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

Published online by Cambridge University Press:  23 October 2012

Shelly Waskiewich ,
Laura M. Funk  and
Kelli I. Stajduhar
Laura M. Funk*
Affiliation:
Department of Sociology, University of Manitoba
Kelli I. Stajduhar
Affiliation:
School of Nursing and Centre on Aging, University of Victoria
*
†Correspondence and requests for offprints should be sent to / La correspondance et les demandes de tirés-à-part doivent être adressées à: Laura M. Funk, Ph.D. Department of Sociology University of Manitoba Isbister Building 307-183 Dafoe Road Winnipeg, Manitoba R3T 2N2 ([email protected])
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Abstract

We explored contextual features shaping end-of-life (EOL) care in residential care facilities by drawing on the perspectives of 11 resident care aides (RCAs) in one Western Canadian urban centre. RCAs characterized EOL care as “providing comfort”, including physical and emotional comfort. Concerns with time and workload challenges dominated accounts and generated guilt, sadness, and frustration. RCAs tried to “find the time” by taking it from themselves or other residents, and by relying on the commitment of co-workers and on families. Findings emphasize the importance of the RCA role (particularly in emotional comfort), yet call for attention to interpretations of what is involved in this work, and to definitions of scopes of practice and training requirements. Findings reiterate the importance, among Canadian RCAs, of appropriate workloads to facilitate quality EOL care, and raise concerns about how time constraints shape EOL care practice and the meanings infusing this practice.

Résumé

Nous 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.

Keywords

vieillissementaidantsfin-de-viemort et mourantsoins de fin-de-vieétablissements de soins pour bénéficiaires internesétablissements de soins pour personnes agées infirmesagingcare aidesdeath and dyingend-of-life careresidential care facilitiespersonal care homes
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 31 , Issue 4 , December 2012 , pp. 411 - 421
Copyright
Copyright © Canadian Association on Gerontology 2012 

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Footnotes

*

We thank the RCAs who contributed their time, as well as Elizabeth Causton, who assisted with interviewing and review of this manuscript. The guidance of Heather Cook, Holly Tuokko, and André Smith is also acknowledged, as is the advice of John Bond. Shelly Waskiewich was supported by a University of Victoria Interdisciplinary Student Award; Kelli Stajduhar is supported by a New Investigator award from the Canadian Institutes of Health Research and a Scholar Award from the Michael Smith Foundation for Health Research.

†

Deceased

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