Palliative care culture in nursing homes: the relatives' perspective

J Res Nurs. 2018 May;23(2-3):239-251. doi: 10.1177/1744987117753275. Epub 2018 May 15.

Abstract

Background: Nursing homes are confronted with a significant change in their client structure. Palliative care gains importance in caring for residents until the end of their life. Relatives play a crucial role in caring for older people in nursing homes, especially in palliative care. As the perspective of relatives on palliative care culture in nursing homes has not yet been studied extensively, research in this field still has an exploratory character.

Aim: The aim of the paper is to highlight some of the most important insights into themes and issues that relatives of persons having died in a nursing home find essential, with a view to fostering a well-established palliative care culture.

Methods: Within a qualitative approach, four focus group interviews were conducted.

Findings: Findings indicate that good communication is a core element of a well-established palliative care culture. Direct contact with relatives, talking about death and dying and the opportunity to be involved in decision-making all support a good palliative care culture. The fact that residents have a diverse range of social backgrounds, for example, regarding ethnicity, gender and living with dementia, influences palliative care in nursing homes and has to be taken into account.

Conclusions: To create a good palliative care culture, management has to support this approach, continuously develop appropriate structures and act in a competent way.

Keywords: end-of-life care; focus groups; nursing home; older people; palliative care; qualitative approach; relatives.