Diversity and Access to Palliative Care and Medical Assistance in Dying in an Urban Setting.

This article focuses on the end-of-life experiences of migrants and non-migrants from young to old, who died in a Canadian cosmopolitan city in the years preceding the COVID-19 pandemic. Based on interviews with over one hundred relatives of as many deceased, the authors discuss end of life issues, namely access to palliative care and medical assistance in dying. The data indicate unequal access to care at the intersection of several factors, including type of disease, patient's age, uncertainty of their prognosis, and migrant/non-migrant status. While being young and having cancer were undeniably associated with the provision of care (curative and palliative), those who did not benefit from palliative care tended to be social minorities in the local society and suffered from diseases with ambiguous prognosis. The right to "Die with dignity" is fundamental, with or without palliative care and regardless of where the end of life takes place.

Knowledge and practices of youth awareness on death and dying in school settings: a systematic scoping review protocol.

BACKGROUND: Awareness-raising and education have been identified as strategies to counter the taboo surrounding death and dying. As the favoured venue for youth education, schools have an essential role to play in informing future decision-makers. However, school workers are not comfortable addressing the subjects of death and dying, which, unlike other social issues, have no guidelines to influence awareness of these subjects in youth. OBJECTIVES: To systematically explore the knowledge and practices on raising awareness about death and dying in schools, the viewpoints of the people involved (young people, school workers; parents), and the factors that either promote or hinder awareness practices. METHOD: The scoping review method of Levac and Colquhoun (Implement Sci 5(1):69, 2010) will be used. Using a combination of keywords and descriptors, a body of literature will be identified through 15 databases and through grey literature searches, manual searches, consultation of key collaborators, and the list of relevant literature. Publications since 2009 will be selected if they relate directly to awareness-raising about death and dying in schools. Writings will be selected and extracted by two independent people, and conflicts resolved by consensus. The extracted data will be synthesized using a thematic analysis method. Experts from a variety of disciplines (health sciences, humanities, social sciences, and education) will be consulted to enhance the interpretation of the preliminary results. Results will be presented in narrative form and will include tables and diagrams. CONCLUSION: The results of this scoping review will contribute to the development of educational practices adapted to young people and to the identification of future avenues of research on awareness of death and dying.

Attitudes toward death, dying, end-of-life palliative care, and interdisciplinary practice in long term care workers.

BACKGROUND: Besides personal and professional experiences, long term care providers' own attitudes toward death may affect the care given to dying residents. OBJECTIVES: To assess beliefs, values, and attitudes toward death, dying, palliative, and interdisciplinary care in long term care workers and identify any differences between different job categories and places of work. DESIGN: Descriptive cross-sectional survey study. SETTING: Five public long term care facilities. PARTICIPANTS: One thousand one hundred seventy volunteers, clinical managers, and all categories of residential long term care workers. MEASUREMENTS AND METHODS: An anonymous paper or electronic self-administered survey questionnaire consisting of 24 items, answered on a 4-point bipolar Likert scale. Between-group differences were compared with the analysis of variance test after adjustment for the multiple post-hoc comparisons. RESULTS: Healthcare workers had a relatively positive attitude toward more than one-half of the selected aspects of interdisciplinary practice and end-of-life palliative care for long-term residents. However, attitudes were more mixed about 10 other aspects and a higher percentage of respondents indicated negative attitudes toward them. Overall, there are significant differences between upper-level professionals and managers (registered nurses, physicians, rehabilitation staff, and clinical managers) vs the hands-on caregivers (nursing assistants, patient assistants, and volunteers) with regard to some aspects of the care of the dying. CONCLUSIONS: The results suggest that healthcare workers' attitudes need to be taken into account in long term care facilities. Patient assistants, volunteers, and nursing assistants seem most likely to above all benefit from training and support programs.