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“Caring as if it were my family”: Health care aides' perspectives about expert care of the dying resident in a personal care home

Published online by Cambridge University Press:  26 November 2009

Susan McClement ,
Suzanne Wowchuk  and
Kathleen Klaasen
Susan McClement*
Affiliation:
Faculty of Nursing, University of Manitoba, Winnipeg, Manitoba, Canada Manitoba Palliative Care Research Unit, CancerCare Manitoba, Winnipeg, Manitoba, Canada
Suzanne Wowchuk
Affiliation:
College of Registered Nurses of Manitoba, Winnipeg, Manitoba, Canada
Kathleen Klaasen
Affiliation:
Lions' Personal Care Centre, Winnipeg, Manitoba, Canada
*
Address correspondence and reprint requests to: Susan McClement, Manitoba Palliative Care Research Unit, CancerCare Manitoba, 3017-675 McDermot Avenue, Winnipeg, Manitoba, R3E 0V9, Canada. E-mail: [email protected]
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Abstract

Objective:

A qualitative pilot study was conducted to identify and describe expert behaviors in care of the dying resident in a personal care home setting from the perspective of health care aides (N = 5) nominated by their peers as demonstrating excellence in end-of-life care.

Methods:

Data was collected through audio-taped semi-structured interview, and transcribed verbatim using constant-comparative analysis procedures.

Results:

The over-arching theme emerging from the data was “caring as if it were my family.” Subsumed within this main theme included the sub-themes of: (1) care of the resident; (2) tending to the environment; (3) care of the family; (4) going to bat; and (5) processing loss.

Significance of results:

The findings from this pilot study provide preliminary empirical evidence that could inform educational programs for and performance evaluation of, health care aides providing end-of-life care in personal care home environments.

Keywords

Health care aidesExpert careDying residentsQualitative research
Type
Original Articles
Information
Palliative & Supportive Care , Volume 7 , Issue 4 , December 2009 , pp. 449 - 457
Copyright
Copyright © Cambridge University Press 2009

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References

REFERENCES

Anderson, K.A. (2008). Grief experiences of CNAs: Relationships with burnout and turnover. Journal of Gerontological Nursing, 34, 42–49.CrossRefGoogle ScholarPubMed
Back, A.L., Wallance, J.I., Starks, H.E., et al. (1996). Physician-assisted suicide and euthanasia in Washington State. Patient requests and physician responses. JAMA, 275, 919–925.CrossRefGoogle ScholarPubMed
Beauchemin, K.M. & Hays, P. (1996). Sunny hospital rooms expedite recovery from severe and refractory depressions. Journal of Affective Disorders, 40, 49–51.CrossRefGoogle ScholarPubMed
Beauchemin, K.M. & Hays, P. (1998). Dying in the dark: Sunshine, gender and outcomes in myocardial infarction. Journal of the Royal Society of Medicine, 91, 352–354.CrossRefGoogle ScholarPubMed
Benner, P. (1982). From novice to expert. American Journal of Nursing, 82, 402–407.Google ScholarPubMed
Bliss, D.Z., Zehrer, C., Savik, K., et al. (2007). An economic evaluation of four skin damage prevention regimens in nursing home residents with incontinence: Economics of skin damage prevention. Journal of Wound Ostomy Continence Nursing, 34, 143–152.CrossRefGoogle ScholarPubMed
Brazil, K., Krueger, P., Bedard, M., et al. (2006). Quality of care for residents dying in Ontario long-term care facilities: Findings from a survey of directors of care. Journal of Palliative Care, 22, 18–25.CrossRefGoogle ScholarPubMed
Burns, N. & Gove, S.K. (2005). The Practice of Nursing Research: Conduct, Critique, and Utilization (5th ed.). St. Louis: Elsevier Saunders.Google Scholar
Carlson, A.L. (2007). Death in the nursing home: Resident, family, and staff perspectives. Journal of Gerontological Nursing, 33, 32–41.CrossRefGoogle ScholarPubMed
Caspari, S., Eriksson, K. & Nåden, D. (2006). The aesthetic dimension in hospitals—An investigation into strategic plans. International Journal of Nursing Studies, 43, 851–859.CrossRefGoogle ScholarPubMed
Chichin, E.R., Burack, O.R., Olson, E., et al. (2000). End-of-Life Ethics and the Nursing Assistant. New York: Springer.Google Scholar
Chochinov, H.M., Kristjanson, L.J., Hack, T.F., et al. (2006). Dignity in the terminally ill revisited. Journal of Palliative Medicine, 9, 666–672.CrossRefGoogle ScholarPubMed
Dean, R.A. & Gregory, D.M. (2004). Humor and laughter in palliative care: An ethnographic investigation. Palliative & Supportive Care, 2, 139–148.CrossRefGoogle ScholarPubMed
Degner, L.F., Gow, C.M. & Thompson, L.A. (1991). Critical nursing behaviors in care of the dying. Cancer Nursing, 14, 246–253.CrossRefGoogle Scholar
Dowling, G.A., Hubbard, E.M., Mastick, J., et al. (2005). Effect of morning bright light treatment for rest-activity disruption in institutionalized patients with severe Alzheimer's disease. International Psychogeriatrics, 17, 221–236.CrossRefGoogle ScholarPubMed
Emanuel, L.L. & Librach, S.L. (2007). Palliative Care: Core Skills and Clinical Competencies. Philadelphia: Saunders Elsevier.CrossRefGoogle Scholar
Forbes, S., Bern-Klug, M. & Bessert, C. (2000). End of life decision making for nursing home residents with dementia. Journal of Nursing Scholarship, 32, 251–258.CrossRefGoogle ScholarPubMed
Goodridge, D., Bond, J.B. Jr., Cameron, C., et al. (2005). End-of-life care in a nursing home: A study of family, nurse and health care aide perspectives. International Journal of Palliative Nursing, 11, 226–232.CrossRefGoogle Scholar
Hanson, L.C. (2003). Creating excellent palliative care in nursing homes. Journal of Palliative Medicine, 6, 7–9.CrossRefGoogle ScholarPubMed
Hanson, L.C., Eckert, J.K., Williams, C.S., et al. (2008). Symptom experience of dying long-term care residents. Journal of the American Geriatrics Society, 56, 91–98.CrossRefGoogle ScholarPubMed
Hawkins, L.E. (1995). Critical Nursing Behaviors in the Care of Dying Children in the Hospital Setting. Unpublished master's thesis. Winnipeg, Manitoba: University of Manitoba.Google Scholar
Helwer, P.K. (1995). Critical Nurse Behaviors in Care of the Adult Dying Of Cancer in the Community. Unpublished master's thesis. Winnipeg, Manitoba: University of Manitoba.Google Scholar
Hyer, L.A. & Ragan, A.M. (2002). Training in long-term care facilities: Critical issues. Clinical Gerontology, 25, 197–237.CrossRefGoogle Scholar
Jedrziewski, M.K., Lee, V.M. & Trojanowski, J.Q. (2007). Physical activity and cognitive health. Alzheimers and Dementia, 3, 98–108.CrossRefGoogle ScholarPubMed
Kayser-Jones, J.S., Wiener, C.L. & Barbaccia, J.C. (1989). Factors contributing to the hospitalization of nursing home residents. Gerontologist, 29, 502–510.CrossRefGoogle Scholar
Kristjanson, L.J., Sloan, J.A., Dudgeon, D., et al. (1996). Family members' perceptions of palliative cancer care: Predictors of family functioning and family members' health. Journal of Palliative Care, 12, 10–20.CrossRefGoogle ScholarPubMed
McClement, S.E. & Degner, L.F. (1995). Expert nursing behaviors in care of the dying adult in the intensive care unit. Heart & Lung, 24, 408–419.CrossRefGoogle ScholarPubMed
Moss, M.S., Moss, S.Z., Rubinstein, R.L., et al. (2003). The metaphor of “family” in staff communication about dying and death. Journal of Gerontology Series B: Psychological and Social Sciences, 58, S290–S296.CrossRefGoogle ScholarPubMed
Pelletier, C.A. (2004). What do certified nurse assistants actually know about dysphagia and feeding nursing home residents? American Journal of Speech-Language Pathology, 13, 99–113.CrossRefGoogle ScholarPubMed
Pennington, K., Scott, J. & Magilvy, K. (2003). The role of certified nursing assistants in nursing homes. Journal of Nursing Administration, 33, 578–584.CrossRefGoogle ScholarPubMed
Phillips, J.L., Davidson, P.M., Ollerton, R., et al. (2007). A survey of commitment and compassion among nurses in residential aged care. International Journal of Palliative Nursing, 13, 282–290.CrossRefGoogle ScholarPubMed
Reynolds, K., Henderson, M., Schulman, A., et al. (2002). Needs of the dying in nursing homes. Journal of Palliative Medicine, 5, 895–901.CrossRefGoogle ScholarPubMed
Rhodes, R.L., Mitchell, S.L., Miller, S.C., et al. (2008). Bereaved family members' evaluation of hospice care: What factors influence overall satisfaction with services? Journal of Pain and Symptom Management, 35, 365–371.CrossRefGoogle ScholarPubMed
Shield, R.R., Wetle, T., Teno, J., et al. (2005). Physicians “missing in action”: Family perspectives on physician and staffing problems in end-of-life care in the nursing home. Journal of the American Geriatrics Society, 53, 1651–1657.CrossRefGoogle ScholarPubMed
Shusterman, L.R. & Sechrest, L. (1973). Attitudes of registered nurses toward death in a general hospital. International Journal of Psychiatry in Medicine, 4, 411–426.Google ScholarPubMed
Speziale, H.J.S. & Carpenter, D.R. (2007). Qualitative Research in Nursing: Advancing the Humanistic Imperative (4th ed.). Philadelphia: Lippincott Williams & Wilkins.Google Scholar
Thompson, G.N., Menec, V.H., Chochinov, H.M. & McClement, S.E. (2008). Family satisfaction with care of a dying loved one in nursing homes: what makes the difference? Journal of Gerontological Nursing, 34, 37–44.CrossRefGoogle ScholarPubMed
Trask, P.C., Teno, J.M. & Nash, J. (2006). Transitions of care and changes in distressing pain. Journal of Pain and Symptom Management, 32, 104–109.CrossRefGoogle ScholarPubMed
Wowchuk, S.M., McClement, S.E. & Bond, J. Jr. (2006). The challenge of providing palliative care in the nursing home: Part I—External factors. International Journal of Palliative Nursing, 12, 260–267.CrossRefGoogle Scholar
Wowchuk, S.M., McClement, S. & Bond, J. Jr. (2007). The challenge of providing palliative care in the nursing home: Part II—Internal factors. International Journal of Palliative Nursing, 13, 345–350.CrossRefGoogle ScholarPubMed
Vaartio, H., Leino-Kilpi, H., Salantera, S., et al. (2006). Nursing advocacy: How is it defined by patients and nurses, what does it involve and how is it experienced? Scandinavian Journal of Caring Sciences, 20, 282–292.CrossRefGoogle Scholar
Vohra, J.U., Brazil, K., Hanna, S., et al. (2004). Family perceptions of end-of-life care in long-term care facilities. Journal of Palliative Care, 20, 297–302.CrossRefGoogle ScholarPubMed
Vohra, J.U., Brazil, K. & Szala-Meneok, K. (2006). The last word: Family members' descriptions of end-of-life care in long-term care facilities. Journal of Palliative Care, 22, 33–39.CrossRefGoogle ScholarPubMed