title: Learning, support and communication for staff in care homes: outcomes of reflective debriefing groups in two care homes to enhance end-of-life care.
abstract: BACKGROUND
  Nursing care homes are increasingly the place where frail older people die. However, training in end-of-life care is not statutory.
  
  
  OBJECTIVE
  To develop strategies to promote quality end-of-life care in nursing care homes.
  
  
  METHODS
  Action research was used to work collaboratively with the managers and staff in two nursing care homes to develop end-of-life care.
  
  
  METHODS
  There were three overarching phases: an exploratory phase, feedback/planning of actions and a summative evaluation. Two main actions were inductively derived. One of the actions, reflective debriefing groups following a resident's death, is reported.
  
  
  RESULTS
  Ten reflective debriefing groups, led by the researcher (a specialist palliative care nurse), were undertaken. The groups facilitated learning at three different levels (being taught, developing understanding and critical thinking) and enabled staff to feel supported and valued.
  
  
  CONCLUSIONS
  The use of reflective debriefing groups is a useful mechanism to support experience-based learning about death/dying in care homes.
authors.affiliation: Care Home Project Team, St Christopher's Hospice, London, UK.
authors.forename: Jo
authors.initials: J
authors.lastname: Hockley
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001293:Attitude to Death; D003142:Communication; D003299:Cooperative Behavior; D005851:Geriatric Nursing; D006801:Humans; D007858:Learning; D009735:Nursing Homes; D009740:Nursing Staff / Q000523:psychology*; D058996:Quality Improvement; D012606:Scotland; D013727:Terminal Care
keywords: action research; end-of-life care; experience-based learning; nursing homes; older people; reflection