ORCID Profile
0000-0002-5015-6420
Current Organisation
National Ageing Research Institute
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Publisher: Elsevier BV
Date: 07-2022
DOI: 10.1016/J.GERINURSE.2022.05.004
Abstract: Predicting older patients' life expectancy is an important yet challenging task. Hospital aged care assessment teams advise treating teams on older patients' type and place of care, directly affecting quality of care. Yet, little is known about their experiences with prognostication. Twenty semi-structured interviews were conducted with seven geriatricians/ registrars, ten nurses and three allied health staff from aged care assessment teams across two hospitals in Melbourne, Australia. Data were analysed thematically. To generate prognoses, clinicians used analytical thinking, intuition, assessments from others, and pattern matching. Prognostic tools were an underutilised resource. Barriers to recognition of dying included: diffusion of responsibility regarding whose role it is to identify patients at end-of-life lack of feedback about whether a prognosis was correct system pressures to pursue active treatment and vacate beds avoidance of end-of-life discussions lack of confidence, knowledge and training in prognostication and pandemic-related challenges.
Publisher: Elsevier BV
Date: 08-2021
Publisher: Informa UK Limited
Date: 04-03-2019
Publisher: SAGE Publications
Date: 03-05-2019
Abstract: It is often suggested that terminally ill patients favour end-of-life care at home. Yet, it is unclear how these preferences are formed, if the process is similar for patients and family caregivers, and if there are discrepancies between preferences for place of care and place of death. Understanding these nuances is essential to support people in their decision-making and ultimately provide better care at the end-of-life. To gain an in-depth understanding of how terminally ill patients and their family caregivers make decisions about preferred place of care and place of death. Semi-structured interviews with patients and family caregivers, which were analysed thematically using qualitative description. A total of 17 participants (8 patients and 9 caregivers) recruited from an acute palliative care hospital ward, a sub-acute hospice unit, and a palliative homecare organisation in Melbourne, Australia. The process of forming location preferences was shaped by uncertainty relating to the illness, the caregiver and the services. Patients and caregivers dealt with this uncertainty on a level of thoughts, emotions, and actions. At the end of this process, patients and caregivers expressed their choices as contextual, personal, relational, conditional and flexible preferences. These findings suggest that in many cases end-of-life decision-making does not conclude with a clear and stable choice. Understanding the reasons for the malleability of preferences and the process of how they are formed has implications for both clinicians and researchers.
Publisher: Oxford University Press (OUP)
Date: 03-2022
Abstract: Older people are more likely to experience bereavements than any other age group. However, in healthcare and society, their grief experiences and support needs receive limited attention. Through innovative, arts-based research poetry, this study aimed to capture older people’s bereavement stories and the effects of grief on their physical and mental health. Semi-structured in-depth interviews with 18 bereaved older adults were analysed using thematic and poetic narrative analysis, following a five-step approach of immersion, creation, critical reflection, ethics and engagement. Research poems were used to illustrate three themes of bereavement experiences among older adults: feeling unprepared, accumulation of losses and ripple effects of grief. While half of participants reported that the death of their family member was expected, many felt unprepared despite having experienced multiple bereavements throughout their life. Instead, the accumulation of losses had a compounding effect on their health and well-being. While these ripple effects of grief focussed on emotional and mental health consequences, many also reported physical health effects like the onset of a new condition or the worsening of an existing one. In its most extreme form, grief was connected with a perceived increased mortality risk. By using poetry to draw attention to the intense and often long-lasting effects of grief on older people’s health and well-being, this article offers emotional, engaging and immersive insights into their unique bereavement experiences and thereby challenges the notion that grief has an expiry date.
Publisher: Hindawi Limited
Date: 10-02-2021
DOI: 10.1111/ECC.13425
Publisher: SAGE Publications
Date: 07-02-2020
Abstract: Some patients do not receive adequate pain and symptom relief at the end of life, causing distress to patients, families and healthcare professionals. It is unclear whether undertreatment of symptoms occurs, in part, because of nurses’ concerns about legal and/or disciplinary repercussions if the patient dies after medication is administered. The aim was to explore nurses’ experiences and knowledge of the law relating to the provision of end-of-life pain and symptom relief. Semi-structured interviews with nurses were assessed using a six-stage hybrid thematic analysis technique. Four face-to-face and 21 telephone interviews were conducted with nurses who routinely prescribed and/or administered pain and symptom relief to patients approaching the end of their lives in Queensland and New South Wales, Australia. While many nurses had no personal experiences with legal or professional repercussions after a patient had died, the fear of hastening death and being held accountable was frequently discussed and regarded as relevant to the provision of inadequate pain and symptom relief. Concerns included potential civil or criminal liability and losing one’s job, registration or reputation. Two-thirds of participants believed that pain relief was sometimes withheld because of these legal concerns. Less than half of the interviewed nurses demonstrated knowledge of the doctrine of double effect, the legal protection for health professionals who provide end-of-life pain and symptom relief. Education is urgently required to strengthen nurses’ knowledge of the legal protections supporting the provision of appropriate palliative medication, thereby improving their clinical practice with end-of-life patients.
Publisher: BMJ
Date: 09-12-2020
DOI: 10.1136/BMJSPCARE-2020-002617
Abstract: The unprecedented scale of contemporary migration across countries over the last decade means that ageing and dying occur in a more globalised, multicultural context. It is therefore essential to explore the end-of-life experiences of older people from migrant backgrounds. A scoping review of peer-reviewed articles published in English from 2008 to 2018. Included studies addressed end-of-life preferences, attitudes, values and beliefs of first-generation international migrants who were at least 50 years of age. Fifteen studies met the inclusion criteria for this review, which addressed six key themes: (1) the reluctance among older migrants and their families to talk about death and dying (2) difficult communication in patient-clinician relationships (3) the contrast between collectivistic and in idualistic norms and its associated end-of-life preferences (4) limited health literacy in older adults from migrant backgrounds (5) experiences with systemic barriers like time pressure, inflexibility of service provision and lack of cultural sensitivity and (6) the need for care providers to appreciate migrants’ ‘double home experience’ and what this means for end-of-life decision-making regarding place of care and place of death. To respond effectively to an increasingly culturally erse population, healthcare staff, researchers and policymakers need to invest in the provision of culturally sensitive end-of-life care. Areas for improvement include: (a) increased awareness of cultural needs and the role of family members (b) cultural training for healthcare staff (c) access to interpreters and translated information and (d) involvement of older migrants in end-of-life discussions, research and policymaking.
Publisher: Informa UK Limited
Date: 19-07-2019
Publisher: Informa UK Limited
Date: 30-05-2020
Publisher: Elsevier BV
Date: 06-2020
Publisher: Informa UK Limited
Date: 17-12-2022
Publisher: Springer Science and Business Media LLC
Date: 03-07-2021
Publisher: Elsevier BV
Date: 11-2023
Publisher: Elsevier BV
Date: 06-2022
Publisher: Elsevier BV
Date: 02-2022
No related grants have been discovered for Katrin Gerber.