'The beauty and the less beautiful': exploring the meanings of dying at 'home' among community and practitioner representatives and advocates across Canada.

Background: Significant structural and normative pressures privilege the ideal of dying at home in Canada. At the same time, the social complexities and meanings associated with dying in particular locations remain critically unexamined. Objective: The aim of this study is to explore how diverse community members, including health and social care stakeholders, talk about preferences for locations of dying, with a particular focus on meanings of dying at home. Design: Semi-structured virtual interviews were conducted with 24 community and practitioner representatives and advocates across Canada during the Covid-19 pandemic. This included compassionate community advocates, palliative care professionals and volunteers, bereaved carers, and members of queer, rural, and immigrant communities. Participants were asked about their own preferences for location of dying and elaborated on these aspects with regard to their client population or community group. Results: Our analysis illuminates how meanings of dying at home are connected to previous experiences and perceptions of institutional care. As such, participants' perspectives are often framed as a rejection of institutional care. Dying at home also often signals potential for preserving ontological security and relational connection in the face of life-threatening illness. However, participants' expertise simultaneously informs a sense that dying at home is often unattainable. At times, this awareness underpins interpretations of both preferences and choices as contingent on considerations of the nature and type of illness, concerns about impacts on families, and available resources. Conclusion: The ideal of dying at home is nuanced by identity, relational, and structural contexts. Knowledge from this study can inform realistic and practical person-centered planning across care settings. It can also help create more representative public policy and health system quality indicators regarding a 'good death' that do not rely on or perpetuate undeveloped and unrealistic assumptions about dying, home, and family care.

The Problems with Care: A Feminist Care Scholar Retrospective

Seeking to support qualitative researchers in the artful development of feminist care scholarship, our goal here is to ‘look back’ on how we have conceptualized the problems of care and developed research that illuminates the social organization of care in distinct ways. As part of a ‘feminist care scholar retrospective’, we present five condensed ‘reverse research proposals’, which are retrospective accounts of past research or scholarly activity. From there, we discuss how each project begins with a particular problematic for investigation and a particular conception of care (e.g., as practices, as work, as a concept) to illuminate facets of the social organization of care shaping paid and unpaid care work and its interpretations. These approaches reveal multiple and overlapping ways that care is embodied, understood and organized, as well as ways care can be transformed.