End-of-life care in residential care homes: a retrospective study of the perspectives of family members using the VOICES questionnaire

2016 ◽  
Vol 31 (1) ◽  
pp. 72-84 ◽  
Author(s):  
Sofia Andersson ◽  
Olav Lindqvist ◽  
Carl-Johan Fürst ◽  
Margareta Brännström
Keyword(s):  
Retrospective Study ◽  
End Of Life ◽  
Residential Care ◽  
End Of Life Care ◽  
Family Members ◽  
Care Homes ◽  
Life Care

Care professional's experiences about using Liverpool Care Pathway in end-of-life care in residential care homes

2017 ◽  
Vol 32 (1) ◽  
pp. 299-308 ◽  
Author(s):  
Sofia Andersson ◽  
Olav Lindqvist ◽  
Carl-Johan Fürst ◽  
Margareta Brännström
Keyword(s):  
End Of Life ◽  
Residential Care ◽  
End Of Life Care ◽  
Care Pathway ◽  
Care Homes ◽  
Life Care

scholarly journals Factors Associated With Symptom Relief in End-of-Life Care in Residential Care Homes: A National Register-Based Study

2018 ◽  
Vol 55 (5) ◽  
pp. 1304-1312 ◽  
Author(s):  
Sofia Andersson ◽  
Kristofer Årestedt ◽  
Olav Lindqvist ◽  
Carl-Johan Fürst ◽  
Margareta Brännström
Keyword(s):  
End Of Life ◽  
Residential Care ◽  
End Of Life Care ◽  
Symptom Relief ◽  
Care Homes ◽  
Life Care ◽  
National Register ◽  
Factors Associated

Developing, implementing and sustaining an end-of-life care programme in residential care homes

2017 ◽  
Vol 23 (4) ◽  
pp. 186-193 ◽  
Author(s):  
Julie Kinley ◽  
Louisa Stone ◽  
Anna Butt ◽  
Barbara Kenyon ◽  
Nuno Santos Lopes
Keyword(s):  
End Of Life ◽  
Residential Care ◽  
End Of Life Care ◽  
Care Homes ◽  
Life Care ◽  
Care Programme

Exploring resource use and associated costs in end-of-life care for older people with dementia in residential care homes

2013 ◽  
Vol 29 (7) ◽  
pp. 758-766 ◽  
Author(s):  
Sarah Amador ◽  
Claire Goodman ◽  
Derek King ◽  
Yi Ting Ng ◽  
Natasha Elmore ◽  
...  
Keyword(s):  
Older People ◽  
End Of Life ◽  
Residential Care ◽  
Resource Use ◽  
End Of Life Care ◽  
Care Homes ◽  
Life Care ◽  
People With Dementia ◽  
Care For Older People

scholarly journals Comparative study of perceptions of family members to the end-of-life care in residential care facilities and hospitals in Tampere, Finland

2015 ◽  
Vol 4 (5) ◽  
pp. 84
Author(s):  
Aino Lehmus ◽  
Lauri Seinelä ◽  
Jaakko Valvanne
Keyword(s):  
End Of Life ◽  
Residential Care ◽  
End Of Life Care ◽  
Current Trend ◽  
Family Members ◽  
Life Care ◽  
Term Care ◽  
Residential Care Facilities ◽  
Care Facilities

Objective: Current trend in long-term care (LTC) is to bring the care to the place where the person lives and to avoid unnecessary transitions. The purpose of the study was to find out family members’ opinions about the quality of end-of-life care in LTC compared to care in hospitals.Methods: A postal questionnaire was sent to the family members of 168 residents, who had died during the year 2012 in LTC in Tampere, southern Finland.Results: A total of 97 family members (58%) returned the questionnaire. Eighty-two percent of the residents suffered from dementia. Family members seemed to be more satisfied with the care if the resident had died in LTC. Family members reported that residents who had died in LTC were more often kept clean (80% vs. 55%; p = .020), their dignity was maintained more often (84% vs. 56%; p = .021) and their wishes considering their care were acknowledged better (82% vs. 50%; p = .033) compared to the residents that died in a hospital. Residents who died in LTC suffered also less from agitation (32% vs. 60%; p = .047). The trend in the prevalence of other signs and symptoms and the prevalence of non-palliative interventions was lower, if the resident had died in LTC.Conclusions: Family members perceived the quality of end-of-life care given in residential care facilities to be at least as good, or, in some cases, better than the quality of end-of-life care given in a hospital.

scholarly journals Conversations About Death and Dying, End-of-Life Care Plans and Preferences Between Aging Parents and Adult Children

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 417-417
Author(s):  
Hyo Jung Lee ◽  
Jacobbina Jin Wen Ng
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
Adult Children ◽  
End Of Life Care ◽  
Death And Dying ◽  
Family Members ◽  
Life Care ◽  
Joint Decision ◽  
Aging Parents ◽  
Care Plans

Abstract This study aims to investigate whether attitude and perception on late-life death and dying, end-of-life care plans and preferences could be better understood from current values shared between aging parents and their adult children in the multi-cultural city-bound country, Singapore. We are in the process of interviewing 20 aging parent-adult child dyads. Up to date, six semi-structured interviews were completed and transcribed. We performed Content analysis to analyze the transcripts. Preliminary findings showed that both aging parents and adult children rarely discussed this issue, although parents had their own plans or preferences. The major barriers against open conversations about death and dying of aging parents include: the perception of not-yet time to talk about this issue (without knowing when the right time is) and tendency to have conversations about death in tandem with finances, but not death itself. Although specific end-of-life care plans or arrangements were not thought out thoroughly, aging parents expressed a high level of trust and reliance on close family members’ decisions regarding their end-of-life care. They tended to agree on joint decision-making process within family, even though adult children had no or unmatched ideas about their aging parents’ end-of-life wishes. This did not necessarily align with previous findings in Western countries, underscoring individuals’ control over their own death and dying process. Open conversation within family, family-involved advance care planning, or joint decision-making processes may be warranted to promote quality of life and death in older Singaporeans and well-being of their family members of all ages.

scholarly journals Course and predictors of posttraumatic stress-related symptoms among family members of deceased ICU patients during the first year of bereavement

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Siew Tzuh Tang ◽  
Chung-Chi Huang ◽  
Tsung-Hui Hu ◽  
Wen-Chi Chou ◽  
Li-Pang Chuang ◽  
...  
Keyword(s):  
Social Support ◽  
Posttraumatic Stress ◽  
End Of Life ◽  
End Of Life Care ◽  
Family Members ◽  
Life Care ◽  
Ptsd Symptoms ◽  
Icu Patients ◽  
Clinically Significant ◽  
Bereaved Family

Abstract Background/Objective Death in intensive care units (ICUs) may increase bereaved family members’ risk for posttraumatic stress disorder (PTSD). However, posttraumatic stress-related symptoms (hereafter as PTSD symptoms) and their precipitating factors were seldom examined among bereaved family members and primarily focused on associations between PTSD symptoms and patient/family characteristics. We aimed to investigate the course and predictors of clinically significant PTSD symptoms among family members of deceased ICU patients by focusing on modifiable quality indicators for end-of-life ICU care. Method In this longitudinal observational study, 319 family members of deceased ICU patients were consecutively recruited from medical ICUs from two Taiwanese medical centers. PTSD symptoms were assessed at 1, 3, 6, and 13 months post-loss using the Impact of Event Scale-Revised (IES-R). Family satisfaction with end-of-life care in ICUs was assessed at 1 month post-loss. End-of-life care received in ICUs was documented over the patient’s ICU stay. Predictors for developing clinically significant PTSD symptoms (IES-R score ≥ 33) were identified by multivariate logistic regression with generalized estimating equation modeling. Results The prevalence of clinically significant PTSD symptoms decreased significantly over time (from 11.0% at 1 month to 1.6% at 13 months post-loss). Longer ICU stays (adjusted odds ratio [95% confidence interval] = 1.036 [1.006, 1.066]), financial insufficiency (3.166 [1.159, 8.647]), and reported use of pain medications (3.408 [1.230, 9.441]) by family members were associated with a higher likelihood of clinically significant PTSD symptoms among family members during bereavement. Stronger perceived social support (0.937 [0.911, 0.965]) and having a Do-Not-Resuscitate (DNR) order issued before the patient’s death (0.073 [0.011, 0.490]) were associated with a lower likelihood of clinically significant PTSD symptoms. No significant association was observed for family members’ satisfaction with end-of-life care (0.988 [0.944, 1.034]) or decision-making in ICUs (0.980 [0.944, 1.018]). Conclusions The likelihood of clinically significant PTSD symptoms among family members decreased significantly over the first bereavement year and was lower when a DNR order was issued before death. Enhancing social support and facilitating a DNR order may reduce the trauma of ICU death of a beloved for family members at risk for developing clinically significant PTSD symptoms.

scholarly journals “A good death but there was all this tension around”- perspectives of residential managers on the experience of delivering end of life care for people living with dementia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jessica A. L. Borbasi ◽  
Allison Tong ◽  
Alison Ritchie ◽  
Christopher J. Poulos ◽  
Josephine M. Clayton
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Aged Care ◽  
Care Staff ◽  
Care Homes ◽  
Residential Aged Care ◽  
Life Care ◽  
Advanced Dementia ◽  
Front Line ◽  
Care Managers

Abstract Background End of life care for residents with advanced dementia in the aged care setting is complex. There is prolonged and progressive cognitive decline, uncertain disease trajectory, significant symptom burden and infrequent access to specialist palliative care. Residential aged care managers offer a unique perspective in understanding the experience of providing end of life care for residents with advanced dementia. They bring insight from the coalface to the broader policy context. The aim of this study was to describe the experience and perspectives of residential aged care managers on providing end of life care for residents living with dementia. Methods Focus groups and semi-structured interviews were conducted with residential or care managers from various care homes from one dementia specific aged care organisation in Australia. A comprehensive sampling strategy was used in participating care homes. Transcripts were analysed using thematic analysis. Results 20 residential or care managers from 11 aged care homes in two states of Australia participated in two focus groups (total 16 participants) or individual interviews (4 participants). Six themes were identified: laying the ground work to establish what families understand about dementia, playing the peacemaker in the face of unrealistic family demands and expectations, chipping away at denial and cultivating a path towards acceptance of death, recruiting general practitioners as allies, supporting and strengthening the front line, and dedication to optimal care is relentless but rewarding. Conclusion Aged care manager participants described provision of end of life dementia care as a rewarding but sometimes fraught experience requiring persistent personalisation of care and communication to enable family acceptance of the resident’s terminal condition. The findings suggest that continuous front line aged care staff skill development, iterative family discussions, and partnership building between aged care staff and general practitioners, are all required to promote optimal end of life dementia care in residential aged care settings.

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.

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