End-of-life care in a nursing home: Assistant nurses' perspectives. 2019

Bodil Holmberg, and Ingrid Hellström, and Jane Österlind
Ersta Sköndal Bräcke University College, Sweden.

BACKGROUND Worldwide, older persons lack access to palliative care. In Sweden, many older persons die in nursing homes where care is provided foremost by assistant nurses. Due to a lack of beds, admission is seldom granted until the older persons have complex care needs and are already in a palliative phase when they move in. OBJECTIVE To describe assistant nurses' perspectives of providing care to older persons at the end of life in a nursing home. METHODS Data were collected in semi-structured individual interviews and analyzed with inductive qualitative content analysis. METHODS Seven assistant nurses from a nursing home in Sweden were randomly selected. The research was approved by the local ethics committee. RESULTS Three main categories emerged; "Death a natural part of life"; "The older person's well-being"; and "Care in the moment of death"; and seven sub-categories. The assistant nurses described themselves as knowing the older persons well enough to provide good end-of-life care. This was achieved by making small-talk while providing daily care. Relying on experience-based knowledge, they strove to provide end-of-life care built upon respect and engagement with the ambition to strengthen older persons' dignity, for example, by lowering the tempo of care at the end of life, in spite of organizational restrictions. CONCLUSIONS The assistant nurses offered attentive end-of-life care, focusing upon bodily care. The existential needs of the older persons were not foregrounded. CONCLUSIONS To develop their work, and to promote an ethical foundation for such care, assistant nurses might need support and education to be able to offer a care more in line with the aims of palliative care. Furthermore, the organization of care needs to promote, not impede, the realization of this development.

UI MeSH Term Description Entries
D007407 Interviews as Topic Works about conversations with an individual or individuals held in order to obtain information about their background and other personal biographical data, their attitudes and opinions, etc. It includes works about school admission or job interviews. Group Interviews,Interviewers,Interviews, Telephone,Oral History as Topic,Group Interview,Interview, Group,Interview, Telephone,Interviewer,Interviews, Group,Telephone Interview,Telephone Interviews
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009728 Nursing Assistants Nurse Aide,Nurses' Aides,Nursing Auxiliaries,Aide, Nurse,Aides, Nurse,Aides, Nurses',Assistant, Nursing,Assistants, Nursing,Auxiliaries, Nursing,Auxiliary, Nursing,Nurse Aides,Nurse's Aides,Nurses Aides,Nurses' Aide,Nursing Assistant,Nursing Auxiliary
D009735 Nursing Homes Facilities which provide nursing supervision and limited medical care to persons who do not require hospitalization. Homes, Nursing,Nursing Home
D010465 Perception The process by which the nature and meaning of sensory stimuli are recognized and interpreted. Sensory Processing,Processing, Sensory
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D013548 Sweden Country in northern Europe, bordering the Baltic Sea, between Finland and Norway. The capital is Stockholm.

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