At Home in the Company of Strangers: The Specialization of Home Care of the Dying 1965-1982

2.50
Hdl Handle:
http://hdl.handle.net/10755/156654
Type:
Presentation
Title:
At Home in the Company of Strangers: The Specialization of Home Care of the Dying 1965-1982
Abstract:
At Home in the Company of Strangers: The Specialization of Home Care of the Dying 1965-1982
Conference Sponsor:Sigma Theta Tau International
Conference Year:2004
Conference Date:July 22-24, 2004
Author:Buck, Joy, MSN, RN
P.I. Institution Name:University of Virginia
Title:Pre-Doctoral Fellow
Purpose: During the 1960s, nursing research documented the stark realities of dying in a medical institution: pain control was virtually nonexistent, and patients often died in a room at the end of the hall, behind a closed door, in pain, and alone. Few studies delved into the almost invisible realms of home care of the dying. This study examines the processes of creating alternatives to hospital-based care of the dying in America. Specifically, it uses Connecticut between 1965 and 1982 as a case study to explore the sociopolitical forces that shaped specialization of home care of the dying. Method/Sources: A social history framework was used to conduct this study. Primary sources included oral histories and archived papers of early hospice leaders and community nurses, Visiting Nurses Association and private foundation records, and legislative histories. Findings: The deinstitutionalization and expansion of third party reimbursement for home care significantly shaped care provision. In the 1970s, health reformers turned to hospice as a humane and cost effective alternative to institutionalized dying. Hospice was in stark contrast to institutional terminal care; it differed little from traditional home care. As care of the dying transitioned from institution to home, tensions arose between individuals and organizations providing this care. Cooperation between hospice and non-hospice agencies turned into competition--the ideals of care co-opted in the struggle for organizational viability. Conclusions: Hospice cut across many boundaries and challenged assumptions about the locus of care provision and control of care decisions for the terminally ill. Molding the hospice ideal into a reimbursable model of care ultimately served to further professionalize and specialize home care of the dying. Implications: This study raises critical questions about the rationality and US health policy and of how research, practice, and theory do or do not inform it.
Repository Posting Date:
26-Oct-2011
Date of Publication:
22-Jul-2004
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleAt Home in the Company of Strangers: The Specialization of Home Care of the Dying 1965-1982en_GB
dc.identifier.urihttp://hdl.handle.net/10755/156654-
dc.description.abstract<table><tr><td colspan="2" class="item-title">At Home in the Company of Strangers: The Specialization of Home Care of the Dying 1965-1982</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2004</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">July 22-24, 2004</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Buck, Joy, MSN, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Virginia</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Pre-Doctoral Fellow</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">joybuck@adelphia.net</td></tr><tr><td colspan="2" class="item-abstract">Purpose: During the 1960s, nursing research documented the stark realities of dying in a medical institution: pain control was virtually nonexistent, and patients often died in a room at the end of the hall, behind a closed door, in pain, and alone. Few studies delved into the almost invisible realms of home care of the dying. This study examines the processes of creating alternatives to hospital-based care of the dying in America. Specifically, it uses Connecticut between 1965 and 1982 as a case study to explore the sociopolitical forces that shaped specialization of home care of the dying. Method/Sources: A social history framework was used to conduct this study. Primary sources included oral histories and archived papers of early hospice leaders and community nurses, Visiting Nurses Association and private foundation records, and legislative histories. Findings: The deinstitutionalization and expansion of third party reimbursement for home care significantly shaped care provision. In the 1970s, health reformers turned to hospice as a humane and cost effective alternative to institutionalized dying. Hospice was in stark contrast to institutional terminal care; it differed little from traditional home care. As care of the dying transitioned from institution to home, tensions arose between individuals and organizations providing this care. Cooperation between hospice and non-hospice agencies turned into competition--the ideals of care co-opted in the struggle for organizational viability. Conclusions: Hospice cut across many boundaries and challenged assumptions about the locus of care provision and control of care decisions for the terminally ill. Molding the hospice ideal into a reimbursable model of care ultimately served to further professionalize and specialize home care of the dying. Implications: This study raises critical questions about the rationality and US health policy and of how research, practice, and theory do or do not inform it.</td></tr></table>en_GB
dc.date.available2011-10-26T14:59:41Z-
dc.date.issued2004-07-22en_GB
dc.date.accessioned2011-10-26T14:59:41Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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