Content area
Full Text
ABSTRACT
As part of a larger study examining end-of-life care in nursing homes, qualitative focus groups were conducted with bereaved family members to explicate those factors contributing to satisfaction and dissatisfaction with end-of-life care in the nursing home setting. Content analysis of focus group data revealed two overarching themes that influenced family members' satisfaction with care. These included: (a) ability of staff to recognize signs of imminent dying, and (b) communication and information sharing about the resident's status and plan of care. Family members dissatisfied with their relative's end-of-life care expressed feelings of guilt, anger, and frustration, both while the resident was alive and in the bereavement period. The findings of this study have implications for clinicians committed to delivering quality end-of-life care to residents and their families and provides the basis for educational interventions and quality care improvement initiatives in the long-term care setting.
While most older adults report relatively good health, the chances of requiring supportive care in the form of nursing home placement increase with age (Carrière & Pelletier, 1995; Gaugler et al., 2000). Thus, as the population ages, nursing homes will be responsible for delivering care at the end of life for a growing number of older adults. The ability of nursing homes to provide quality end-of-life care is contingent on the availability of meaningful outcome measures that can help facilities monitor and improve the quality of care they provide (Dy, Shugarman, Lorenz, Mularski, & Lynn, 2008). Given that both nursing home residents and their family members are the consumers of palliative and end-of-life care, it is important to access the perspectives of these respective constituencies regarding their satisfaction with the care provided (Kutner, 2008).
Families play an important role as caregivers in end-of-life care and frequently serve as both formal and informal proxy decision makers for residents (Levin et al., 1999; Shalowitz, Garrett-Mayer, & Wendler, 2006). When declines in physical health and mental cognition prevent residents from providing their own feedback (Dean & McClement, 2002), it becomes critically important to solicit the views of their family representatives and partners in care. Thus, nursing homes need to recognize that in addition to residents, family members are also recipients of care who are in need of support and information and who...