Institute of Nursing Science and Practice, Paracelsus Medical University, Strubergasse 21, 5020, Salzburg, Austria.
Z Gerontol Geriatr. 2024 Jul;57(4):284-289. doi: 10.1007/s00391-024-02313-4. Epub 2024 Jun 4.
Shared housing arrangements (SHA) are alternatives to long-term care facilities for care-dependent people. The collective perspective of nursing professionals working in SHA in dealing with death and dying is missing in recent studies. This study aimed to investigate the perspective of professionals concerning a palliative (farewell) culture in SHA.
In this study two group discussions were conducted with nurses and nursing assistants working in SHA. Data were analyzed using the documentary method, with the aim of working out the professional orientation framework concerning a collective palliative culture.
Nurses enable a palliative (farewell) culture. This leads to the fact that hospice services are not used in these SHA. The distance to relatives as well as a short dying process or incomplete dying support can make a successful palliative culture difficult. Depending on the conscious assumption of responsibility for a palliative culture in the nursing concept of SHA, death and dying are discussed at an early stage with the relatives and care-dependent people.
The constantly progressing palliative culture in SHA is based on nurses' experiences, general practitioners (GP) and relatives. The family carers' role is ambiguous. If they do what they are supposed to do from the professional nurses' point of view and are closely connected to the nurses, they are viewed positively and as enablers of a palliative culture. If family carers' responsibilities are not communicated and they are not in close contact with professional nurses, they are viewed as opponents of a palliative culture. The GPs are seen as enablers of a palliative culture in both discussions. A timely discussion on what might happen in the end of life phase, formalized or not, helps all involved groups to be prepared.
共享住房安排（SHA）是依赖护理的人替代长期护理机构的选择。在最近的研究中，缺乏从事 SHA 的护理专业人员在处理死亡和临终问题上的集体观点。本研究旨在调查专业人员对 SHA 中姑息（告别）文化的看法。
本研究对在 SHA 工作的护士和护理助理进行了两次小组讨论。使用文件方法分析数据，旨在制定关于集体姑息文化的专业定向框架。
护士能够营造姑息（告别）文化。这导致这些 SHA 不使用临终关怀服务。与亲属的距离、短暂的临终过程或不完整的临终支持，可能使成功的姑息文化变得困难。根据在 SHA 的护理概念中对姑息文化有意识地承担责任，与亲属和依赖护理的人在早期就讨论死亡和临终问题。
SHA 中不断发展的姑息文化基于护士的经验、全科医生（GP）和亲属。家庭护理人员的角色模棱两可。如果他们从专业护士的角度做他们应该做的事情，并与护士密切联系，他们就会被视为姑息文化的推动者，并受到积极评价。如果没有沟通家庭护理人员的责任，并且他们与专业护士没有密切联系，他们就会被视为姑息文化的反对者。在这两次讨论中，全科医生都被视为姑息文化的推动者。及时讨论生命末期可能发生的事情，无论是正式的还是非正式的，都有助于所有相关群体做好准备。
