TY - JOUR
T1 - Conversations about death and dying with older people
T2 - an ethnographic study in nursing homes
AU - Alftberg, Åsa
AU - Ahlström, Gerd
AU - Nilsen, Per
AU - Behm, Lina
AU - Sandgren, Anna
AU - Benzein, Eva
AU - Wallerstedt, Birgitta
AU - Rasmussen, Birgit H
PY - 2018
Y1 - 2018
N2 - Nursing homes are often places where older persons “come to die.” Despite this, death and dying are seldom articulated or talked about. The aim of this study was to explore assistant nurses’ experiences of conversations about death and dying with nursing home residents. This study is part of an implementation project through a knowledge-based educational intervention based on palliative care principles. An ethnographic study design was applied in seven nursing homes, where eight assistant nurses were interviewed and followed in their daily assignments through participant observations. The assistant nurses stated that they had the knowledge and tools to conduct such conversations, even though they lacked the time and felt that emotional strain could be a hinder for conversations about death and dying. The assistant nurses used the strategies of distracting, comforting, and disregarding either when they perceived that residents’ reflections on death and dying were part of their illness and disease or when there was a lack of alignment between the residents’ contemplations and the concept of dying well. They indicated that ambivalence and ambiguity toward conversations about death and dying should be taken into consideration in future implementations of knowledge-based palliative care that take place in nursing homes after this project is finalized.
AB - Nursing homes are often places where older persons “come to die.” Despite this, death and dying are seldom articulated or talked about. The aim of this study was to explore assistant nurses’ experiences of conversations about death and dying with nursing home residents. This study is part of an implementation project through a knowledge-based educational intervention based on palliative care principles. An ethnographic study design was applied in seven nursing homes, where eight assistant nurses were interviewed and followed in their daily assignments through participant observations. The assistant nurses stated that they had the knowledge and tools to conduct such conversations, even though they lacked the time and felt that emotional strain could be a hinder for conversations about death and dying. The assistant nurses used the strategies of distracting, comforting, and disregarding either when they perceived that residents’ reflections on death and dying were part of their illness and disease or when there was a lack of alignment between the residents’ contemplations and the concept of dying well. They indicated that ambivalence and ambiguity toward conversations about death and dying should be taken into consideration in future implementations of knowledge-based palliative care that take place in nursing homes after this project is finalized.
KW - Aged
KW - auxiliary nurse
KW - end-of-life
KW - ethnographic approach
KW - existential communication
KW - frailty
KW - life-limiting disease
KW - older
KW - palliative care
KW - residential care
U2 - 10.3390/healthcare6020063
DO - 10.3390/healthcare6020063
M3 - Article
SN - 2227-9032
VL - 6
JO - Healthcare (Basel, Switzerland)
JF - Healthcare (Basel, Switzerland)
IS - 2
ER -