The last word:Family members' descriptions of end-of-life care in long-term care facilities

A postal survey was used to collect data from family members of deceased residents of six long-term care (LTC) facilities in order to explore end-of-life (EOL) care using the Family Perception of Care Scale. This article reports on the results of thematic analysis of family member comments provided while completing the survey. Family comments fell into two themes: 1) appreciation for care and 2) concerns with care. The appreciation for care theme included the following subthemes: psychosocial support, family care, and spiritual care. The concerns with care theme included the subthemes: physical care, staffing levels, staff knowledge, physician availability, communication, and physical environment. This study identified the need for improvement in EOL care skills among LTC staff and attending physicians. As such, there is a need to implement continuing education to address these issues. © 2006 Centre for Bioethics, IRCM.

Freeing order processes in Northern Ireland: Painfully slow

Greg Kelly and Dominic McSherry describe the timescales involved in achieving freeing orders for 23 children in Northern Ireland between 1996 and 1999. There was delay at all stages in the process. The delays were particularly pronounced in social services and social services/legal services processes. The authors conclude that if adoption is to be made available to more children from state care, current arrangements, including legislation, will need revision and reform.