title: End-of-life care in a nursing home: a study of family, nurse and healthcare aide perspectives.
abstract: OBJECTIVE
  To examine the perspectives of family members, registered nurses and healthcare aides regarding the last 72 hours of Canadian nursing home residents' lives.
  
  
  METHODS
  Exploratory, descriptive design using semistructured interviews.
  
  
  METHODS
  Consisted of 14 registered nurses and eight healthcare aides who had provided care within the last 72 hours before a resident's death and four family members who had visited within the same time frame.
  
  
  METHODS
  A 220-bed nursing home located within a larger long-term care facility in Canada.
  
  
  METHODS
  Thematic analysis was conducted independently and through consensus identified themes and subthemes emerging from the interviews.
  
  
  RESULTS
  Dyspnea was a more common end-of-life (EoL) symptom for nursing home residents in this sample than was pain. Caring behaviours of staff were central to the resident's dying process and involved assessment, coordination of care, physical care, family education and nurture. Family members' ambivalence about the resident's death and fear of the resident dying alone were frequently noted.
  
  
  CONCLUSIONS
  Appropriate and timely symptom management and a range of caring behaviours of staff are critical elements in the dying experience of nursing home residents. Additional education and support for personnel involved with caring for this group will enhance end-of-life care.
authors.affiliation: College of Nursing, University of Saskatchewan, Canada. donna.goodridge@usask.ca
authors.forename: Donna
authors.initials: D
authors.lastname: Goodridge
authors.forename: John B
authors.initials: JB
authors.lastname: Bond
authors.forename: Cynthia
authors.initials: C
authors.lastname: Cameron
authors.forename: Elizabeth
authors.initials: E
authors.lastname: McKean
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D001293:Attitude to Death; D001294:Attitude to Health; D003220:Conflict, Psychological; D004417:Dyspnea / Q000517:prevention & control; D004645:Empathy; D005190:Family / Q000523:psychology*; D005239:Fear; D005260:Female; D006801:Humans; D008297:Male; D008350:Manitoba; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D009730:Nursing Assessment; D009728:Nursing Assistants / Q000523:psychology*; D009735:Nursing Homes / Q000592:standards*; D015404:Nursing Methodology Research; D009740:Nursing Staff / Q000523:psychology*; D012944:Social Support; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000523:psychology / Q000592:standards; D013997:Time Factors