Good end-of-life care in nursing home according to the family carers' perspective: A systematic review of qualitative findings.

Abstract

BACKGROUND:

Nursing homes are becoming a common site where delivering end-of-life care for older adults. They often represent the junction between the curative and the palliative phase.

AIM:

To identify the elements that nursing home residents' family carers perceive as good end-of-life care and develop a conceptual model of good end-of-life care according to the family perspective.

DESIGN:

Systematic review (PROSPERO no. 95581) with meta-aggregation method.

DATA SOURCES:

Five electronic databases were searched from inception between April and May 2018. Published qualitative studies (and mixed-method designs) of end-of-life care experience of nursing home family carers whose relative was dead or at the end-of-life were included. No language or temporal limits were applied.

RESULTS:

In all, 18 studies met inclusion criteria. A 'life crisis' often resulted in a changed need of care, and the transition towards palliative care was sustained by a 'patient-centered environment'. Family carers described good end-of-life care as providing resident basic care and spiritual support; recognizing and treating symptoms; assuring continuity in care; respecting resident's end-of-life wishes; offering environmental, emotional and psychosocial support; keeping family informed; promoting family understanding; and establishing a partnership with family carers by involving and guiding them in a shared decision-making. These elements improved the quality of end-of-life of both residents and their family, thus suggesting a common ground between good end-of-life care and palliative care.

CONCLUSION:

The findings provide a family-driven framework to guide a sensitive and compassionate transition towards palliative care in nursing home.

• Authors: Silvia Gonella, Ines Basso, Maria Grazia De Marinis, Sara Campagna, Paola Di Giulio
• Journal: Palliative medicine (Palliat Med) Vol. 33 Issue 6 Pg. 589-606 (06 2019) ISSN: 1477-030X [Electronic] England
• PMID: 30969160 (Publication Type: Journal Article, Systematic Review)

Topics

• Adult
• Aged
• Aged, 80 and over
• Attitude to Death
• Caregivers (psychology)
• Family (psychology)
• Female
• Hospice Care (psychology)
• Humans
• Male
• Middle Aged
• Nursing Homes
• Palliative Care (psychology)
• Qualitative Research
• Terminal Care (psychology)