Experiences of older people dying in nursing homes: a narrative systematic review of qualitative studies

Greenwood, Nan; Menzies-Gow, Emma; Nilsson, David; Aubrey, Dawn; Emery, Claire; Richardson, Angela

doi:10.1136/bmjopen-2017-021285

Cited by 20 publications

(19 citation statements)

References 31 publications

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“…Several research studies have used narratives to process end-of-life experiences (Bingley, Thomas, Brown, Reeve, & Payne, 2008;Dobratz, 2013;Greenwood et al, 2018;Romanoff & Thompson, 2009;Tullis, Roscoe, & Dillon, 2017;Williams et al, 2013). Narrative research has focused primarily on the experiences of hospice patients (Dobratz, 2013;Greenwood et al, 2018). Endof-life narratives, developed through dialogue between health care providers and family caregivers, have been found to foster psychological comfort and meaning making for the death of the patient (Tullis et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Outcomes of collage art-based and narrative self-expression among home hospice caregivers

Kaimal

Mensinger

Carroll-Haskins

2020

International Journal of Art Therapy

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Aims: This mixed methods quasi-experimental study examined the outcomes of a brief art therapy-based and a narrative interview-based intervention to address the psychosocial needs of home hospice caregivers. Methods: Participants (n = 14) chose to participate either in a narrative interview (n = 7) or artsbased interview (n = 7). Standardised self-report measures of affect, spiritual well-being, perceived stress, and self-efficacy and physiological markers of stress(salivary cortisol) and social/emotional connection (oxytocin levels) were collected before and after intervention sessions. Results: Qualitative findings indicated that caregivers (a) recognized their need for reducing stress and isolation; (b) experienced a learning curve related to illness and hospice care; (c) engaged in existential reflections on purpose and values; and were (d) living through progressive grief and loss. Quantitative findings indicated that the narrative condition group experienced improved spiritual well-being and negative affect. Both conditions were followed by improved positive affect. There were no statistically significant changes in salivary cortisol or oxytocin for either condition. Conclusion: The results suggest that caregivers might need longer term interventions for sustained changes. Implications for further research: Further research is needed to examine the role of narrative and visual self-expression among home hospice caregivers. Study limitations included a small non-randomised sample, lack of transcribed interview data, and incomplete survey and biomarker data.

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Section: Introductionmentioning

confidence: 99%

Outcomes of collage art-based and narrative self-expression among home hospice caregivers

Kaimal

Mensinger

Carroll-Haskins

2020

International Journal of Art Therapy

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“…11 Previous research highlighted that many dying nursing home residents experience potentially avoidable symptoms. 12 Inappropriate emergency transfers to hospitals are an inevitable consequence, with emergency departments ill equipped to meet the challenging needs of such vulnerable patient groups.…”

Section: Discussionmentioning

confidence: 99%

Does an Interactive, Teleconference-Delivered, Palliative Care Lecture Series Improve Nursing Home Staff Confidence?

Dowling

Payne

Larkin

et al. 2020

Journal of Palliative Medicine

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Background: Project ECHOÔ (Extension for Community Healthcare Outcomes) is a form of online interactive teaching, which has gained international traction. This project evaluates the effectiveness of an ECHOdelivered palliative care education program for the South Dublin region of Ireland. Our aim was to measure project success by quantifying gains in staff confidence. Methods: The educational program consisted of 10 interactive sessions over a five-month period on palliative care topics ranging from pain management to advance care planning. Twenty nursing homes took part in the education program. Of these, a subgroup of six nursing homes were randomly selected for assessment. Likert scale-based questionnaires assessed staff confidence before and after each lecture and assessment was repeated at least six weeks postlecture. Five of the 10 sessions were assessed in this way. Other characteristics such as staff role and years of experience were also collected. Results: Twenty nursing homes and 353 staff participated in the education sessions. Of the 6 nursing homes chosen for assessment, an average of 42 questionnaires were returned per session (n = 211), representing 83% of attendees at these 6 selected nursing homes. Seventy-seven percent of questionnaires were successfully followed up for six weeks. Average confidence increased by 27% pre-to postlecture (6.4 [SD = 1.4] to 8.1 [SD = 2.1], p < 0.005). Confidence gains persisted at six weeks; 8.1 of 10 (SD = 1.4), with no significant drop-off (-0.01/10, p = 0.95). All staff groups (nursing vs. non-nursing) exhibited equal confidence gains (nursing gain of 27%, non-nursing gain 22%, p = 0.16), and all confidence gains persisted at six weeks. Conclusion: This interactive, novel, training program significantly improved nursing home staff confidence in managing palliative care situations, and this confidence was sustained at least six weeks after the sessions.

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“…However, 32% of deaths occurred at home, 42% in a hospital, and 18% in a nursing home (California Healthcare Foundation, 2012). Greenwood et al (2018) further identified older people's (65+) experiences of dying in nursing and care homes from the perspectives of the older people themselves, their families or staff. A narrative systematic review highlighted the physical discomfort of dying in an institution, along with negative psychosocial experiences such as loneliness and depression, with limited support for residents' spiritual needs.…”

Section: Regression Analysismentioning

confidence: 99%

Exploring the meaning of old age from the Czech adult perspective: A quantitative research study

Vaculíková¹,

Vávrová²

2019

Kontakt

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It is believed that age is just a number, meaning that it does not dictate how to feel or how to act. However, empirical studies, on a representative sample, describing old age boundaries in terms of longevity and in words that best describe old age are, to our knowledge, lacking in the Czech environment. This article is, therefore, methodologically grounded in the quantitative approach, applying a descriptive design in the investigation of the interrelationships of the self-reported data taken from a representative Czech adult population perspective (n = 1,040). The research shows that most respondents consider age 70+ to be old age and associate it with illness, experience or wisdom. The majority of respondents wished to end their life at home. On the other hand, the ability of respondents to imagine life in a home for the elderly grows with increasing age, with women more often admitting this possibility. Women are also more likely to provide home care to a dependent family member. The willingness to provide informal care continues to increase, depending on age, higher level of education, and better living conditions. Besides gender and education, participants' willingness to move to a retirement home if necessary made the strongest contribution to the likelihood of their willingness to be a family caregiver. Based on the cluster analysis, respondents living in the Central and North Bohemia regions manifested a lower willingness to live in a retirement home and to provide home care.

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Experiences of older people dying in nursing homes: a narrative systematic review of qualitative studies

Cited by 20 publications

References 31 publications

Outcomes of collage art-based and narrative self-expression among home hospice caregivers

Outcomes of collage art-based and narrative self-expression among home hospice caregivers

Does an Interactive, Teleconference-Delivered, Palliative Care Lecture Series Improve Nursing Home Staff Confidence?

Exploring the meaning of old age from the Czech adult perspective: A quantitative research study

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