VP-NET Vulnerable Persons and End of Life New Emerging Team
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Revised Vulnerability Model of Palliative Care

The revised vulnerability model of palliative care shown here has developed out of the research done by the VP-Net team. The diagram illustrates our finding that among populations who experience socially constructed vulnerability or marginalization access to health care decreases with the increasing marginalization of a population. In addition, palliative care tends to dominate over curative treatment as marginalization increases; the greater a person’s marginalization the lower their access to curative treatment. The same is true for bereavement support; populations that are more marginalized receive lower levels of bereavement support.

"Within a contemporary model of palliative care, the focus of inquiry—like medicine itself—has tended to be on the individual him or herself. Within this model, palliative or supportive care measures are applied to individuals in varying degrees, depending on their level of need or intensity of discomfort."7. This model differs from the conventional understanding of palliative care, where it is assumed that everyone receives a decreasing amount of curative treatments as palliative care increases closer to the end of a person’s life by demonstrating that social factors, beyond the patient’s prognosis, are involved in the allocation of and access to palliative and healthcare.

this diagram depicts the revised vulnerability model of palliative care in black, white and grey tones. The diagram shows a set of five steps tapering in size from bottom to top, with the largest section on the bottom and smallest section on top. Each of the sections is divided diagonally between a light grey triangular section with the word Curative in it and a darker grey triangle with the word Palliative written in it. In each of the tapering sections above the bottom step shows an increasingly large proportion of palliative care and a smaller proportion of curative treatment, until, at the top there is mostly palliative care and very little curative treatment. Along the left side of diagram there is a black arrow that follows the taper of the steps with the word Marginalization written along it. The arrow indicates an increasing level of marginalization. Along the right side of the diagram there is a dark grey square with the word Bereavement written in it which tapers into a triangle.

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