Methodology for palliative care research: evaluating palliative care & aged care policy using discourse analysis Why is it, that when palliative care philosophy promises care for all dying, inequity of access is evident when a person is dying in an aged care environment? This question formed the basis of a discourse analysis of Australian palliative and aged care policy; with the aims of gaining an understanding of the relationship of policy to practice; to elucidate the social and historical discourses that exist about care of the dying; and to draw out the commonalities and differences between aged and palliative care policies.
Method: a qualitative study using discourse analysis was undertaken using a range of literature and organised into various layers.While few formal policy documents were found, it was possible to develop a thematic analysis of such documents as the daily newspapers, the academic literature and annual reports, as well as the more formal government and agency policy documents.
Results of the study revealed hidden and inconsistent discourses in levels of documents - in aged care policy, for example, the promotion of healthy active financially independent living and a consequent suppression of the realities of frail, vulnerable ageing. The analysis of palliative care policy revealed difficult to access language and selective clientele, perhaps indicative of exclusive practice.
Conclusion: that discourse analysis is a valuable research tool, enabling objective reflection on the influence of policy on practice. Palliative care and aged care policies have many commonalities, including shared discourses on death and dying. Developmental work will assist understandings of death in various settings.