Date of Graduation

6-2007

Document Type

Thesis

Degree Name

Master of Nonprofit Administration (MNA)

Abstract

Development of the field of palliative care, which was nourished through extensive private foundation funding over more than a decade, has to some extent been stalled because of sharply reduced private funding, a lack of understanding by the general population, and the inaction of major institutions.

This study investigated the current state of palliative care funding efforts in the San Francisco Bay Area (the "Bay Area") and across the U.S. The individuals that participated in the research component of this study included palliative care experts and palliative care funders. Through two separate surveys and two interview groups their perceptions and opinions were recorded. Three Bay Area counties were used for the purpose of considering how palliative care might be advanced across one specific finite region - with the hope that resulting information would be applicable to other regions in the U.S.

Research data indicated that Bay Area patients and their families, in the opinion of survey respondents and interview informants, would benefit from the advancement of palliative care, and that existing organizational priorities, capacity, and mission statements are congruent with the advancement of palliative care. This research revealed that most Bay Area funders are not knowledgeable about palliative care or of its capacity to improve quality of life, and that they do not plan to make related grants. Expert opinions from around the U.S. indicated that this is also the case among funders in general. Yet despite these findings the field continues to develop, if not at a rate that matches the ability of palliative care to impact positively the quality of life for patients and their caregivers.

The study revealed that where palliative care is not advancing there are individual professionals, organizations, systems, and policies that continue to impede its development. lV Study findings suggest that there is an ongoing need among the general public, healthcare professionals, healthcare organizations and healthcare funders to understand the emotional, spiritual, and psychological barriers to dealing with chronic illness and death. Interview informant data suggests that America's ageist society, its general inability to deal with death in holistic and healthy ways, and its medical culture that equates death with failure, regardless of quality of life, are all part of a complicated situation that makes funding in this field less than attractive and less than a top priority.

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