End of Life in Residential Care from the Perspective of Care Aides

Abstract

RÉSUMÉNous avons examiné les caractéristiques contextuelles qui façonnent les soins de fin de vie (SFV) dans les établissements de soins pour bénéficiaires, en s’appuyant sur les perspectives de 11 aidants résidents (AR) dans un centre urbain canadien de l’Ouest. ARs décrivent les soins de fin de vie comme “offrant un confort,” y compris le bien-être physique et émotionnel. Les inquiétudes au sujet des défis posés par le temps et la charge de travail ont dominé les comptes et ont généré la culpabilité, la tristesse et de la frustration. ARs ont essayé de “trouver le temps” en le prenant d’eux-mêmes ou les autres résidents, et en s’appuyant sur l’engagement des collègues et sur les familles. Les résultats soulignent l’importance du rôle d’AR (en particulier en offrant un confort émotionnel), mais faire appel à l’attention à l’interprétation de ce qui est impliqué dans ce travail, et à la définition du portée de la pratique et de la formation. Les résultats également réitère l’importance, entre aidants résidents canadiens, des charges de travail adéquates pour faciliter les soins de fin de vie de qualité, et soulève des préoccupations au sujet des contraintes et comment elles forment la pratique de soins de fin de vie et les significations qui infusent une telle pratique.

Developing and Implementing Peer-Led Intervention to Support Staff in Long-Term Care Homes Manage Grief

“…Consequently, a sub-study was undertaken, aiming to better understand staff's grief experience and to identify their perceived support needs (Marcella & Kelley, 2015). The findings, similar to that of the research by Waskiewich, Funk, and Stajduhar (2012), indicated that the UCP's experiences with loss and grief are complex, much shaped by the emotional impact of each loss, the cumulative burden of ongoing grief, and the organizational culture in LTC. The study identified several recommendations, among them the implementation of organizational procedures to support staff dealing with loss and grief, the implementation of organizational strategies and rituals to acknowledge all residents who die in the LTC home, and supporting staff with time and resources to reach out to colleagues after the death of a resident to acknowledge their loss and grief.…”

“…Whether it be discussing details about the resident's death, what they need to do to begin closure or what they need from each other, the attention paid to the needs of the staff are seen as a vital intervention. Waskiewich et al (2012) support this process through their research, noting the importance of emotional processing as it links to an opportunity for closure following a resident's death. While it is the relationship between the UCP and resident that creates quality end-of-life care, it is this very relationship that must be addressed when this relationship ends through death.…”

“…Over time, a belief emerges that supports the notion that death of a resident should be expected and managed accordingly (Maitland, Brazil, & James-Abra, 2012). The accumulated stress of continuously being faced with cumulative losses and difficult dynamics can all have profound effects on professional coping abilities (Showalter, 2010;Waskiewich et al, 2012). Without interventions aimed at the opportunity for managing difficult emotions post death of a resident, UCPs are left struggling in silence regarding their interpretation and/or meaning concerning their reactions to the death of residents (Funk, Waskiewich, & Stajduhar, 2013-2014.…”

“…As noted previously, the UCPs not only provide direct care, but it is also the nature of the relationship that makes one feel as if the resident is a close friend or family member. This experience is something that is difficult to define, yet is reported consistently among UCPs in the literature (Funk et al, 2013(Funk et al, -2014Waskiewich et al, 2012). Support among peers who can instinctively draw on their own experience and solutions is vital to an intervention intended to address disenfranchised grief.…”

Measuring nursing assistants' knowledge, skills and attitudes in a palliative approach: A literature review

“…The qPAD(Long et al, 2012) with its specificity for evaluating knowledge of advanced dementia precludes a more generalised knowledge and need for skills in a palliative approach when caring for cognitively intact older people who may voice their existential concerns at end of life(Waskiewich et al, 2012). The Comfort Scale (Nochomovitz et al, 2010) administered as an audio questionnaire offers an initiative for participants for whom understanding the written English language may be difficult.…”