, which profoundly affected healthcare delivery at the end of life and dying experiences and perceptions. The objective of this study was to identify implications of early policy changes for dying at home. Methods Analysis of interviews with 29 key informants with expertise in the policy and practice context of dying at home and care for those dying at home was conducted as part of a larger mixed-methods study on dying at home in Canada. Results Initial pandemic policy responses, especially visitor restrictions and limitations to home care services, shaped dying at home in relation to three themes: (1) increasing preferences and demand for, yet constrained system ability to support dying at home; (2) reinforcing and illuminating systemic reliance on and need for family/friend caregivers and community organizations, while constraining their abilities to help people die at home; and (3) illuminating challenges in developing and implementing policy changes during a pandemic, including equity-related implications. Conclusion This study contributes to broader understanding of the multifaceted impacts of COVID-19 policy responses in various areas within Canadian healthcare systems. Implications for healthcare delivery and policy development include (1) recognizing the role of family/friend caregivers and community organizations in end-of-life care, (2) recognizing health inequities at the end of life, and (3) considering possible changes in future end-of-life preferences and public attitudes about dying at home and responsibility for end-of-life care.
dc.identifier.citationBMC Health Services Research. 2023 Nov 30;23(1):1330
dc.identifier.doi10.1186/s12913-023-10340-x
dc.identifier.urihttp://hdl.handle.net/1993/37902
dc.language.isoeng
dc.language.rfc3066en
dc.publisherBMC
dc.rightsopen accessen_US
dc.rights.holderThe Author(s)
dc.subjectCanada
dc.subjectCOVID-19
dc.subjectEnd-of-life care
dc.subjectPalliative care
dc.subjectPublic policy
dc.subjectThematic analysis
dc.titleHow initial policy responses to COVID-19 contributed to shaping dying at home preferences and care provision: key informant perspectives from Canada
dc.typeJournal Article
local.author.affiliationRady Faculty of Health Sciences::Max Rady College of Medicine::Department of Community Health Sciences
oaire.citation.issue1330
oaire.citation.titleBMC Health Services Research
oaire.citation.volume23
project.funder.identifierhttps://doi.org/10.13039/501100000155
project.funder.nameSocial Sciences and Humanities Research Council of Canada
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