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Background: Decreasing oral intake is common towards the end of life and a potential source of distress and concern for patients, relatives, whānau and clinicians. This paper provides insight to inform practice regarding clinicians' perceptions, practices, responses and communication with patients and their companions regarding declining oral intake towards the end of life. Methods: In this qualitative study ten specialist palliative care staff participated in semi-structured interviews. Qualitative thematic analysis was used to analyse the data. Findings: Three themes were identified: declining oral intake was a natural part of the dying process; responding empathetically; and clinicians described specific aims and ways regarding communication. Conclusion: Insight into clinicians' endeavours to manage declining oral intake and support the wellbeing of patients, families, and whānau can inform practice. However the perspectives of family, whānau and health professionals continue to show significant variation regarding the communication given and received around declining oral intake towards the end of life. [ABSTRACT FROM AUTHOR]

This article draws on the findings of the qualitative phase of a New Zealand longitudinal study on vulnerable young people’s transitions to adulthood. The young people were aged between 12 and 17 years at the time of the first interview. The paper focuses on one key finding, how youth enact agency through their relationships with significant others: families, social workers, teachers and care workers. These youth had experienced sustained exposure to harm including abuse, violence, addictions, disengagement from school and mental health issues. The qualitative interviews focused on young people’s experiences with services (child welfare, juvenile justice, mental health and education support services) their key transitions, and the strategies they used to locate support and resources. The thematic analysis of the interviews indicated that a search for agency was a central motif in young people’s experiences. This was reflected in three thematic clusters: making sense of the world, having a voice and acting on the world. [ABSTRACT FROM AUTHOR]