scholarly journals Complexity of Nurse Practitioners’ Role in Facilitating a Dignified Death for Long-Term Care Home Residents during the COVID-19 Pandemic

2021 ◽  
Vol 11 (5) ◽  
pp. 433
Author(s):  
Shirin Vellani ◽  
Veronique Boscart ◽  
Astrid Escrig-Pinol ◽  
Alexia Cumal ◽  
Alexandra Krassikova ◽  
...  
Keyword(s):  
End Of Life ◽  
Nurse Practitioners ◽  
End Of Life Care ◽  
Long Term Care ◽  
Care Home ◽  
Good Death ◽  
Life Care ◽  
Care Needs ◽  
Term Care

Due to the interplay of multiple complex and interrelated factors, long-term care (LTC) home residents are increasingly vulnerable to sustaining poor outcomes in crisis situations such as the COVID-19 pandemic. While death is considered an unavoidable end for LTC home residents, the importance of facilitating a good death is one of the primary goals of palliative and end-of-life care. Nurse practitioners (NPs) are well-situated to optimize the palliative and end-of-life care needs of LTC home residents. This study explores the role of NPs in facilitating a dignified death for LTC home residents while also facing increased pressures related to the COVID-19 pandemic. The current exploratory qualitative study employed a phenomenological approach. A purposive sample of 14 NPs working in LTC homes was recruited. Data were generated using semi-structured interviews and examined using thematic analysis. Three categories were derived: (a) advance care planning and goals of care discussions; (b) pain and symptom management at the end-of-life; and (c) care after death. The findings suggest that further implementation of the NP role in LTC homes in collaboration with LTC home team and external partners will promote a good death and optimize the experiences of residents and their care partners during the end-of-life journey.

scholarly journals Cost of shifting from healthcare to long-term care in later life across major diseases: analysis of end-of-life care during the last 24 months of life

2018 ◽  
Vol 13 (1) ◽  
pp. 40-47 ◽  
Author(s):  
Tomoko Terada ◽  
Keiko Nakamura ◽  
Kaoruko Seino ◽  
Masashi Kizuki ◽  
Naohiko Inase
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Long Term Care ◽  
Later Life ◽  
Life Care ◽  
Term Care

scholarly journals END-OF-LIFE CARE PREFERENCES AND WELL-BEING IN LONG-TERM CARE RESIDENTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S669-S669
Author(s):  
Kelly Shryock ◽  
Jacinta Dickens ◽  
Anisha Thomas ◽  
Suzanne Meeks
Keyword(s):  
Quality Of Life ◽  
Positive Affect ◽  
End Of Life ◽  
End Of Life Care ◽  
Long Term Care ◽  
Well Being ◽  
Life Care ◽  
Term Care

Abstract Research on end-of-life care in nursing homes comes largely from the viewpoint of staff or family members. We examined patient perspectives on end-of-life care, preferences for care, and quality of life in long-term care settings. We hypothesized that fulfillment of the Self Determination Theory (SDT) needs of autonomy, competence, and relatedness would be related to better well-being and that the degree to which end-of-life care preferences are seen as possible in the setting would be related to SDT need fulfillment and well-being. Preliminary data, collected from older individuals at the end of life (over 55, presence of significant chronic disease, in long term care setting) (n= 72), demonstrated that autonomy, competence, and relatedness measures were moderately and significantly correlated with well-being as measured by life satisfaction, higher positive affect, lower negative affect, and overall quality of life measures The degree to which residents believed that their end-of-life care preferences could be honored in the setting was also significantly correlated with autonomy, competence, relatedness, positive affect, and psychological quality of life. These results are consistent with SDT and suggest that if long term care settings can promote autonomy, connection, and competence in making end of life decisions, possibly by discovering and fulfilling preferences for end of life care, individuals who end their lives on those settings have potential for greater satisfaction and happiness. These results suggest that SDT is a useful framework for ongoing research on how to improve the end of life experiences of older adults in long term care.

Nursing Guidelines for End-Of-Life Care in Long-Term Care Settings: Sustainable Improvements to Care

2011 ◽  
Vol 27 (3) ◽  
pp. 229-237 ◽  
Author(s):  
Carole Gill ◽  
Loretta M. Hillier ◽  
Jacqueline M. Crandall ◽  
Julie Johnston
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Long Term Care ◽  
Life Care ◽  
Term Care ◽  
Nursing Guidelines

scholarly journals Barriers and facilitators to optimal supportive end-of-life palliative care in long-term care facilities: a qualitative descriptive study of community-based and specialist palliative care physicians’ experiences, perceptions and perspectives

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e037466
Author(s):  
Patricia Harasym ◽  
Sarah Brisbin ◽  
Misha Afzaal ◽  
Aynharan Sinnarajah ◽  
Lorraine Venturato ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Long Term Care ◽  
Symptom Assessment ◽  
Assessment Tools ◽  
Life Care ◽  
Community Based ◽  
Term Care

ObjectiveThe COVID-19 pandemic has highlighted ongoing challenges to optimal supportive end-of-life care for adults living in long-term care (LTC) facilities. A supportive end-of-life care approach emphasises family involvement, optimal symptom control, multidisciplinary team collaboration and death and bereavement support services for residents and families. Community-based and palliative care specialist physicians who visit residents in LTC facilities play an important role in supportive end-of-life care. Yet, perspectives, experiences and perceptions of these physicians remain unknown. The objective of this study was to explore barriers and facilitators to optimal supportive end-of-life palliative care in LTC through the experiences and perceptions of community-based and palliative specialist physicians who visit LTC facilities.DesignQualitative study using semi-structured interviews, basic qualitative description and directed content analysis using the COM-B (capability, opportunity, motivation - behaviour) theoretical framework.SettingResidential long-term care.Participants23 physicians who visit LTC facilities from across Alberta, Canada, including both in urban and rural settings of whom 18 were community-based physicians and 5 were specialist palliative care physicians.ResultsMotivation barriers include families’ lack of frailty knowledge, unrealistic expectations and emotional reactions to grief and uncertainty. Capability barriers include lack of symptom assessment tools, as well as palliative care knowledge, training and mentorship. Physical and social design barriers include lack of dedicated spaces for death and bereavement, inadequate staff, and mental health and spiritual services of insufficient scope for the population.ConclusionFindings reveal that validating families’ concerns, having appropriate symptom assessment tools, providing mentorship in palliative care and adapting the physical and social environment to support dying and grieving with dignity facilitates supportive, end-of-life care within LTC.

Long-term care, dementia care, and end-of-life care in China

2021 ◽  
pp. 38-63
Author(s):  
Sabrina Ching Yuen Luk ◽  
Hui Zhang ◽  
Peter P. Yuen
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Long Term Care ◽  
Dementia Care ◽  
Life Care ◽  
Term Care

End-of-life care in long-term care settings for older people: a literature review

2006 ◽  
Vol 1 (1) ◽  
pp. 45-50 ◽  
Author(s):  
Katherine A. Froggatt ◽  
Donna Wilson ◽  
Christopher Justice ◽  
Margaret MacAdam ◽  
Karen Leibovici ◽  
...  
Keyword(s):  
Literature Review ◽  
Older People ◽  
End Of Life ◽  
End Of Life Care ◽  
Long Term Care ◽  
Life Care ◽  
Term Care

Long-term care nurses' knowledge of end-of-life care

2002 ◽  
Vol 23 (6) ◽  
pp. 296-301 ◽  
Author(s):  
Barbara M. Raudonis ◽  
Ferne C.N. Kyba ◽  
Terri A. Kinsey
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Long Term Care ◽  
Life Care ◽  
Term Care ◽  
Nurses Knowledge
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