Paper
Friday, July 13, 2007
An Ethnographic Study to Define the “Good” Rural Death – Evidence for Action
Donna M. Wilson, RN, PhD, Faculty of Nursing, Edmonton, AB, Canada
| Learning Objective #1: discuss the global applicability of evidence-based information from a rural perspective on the good death. |
| Learning Objective #2: support the view that rurality is a distinct culture needing expression in policy, service planning, and nursing practice. |
Much concern has centered on the “good” death since the hospice/palliative care movement began in the 1970s. This concern is readily apparent in hospice-palliative care definitions that emphasize care that fosters a good death. Much progress has been made in terms of services to promote good urban deaths, but little is known about the perspectives and needs of people living in rural or remote areas. Rural/remote living presents additional challenges for dying persons and for services planning or delivery. Considering that 25-30% of Canadians and citizens in other developed countries live in rural/remote areas, with the health status of rural peoples often poorer than that of urbanites, and with rural populations often older, there is an urgent need to address this deficiency. An ethnographic study was conducted to establish a conceptual understanding of the good death from a rural perspective. Individual and focus group interviews of rural informants in Alberta were undertaken until data saturation. High quality support to address the diverse interests of each dying community member was found to be critically important for enabling a dying process that is in keeping with the ongoing wishes of each individual. The location of end-of-life care was another key finding, with in-community deaths needing to be ensured through a range of home, hospital, and senior-care services. This ethnographic study of a good rural death provides an evidence-based foundation for rural policy, service development, and nursing practice.