Feeling lonely in an unfamiliar place: older people's experiences of life close to death in a nursing home.
OBJECTIVE
The aim of the study was to deepen the understanding of how older persons living in a nursing home experience life close to death.


BACKGROUND
A move to and a life in a nursing home while being close to death is a reality for many older people in Sweden. Being able to express thoughts and feelings about death has been described as both crucial for sustaining personhood as well as for establishing a meaningful existence at the end of life. Important are the experiences of older people living in nursing homes who are approaching death.


METHODS
Six older people were interviewed on one to four occasions. A total of 16 interviews were conducted with the participants. An interpretative approach was chosen.


RESULTS
The main interpretation, Feeling lonely in an unfamiliar place, is based on three themes (i) Waiting for death, with the subthemes death as a release and thinking of oneself as dead; (ii) Subordinate oneself to values and norms of the staff, with the subthemes feeling offended and feeling trapped; and (iii) Keep the courage up. The older people's lives were characterised by feelings of aloneness in an unfamiliar place which contributed to a sense of existential loneliness. They experienced few opportunities to discuss their thoughts of life and death, including preparations for passing away.


CONCLUSIONS
It is of importance for professionals to be able to meet older people as they are and respect them as human beings in their transitions, before, during and after the move to a nursing home. It is important to find ways to support older people's wellbeing and identity near death.
Palliative Research Center, Ersta Sköndal University College, Stockholm, Sweden.|Department of Health Care Sciences, Ersta Sköndal University College, Stockholm, Sweden.
Jane
J
Österlind
Palliative Research Center, Ersta Sköndal University College, Stockholm, Sweden.|Department of Health Care Sciences, Ersta Sköndal University College, Stockholm, Sweden.|Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
Britt-Marie
BM
Ternestedt
Department of Health Care Sciences, Ersta Sköndal University College, Stockholm, Sweden.|Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
Görel
G
Hansebo
Palliative Research Center, Ersta Sköndal University College, Stockholm, Sweden.|Department of Health Care Sciences, Ersta Sköndal University College, Stockholm, Sweden.|Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden.
Ingrid
I
Hellström
D000368:Aged; D000369:Aged, 80 and over; D001293:Attitude to Death; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008132:Loneliness; D008297:Male; D009735:Nursing Homes; D013548:Sweden
end-of-life care; nursing home care; older people; palliative care; transition