Inequity in palliative care: class and active ageing when dying

Iben Charlotte Aamann*, Betina Dybbroe

*Corresponding author af dette arbejde

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Abstract

The purpose of this article is to explore social inequity in palliative care in Denmark, a country that is seen as a stronghold of universal health care. Using data stemming from 2 years of research, we have selected two cases for analysis. They consist of palliative conversations with two quite different patients. Drawing on sociocultural class theory, we find that the conversations involve social exclusion processes due to discourses of active ageing. We find that one privileged patient performs in line with an entrepreneurial self and is supported by the nurse. The other, disadvantaged patient performs in a passive way, and the conversation mainly alleviates the disrespect he has experienced in healthcare encounters. We conclude that palliative care reinforces classifying practices and distinctions between “good” and “bad” patients, when active ageing becomes a dominant factor. We suggest improving the quality and sensitivity of medical training and call for increased reflexivity among professionals on the unequal situation of patients in order to reduce inequity in access to health care when close to death.
OriginalsprogEngelsk
TidsskriftSocial Theory and Health
Vol/bind22
Sider (fra-til)1-17
Antal sider17
ISSN1477-8211
DOI
StatusUdgivet - 2024

Bibliografisk note

Funding Information:
Although Patient 1 has not prepared properly for the meeting by writing in the booklet and sometimes just “lies on the sofa”, he is met with respect and recognition from the nurse. Patient 1 is, thus, continuously supported by the nurse’s approving remarks. She also places him and herself in the same boat by establishing a “we” and by giving him her direct phone number.

Funding Information:
Now the nurse asks if there is anything else about the disease Patient 2 would like to know. He cannot remember. Nurse: “Is it perhaps difficult to describe it with words? Have you tried to write the thoughts down?” Patient 2 says his eyes are getting worse and that he cannot really read or write any more. Nurse: “Have you been to an optician like I have suggested earlier?” “No…”, Patient 2 sighs heavily: “’cause we cannot really afford new glasses and I can’t apply for financial support, cause I don’t know how to fill out the forms online”. He has asked the staff at the care facility, but they are busy and the same goes for the cleaning help at home – they come for one hour every three weeks and they move on quickly. The nurse offers to help him to apply. He seems grateful.

Publisher Copyright:
© 2023, The Author(s).

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