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55 Placing death and dying: on the work of making place at the end of life
  1. Annelieke Driessen,
  2. Erica Borgstrom and
  3. Simon Cohn
  1. London School of Hygiene and Tropical Medicine; The Open University


Background Palliative care policy and professionals are concerned about the location of care, epitomised in phrases like ‘preferred place of care’ and ‘preferred place of death’. There has been an emphasis on home being the ideal place. Conversely, it is recognised that high quality palliative and end-of-life care can be delivered in a wide variety of settings.

Methods This presentation is part of the ongoing Forms of Care project about palliative care. Ethnographic methods include observation of over 60 in- and outpatient palliative care team meetings, 1 year of shadowing palliative care team members in their daily work, and 15 interviews with palliative care staff, including doctors, nurses, social workers, and physiotherapists. Three patients and their families were also interviewed multiple times. Data was thematically analysed, drawing on social theory.

Results Palliative care professionals consider place as part of the care they deliver. Hospital was typified as a place of control, known infrastructure, skilled staff and support, and constant monitoring. The home was a place of being a ‘guest’ and unknown quantity, creating a shift in power dynamics between professionals, and patients and their families. The drive for patients to be cared for at home came with added costs in terms of resources and the emotional labour. However, many cases extended beyond this binary. We highlight the work both professionals and patients do to keep a place stable. We suggest such efforts of ‘placing’ show how place is not merely a geographical location, but made through relations, interactions and activities.

Conclusion In the push to enable patients to die at home, what tends to be overlooked is the work that goes into ‘placing’: the work of ‘making place’. The research indicates the importance of understanding how placing gets done as a form of care.

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