• Nisha Sutherland, Catherine Ward-Griffin, Carol McWilliam, and Kelli Stajduhar.
• 1 School of Nursing, Lakehead University, Thunder Bay, Ontario, Canada.
• Can J Nurs Res. 2018 Dec 1; 50 (4): 189-201.

BackgroundAs home is a site where gendered attitudes, beliefs, and practices are reproduced, it is imperative that policies and practices promote gender equity in end-of-life care at home.PurposeThe purpose of this study was to critically analyze gender relations in the sociopolitical context of hospice palliative home care.MethodsUsing a critical feminist perspective, we examined gender relations between and among clients with cancer, their family caregivers, and nurses in hospice palliative home care. Ethnographic methods of in-depth interviews (n = 25), observations of home visits (n = 9), and review of documents (n = 12) were employed to expose gender (in)equities.FindingsThis critical analysis sheds light on institutional discourses that reproduce gender inequities: discourses of difference and denial; discourses of individuality, autonomy, and choice; and discourses of efficiency, objectivity, and rationality. Although gender was discounted, these neoliberal discourses reinforced traditional gender relations.DiscussionNeoliberal discourses frame health and health-care experiences as resulting primarily from individual behaviors and biomedical factors, permitting health-care providers and policy makers to overlook power relations and the sociopolitical forces that obscure gender inequities. A critical perspective is needed to consider how social structures significantly shape everyday gendered experiences in hospice palliative home care.

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