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Drawing on qualitative interviews with patients near death, in this article we explore people’s experiences of living and dying in a hospice in-patient unit. The results illustrate the tensions and complexities of entering into the hospice environment and how its character (i.e. people, interactions and spaces) shapes experiences near death.The results illustrate the hospice in-patient unit as playing a vitally important role in supporting the end of life, but also, the unique challenges this environment presents to individual well-being. Key themes emergent from the interviews were: loss of self and identity nostalgia; liminality and the home/help dialectic; and the performative elements of dying. To explore and unpack these processes, we draw together different facets of previous conceptual work in sociology, working towards a more nuanced conceptualization of the in-patient hospice experience. [ABSTRACT FROM PUBLISHER]

Hospices are playing an increasingly important role in end of life care in Australia and internationally and the in-patient hospice experience has not been well documented by social scientists. This paper explores some important facets of the contemporary hospice experience through an examination of the perspectives of 11 male and 9 female Australian in-patients in the last few weeks of their lives. Through a series of qualitative in-depth interviews, we explore their conceptions of death and dying and their experiences of being cared for. The results illustrate a range of important themes including: tensions around what constitutes 'the good death'; dying and caring as moral practice; and, the centrality of gender identity and relations in shaping experiences of dying and caring. We argue for a sociological approach to death and dying that better elucidates the interplay of identity, morality and relationality at the end of life., (Copyright (c) 2010 Elsevier Ltd. All rights reserved.)

Background: There is a disparity of availability and cost of drugs in the community for palliative care patients through the Pharmaceutical Benefits Scheme (PBS) compared to those available to inpatients in public hospitals., Methods: The Joint Therapeutics Committee of the Australian and New Zealand Society of Palliative Medicine, Palliative Care Australia and the Clinical Oncological Society of Australia surveyed palliative care practitioners in Australia to compile a list of drugs they considered essential., Results: Drugs nominated generally had good levels of evidence for use in palliative care, although many practitioners still used some without evidence of benefit., Discussion: We are now working with the Commonwealth Department of Health and Ageing to agree on a list of drugs for specific palliative care indications. As a result, the first ever section in the PBS for a specific patient population has been created. There is a need for high quality studies in palliative care to determine the best drugs to add to the list.

Objectives: The aims of this study were to: (1) investigate patients' views on euthanasia and physician-assisted suicide (PAS), and (2) examine the impact of question wording and patients' own definitions on their responses., Design: Cross-sectional survey of consecutive patients with cancer., Setting: Newcastle (Australia) Mater Hospital Outpatients Clinic., Participants: Patients over 18 years of age, attending the clinic for follow-up consultation or treatment by a medical oncologist, radiation oncologist or haematologist., Main Outcome Measures: Face-to-face patient interviews were conducted examining attitudes to euthanasia and PAS., Results: 236 patients with cancer (24% participation rate; 87% consent rate) were interviewed. Though the majority of participants supported the idea of euthanasia, patient views varied significantly according to question wording and their own understanding of the definition of euthanasia., Conclusions: Researchers need to be circumspect about framing and interpreting questions about support of 'euthanasia', as the term can mean different things to different people, and response may depend upon the specifics of the question asked.

Palliative care services aim to achieve the best quality of life for patients by controlling pain and other physical symptoms and attending to their psychospiritual needs. There have been many studies across different countries looking at timing of referral to palliative care services. Almost universally, timing of referral to palliative care is 'late' in the course of the patients' illness. This study looked at survival of patients after enrollment in an Australian integrated palliative care service that consists of inpatient beds (hospice), community care and consultation services. We analyzed the survival of 1138 patients enrolled over a 30-month period. The mean age was 70.1 years and 55% of the patients were male. The most common cancers were lung (19.1%), colorectal (13.4%) and prostate (5.8%), with nonmalignant disease accounting for 5.6% of all patients. The median length of survival was 54 days, with 9.3% of the patients dying within 7 days and 16.96% of patients living longer than six months. Perhaps more importantly than median survival is the time spent on a palliative care program in the overall context of diagnosis till death. The median percentage of time since diagnosis spent on the program was 17%. Timing of referral should be dependent on the need for intervention for physical or psychological symptoms. This can be meaningful whether the number of days till death is small or large.