The hospital environment for end of life care of older adults and their families: an integrative review.
OBJECTIVE
This article is a report of an integrative review to identify key elements of the physical hospital environment for end of life care of older adults and their families as reported by patients, relatives, staff and policy makers.


BACKGROUND
Globally ageing populations and increases in long-term illness mean that more people will need palliative care in the future. Despite policy initiatives to increase end of life care in the community, many older adults prefer, and will require, end of life care in hospital. Providing an appropriate physical environment for older adults requiring end of life care is important given concerns about hospital environments for this group.


METHODS
Thirteen databases from 1966 to 2010 were searched including ASSIA, BNI, Cochrane Library, CINAHL, EMBASE, MEDLINE, PsycINFO, Social Science Citation Index, the Science Citation Index, HMIC and the National Research Register. Reference and citation tracking was performed on included publications.


METHODS
An integrative review was conducted. Two reviewers independently screened titles and abstracts for inclusion and completed data extraction. Study quality is not reported as this poses methodological difficulties in integrative reviews. Data synthesis involved thematic analysis informed by the findings of included literature.


RESULTS
Ten articles were included. Four themes were identified: privacy as needed; proximity (physically and emotionally) to loved ones, home and nature; satisfaction with the physical environment; and deficiencies in physical environment.


CONCLUSIONS
Little evidence exists about physical hospital environments for end of life care of older adults and their families. More research is required in this field.
Division of Nursing, Midwifery and Physiotherapy, Education Centre, Lincoln County Hospital, University of Nottingham, Lincoln, UK. louise.brereton@nottingham.ac.uk
Louise
L
Brereton
Clare
C
Gardiner
Merryn
M
Gott
Christine
C
Ingleton
Sarah
S
Barnes
Christopher
C
Carroll
D017028:Caregivers; D003258:Consumer Behavior; D016206:Databases, Bibliographic; D005190:Family; D005851:Geriatric Nursing; D006272:Health Facility Environment / Q000458:organization & administration / Q000592:standards*; D006761:Hospitals / Q000592:standards; D006801:Humans; D007362:Intensive Care Units / Q000592:standards; D057240:Patient Preference; D011157:Population Dynamics; D018907:Privacy; D013727:Terminal Care