Exploring the gender gap in end-of-life care: ethical considerations for dementia patients

BACKGROUND: Dementia is a common, terminal disease that significantly reduces the quality of life. Home hospice services face ethical challenges when caring for patients in the final stages of the disease. While gender differences are known to exist in various aspects of care, limited research has explored gender variation in end-of-life care perceptions. This study aims to explore how home hospice staff consider gender, particularly regarding ethical issues. METHODS: The study used a phenomenological qualitative approach, conducting semi-structured interviews with 30 multi-professional home hospice staff members caring for dementia patients. FINDINGS: Caregivers tend to ignore gender when caring for elderly patients at the end of their lives. This non-gender-related approach is evident in their attitudes towards ethical issues, such as respecting patients, considering their welfare and dealing with communication difficulties. However, disregarding gender when caring for dementia patients within the home hospice framework raises questions regarding the dying person's perception of human dignity, their wishes, and their overall welfare. CONCLUSIONS: Given that gender is a crucial component of a person's identity, the staff's non-gender-related approach towards end-of-life care reflects the non-gender-related social construction of the elderly. This raises concerns about the quality of care provided to end-of-life patients. To ensure that patients’ dignity is preserved in the final stages of their lives, it is necessary to provide training for caregiving staff on the importance of considering gender in end-of-life palliative care. KEY MESSAGES: • Home hospice staff tend to ignore gender when caring for dementia patients. Neglecting gender raises ethical concerns and questions about patient dignity and welfare. • Considering gender in end-of-life palliative care is crucial to ensure high-quality care for patients with dementia in the final stages of their lives.