Nursing Home Staff Members’ Experiences With and Beliefs About Unusual End-of-Life Phenomena

2020 ◽  
pp. 003022282098123
Author(s):  
Stephen Claxton-Oldfield ◽  
Natalie Richard
Keyword(s):  
Nursing Home ◽  
End Of Life ◽  
Family Members ◽  
Nursing Home Staff ◽  
Staff Members ◽  
Specific Event ◽  
Transpersonal Experiences ◽  
Deathbed Visions ◽  
Life Phenomena

Twenty-two members of a nursing home took part in a study examining their experiences with and beliefs about unusual end-of-life phenomena (EOLP). Nearly all the staff members had witnessed and/or been told about residents holding on for someone to arrive or for a specific event to occur before dying (95% and 91%, respectively). Other commonly witnessed/reported EOLP included residents having sudden, unexpected moments of lucidity, sensing or feeling the presence of deceased residents, residents’ dreaming about deceased relatives, friends or pets, and deathbed visions. More than three-quarters of the staff members regarded EOLP as transpersonal experiences, as comforting to dying residents and their family members, and as part of the dying process. Fourteen staff members described experiences they had had with EOLP in the nursing home. The most frequently described experiences involved the appearance of apparitions. Seventy-seven percent of the staff members expressed an interest in learning more about EOLP.

Nursing Home Resident, Family, and Staff Perspectives on Hospital Transfers for End-of-Life Care

2021 ◽  
pp. 003022282199770
Author(s):  
Janet Sopcheck ◽  
Ruth M. Tappen
Keyword(s):  
Emergency Department ◽  
Nursing Home ◽  
End Of Life ◽  
End Of Life Care ◽  
Family Members ◽  
Terminally Ill ◽  
South Florida ◽  
Care Planning ◽  
Life Care ◽  
Advance Care

Residents who are terminally ill often experience transfers to the emergency department resulting in hospitalizations, which may be potentially avoidable with treatment in the nursing home. This qualitative study explored the perspectives of 15 residents, 10 family members, and 20 nursing home staff regarding end-of-life care and the circumstances prompting resident transfers. Data analysis of participant interviews conducted January to May 2019 in a South Florida nursing home identified four themes related to transfer to the hospital: time left to live, when aggressive treatments would be unavailing, not knowing what the nursing home can do, and transfer decisions are situation-dependent. Study findings underscore the importance of increasing resident and family awareness of treatments available in the nursing home and person-centered advance care planning discussions. Further research should explore the reasons for residents’ and family members’ choice of aggressive therapies and their goals for care at the end of life.

scholarly journals Staff exchange within and between nursing homes in The Netherlands and potential implications for MRSA transmission

2016 ◽  
Vol 145 (4) ◽  
pp. 739-745 ◽  
Author(s):  
R. D. VAN GAALEN ◽  
H. A. HOPMAN ◽  
A. HAENEN ◽  
C. VAN DEN DOOL
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
The Netherlands ◽  
Exploratory Study ◽  
Large Network ◽  
Nursing Home Staff ◽  
Staff Members ◽  
Study Participants ◽  
Staff Exchange ◽  
National Prevalence

SUMMARYA recent countrywide MRSA spa-type 1081 outbreak in The Netherlands predominantly affected nursing homes, generating questions on how infection spreads within and between nursing homes despite a low national prevalence. Since the transfer of residents between nursing homes is uncommon in The Netherlands, we hypothesized that staff exchange plays an important role in transmission. This exploratory study investigated the extent of former (last 2 years) and current staff exchange within and between nursing homes in The Netherlands. We relied on a questionnaire that was targeted towards nursing-home staff members who had contact with residents. We found that 17·9% and 12·4% of the nursing-home staff formerly (last 2 years) or currently worked in other healthcare institutes besides their job in the nursing home through which they were selected to participate in this study. Moreover, 39·7% of study participants worked on more than one ward. Our study shows that, in The Netherlands, nursing-home staff form a substantial number of links between wards within nursing homes and nursing homes are linked to a large network of healthcare institutes through their staff members potentially providing a pathway for MRSA transmission between nursing homes and throughout the country.

The influence of care place and diagnosis on care communication at the end of life: bereaved family members’ perspective

2021 ◽  
pp. 1-8
Author(s):  
Anna O'Sullivan ◽  
Anette Alvariza ◽  
Joakim Öhlén ◽  
Cecilia Larsdotter ex. Håkanson
Keyword(s):  
Decision Making ◽  
Palliative Care ◽  
Nursing Home ◽  
End Of Life ◽  
Family Members ◽  
Palliative Care Unit ◽  
Deceased Person ◽  
Specialized Palliative Care ◽  
Bereaved Family ◽  
At Home

Abstract Objective To investigate the influence of care place and diagnosis on care communication during the last 3 months of life for people with advanced illness, from the bereaved family members’ perspective. Method A retrospective survey design using the VOICES(SF) questionnaire with a sample of 485 bereaved family members (aged: 20−90 years old, 70% women) of people who died in hospital was employed to meet the study aim. Results Of the deceased people, 79.2% had at some point received care at home, provided by general practitioners (GPs) (52%), district nurses (36.7%), or specialized palliative home care (17.9%), 27.4% were cared for in a nursing home and 15.7% in a specialized palliative care unit. The likelihood of bereaved family members reporting that the deceased person was treated with dignity and respect by the staff was lowest in nursing homes (OR: 0.21) and for GPs (OR: 0.37). A cancer diagnosis (OR: 2.36) or if cared for at home (OR: 2.17) increased the likelihood of bereaved family members reporting that the deceased person had been involved in decision making regarding care and less likely if cared for in a specialized palliative care unit (OR: 0.41). The likelihood of reports of unwanted decisions about the care was higher if cared for in a nursing home (OR: 1.85) or if the deceased person had a higher education (OR: 2.40). Significance of results This study confirms previous research about potential inequalities in care at the end of life. The place of care and diagnosis influenced the bereaved family members’ reports on whether the deceased person was treated with respect and dignity and how involved the deceased person was in decision making regarding care.

Communicating With Nursing Home Residents About End of Life

2021 ◽  
pp. 104990912110648
Author(s):  
Janet Sopcheck ◽  
Ruth M. Tappen
Keyword(s):  
Nursing Home ◽  
End Of Life ◽  
End Of Life Care ◽  
Family Members ◽  
Secondary Analysis ◽  
Nursing Home Residents ◽  
Future Research ◽  
Life Care ◽  
Older Individuals ◽  
Past Experiences

Approximately 33% of the 1.2 million older individuals residing in nursing homes have the capacity to discuss their preferences for end-of-life care, and 35% will die within their first year in the nursing home. These conversations necessary to promote care consistent with the resident’s preferences are often limited and most often occur when the resident is actively dying. The purpose of this secondary analysis was to understand the resident’s perspectives on end-of-life communication in the nursing home and suggest approaches to facilitate this communication. We interviewed 46 participants (16 residents, 10 family members, and 20 staff) in a Southeast Florida nursing home from January to May 2019. The data were analyzed using descriptive and pattern coding and matrices to decipher preliminary categories and thematic interpretation within and across each participant group. Two themes emerged from this secondary analysis that residents assume others know their end-of-life preferences, and past experiences may predict future end-of-life choices. Residents and family members were willing to discuss end-of-life care. Study findings also suggested that past experiences with the end-of-life and critical illness of another could impact residents’ and family members’ end-of-life care decisions, and that nurses’ recognition of subtle signs of a resident’s decline may trigger provider-initiated end-of-life conversations. Future research should focus on strategies to promote earlier end-of-life discussions to support independent decision-making about end-of-life care in this relatively dependent population of older adults.

scholarly journals ‘Powerlessness’ or ‘doing the right thing’ – Moral distress among nursing home staff caring for residents at the end of life: An interpretive descriptive study

2017 ◽  
Vol 31 (9) ◽  
pp. 853-860 ◽  
Author(s):  
Amanda Young ◽  
Katherine Froggatt ◽  
Sarah G Brearley
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
End Of Life ◽  
Critical Incident ◽  
Nurse Managers ◽  
Moral Distress ◽  
Structured Interviews ◽  
Nursing Home Staff ◽  
The Right ◽  
Do The Right Thing

Background: Caring for dying people can contribute to moral distress experienced by healthcare professionals. Moral distress can occur when this caring is restricted by organisational processes, resources or the provision of futile care. These factors apply to end of life care in nursing homes but research is lacking. Aim: To describe how nursing home staff experience moral distress when caring for residents during and at the end of life. Methods: An interpretive descriptive design, using the critical incident technique in semi-structured interviews to collect data from nursing home staff. Data were analysed using a thematic analysis approach. Setting: Four nursing homes in one large metropolitan area. Participants: A total of 16 staff: 2 nurse managers, 4 nurses and 10 care assistants. Findings: Participants described holding ‘good dying’ values which influenced their practice. The four practice-orientated themes of advocating, caring, communicating and relating with residents were found to influence interactions with residents, relatives, general practitioners, and colleagues. These led staff to be able to ‘do the right thing’ or to experience ‘powerlessness’, which could in turn lead to staff perceiving a ‘bad death’ for residents. Conclusion: When there are incongruent values concerning care between staff and others involved in the care of residents, staff feel powerless to ‘do the right thing’ and unable to influence care decisions in order to avoid a ‘bad death’. This powerlessness is the nature of their moral distress.

scholarly journals Does Race Influence Conflict Between Nursing Home Staff and Family Members of Residents?

2011 ◽  
Vol 66B (6) ◽  
pp. 750-755 ◽  
Author(s):  
K. Abrahamson ◽  
K. Pillemer ◽  
J. Sechrist ◽  
J. Suitor
Keyword(s):  
Nursing Home ◽  
Family Members ◽  
Nursing Home Staff
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