title: Staff perspectives on the provision of end-of-life care in a community residence for older adults with developmental disabilities.
abstract: OBJECTIVE
  The purpose of the study was to describe the perceptions of community residence (CR) staff who have cared for older adults with developmental disabilities (ADDs) that are at the end of life.
  
  
  METHODS
  This exploratory, descriptive study utilized qualitative methods that involved semistructured interviews with CR staff members.
  
  
  METHODS
  The setting was a CR that was also an intermediate care facility (ICF) that provided 24-hour residential treatment for medical and/or behavioral needs. At least one registered nurse was present at all times. A CR with at least one resident who was over the age of 40 and had a diagnosis of a life-limiting illness was chosen.
  
  
  METHODS
  Participants included three frontline workers, four managers, and one registered nurse.
  
  
  METHODS
  In-person interviews included open-ended questions about end-of-life care for older ADDs. Demographics such as age, length of time working with ADDs, and education were analyzed using descriptive statistics. Descriptive statistics were used to analyze demographics such as age, and length of time working with ADDs. Interviews were digitally recorded, transcribed, and analyzed using grounded theory techniques.
  
  
  RESULTS
  Four themes illuminated unique elements of the provision of end-of-life care in a CR: (1) influence of relationships, (2) expression of individuality, (3) contribution of hospice, (4) grief and bereavement, and (5) challenges to end-of-life care.
  
  
  CONCLUSIONS
  The results provided insight into the unique needs of older ADDs at the end of life and how this influences their care. Emphasis was also placed on the importance of specialized care that involved collaborations with hospice for older ADDs who remain in a CR at the end of life.
authors: 1 School of Social Work, University of Nevada Las Vegas , Las Vegas, Nevada.
authors: Abbie M
authors: AM
authors: Kirkendall
authors: Deborah
authors: D
authors: Waldrop
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D002658:Developmental Disabilities / Q000451:nursing*; D006233:Persons with Disabilities; D004644:Emotions; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D013727:Terminal Care / Q000458:organization & administration*