End-of-life care in a nursing home: a study of family, nurse and healthcare aide perspectives.

AIM

To examine the perspectives of family members, registered nurses and healthcare aides regarding the last 72 hours of Canadian nursing home residents' lives.

STUDY DESIGN

Exploratory, descriptive design using semistructured interviews.

SAMPLE

Consisted of 14 registered nurses and eight healthcare aides who had provided care within the last 72 hours before a resident's death and four family members who had visited within the same time frame.

SETTING

A 220-bed nursing home located within a larger long-term care facility in Canada.

METHODS

Thematic analysis was conducted independently and through consensus identified themes and subthemes emerging from the interviews.

FINDINGS

Dyspnea was a more common end-of-life (EoL) symptom for nursing home residents in this sample than was pain. Caring behaviours of staff were central to the resident's dying process and involved assessment, coordination of care, physical care, family education and nurture. Family members' ambivalence about the resident's death and fear of the resident dying alone were frequently noted.

CONCLUSIONS

Appropriate and timely symptom management and a range of caring behaviours of staff are critical elements in the dying experience of nursing home residents. Additional education and support for personnel involved with caring for this group will enhance end-of-life care.