Specialist palliative care staffs varying experiences of talking with people with intellectual disability about their dying and death: A thematic analysis of in-depth interviews

Published: June 11, 2021, 8:06 a.m.

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This episode features\\xa0Baby Foo\\xa0(School of Psychology, The University of Sydney, Sydney, NSW, Australia) and Dr Michele Wiese (School of Psychology, Western\\xa0Sydney University, Penrith, NSW, Australia).

With advancing age and the experience of life-limiting illness, people with intellectual disability need equitable access to effective palliative care. Palliative care staff experience unique\\xa0challenges when caring for people with intellectual disability, such as communication barriers, which can make it more difficult to address their needs. People with intellectual disability are not\\xa0routinely included in conversations about their dying and death in primary and residential care settings, unless they instigate these discussions.


This study highlights that specialist palliative care staff do not consistently talk with people with intellectual disability about their dying and death. Conversations about dying and death are\\xa0influenced by the (1) perceived capacity of the person with intellectual disability, (2) experience and expertise of palliative care staff, (3) the relationship between palliative care staff and dying\\xa0person, and (4) values of palliative care staff and other caregivers.

Urgent policy and practice changes are required to address misinformation and assumptions about people with intellectual disability, including the development of guidelines regarding\\xa0communication about dying and death with people with intellectual disability in palliative care. Specialist palliative care services need to prioritise staff training for those working with this patient\\xa0group, and focus on developing knowledge and skills in communication strategies relevant to people with intellectual disability. Future research should focus on the needs of people with\\xa0intellectual disability and their caregivers in palliative care across all levels from policy to practice.

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